Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
Pe
COMMUNITY MEC2012 -00137
Date Issued: 03/14/2012
TI C A IZ D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S111 DC04500
Jurisdiction: Tigard
Site address: 9440 SW SUMMERFIELD DR
Project: KREMIDAS Subdivision: SUMMERFIELD NO.7 Lot: 360
Project Description: Replacing NC unit and installing gas furnace with fuel piping.
Contractor: A- ACTION HEATING Owner: KREMIDAS, LETITIA & TOM
18245 SW TV HWY 12297 SW CHANDLER DR
ALOHA, OR 97006 TIGARD, OR 97224
PHONE: 503 - 649 -3524 PHONE:
FAX: 503 - 649 -6095
FEES _
Specifics: Description Date Amount
Air Conditioning 03/14/2012 $46.75
Type of Use: SF Furnaces < 100K BTU 03/14/2012 $46.75
Class of Work: ALT Type of Const: Fuel Piping 03/14/2012 $14.15
Occupancy Grp: 12% State Surcharge - Mechanical 03/14/2012 $12.92
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.57
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: as." 46.1.
dria Call 503.639.4175 by 7:00 a.m. for the next available Inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
07/01/2017 07:53 FAX. li11001 /003
Mechanical Permit Application wiz order. USE oNl_1"
City of Tigard V Received
Date/By: i Permit No.: 7
:I q 13125 SW Hall Blvd., Tigard, OR 9 -.i1s Collo‘l Plan Review
�.11 Itf ?-G - I e Phone: 503.639.4171 Fax: 503.59 : • i o 1`L D Other Permit:
TIC A R U Inspection Line: 503.639 1 & �- Date Ready/By: ® See Page 2 for
Internet www.tigard- or.gov `I P� 1 ^,�O Notified/Method: Val Supplemental Information
si 00 TYPE OF WO RIO 4O\ ` _ •COMMERCIAL : :FEES r _
❑ New construction Ather: ddition/alterati�ment Mechanical permit fees* are based on the value of the work
❑ Demolition performed Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
1 -and 2 -famil dwellin -RESIDENTIAL_�EQUW t$ rE I& EES *'s 11 :
y g ❑ Commercialindustrial ❑ Accessory building
Multi - family ❑ Master builder ❑ Other
For special information use checklist
Description I Qty. I Ea. I Total
JO; SITE INFORMATION AND LOCATION :' ;, ':::. i � Beating/cooling
Job site address: :
� / .7
\ Air conditioning
1
_ ' �. _ �. �. � � (requires site plan showing placement) 1 46.75
City/State/ZIP. . ` . ��� Furnace 100,000 BTU (ducts/vents) I 46.75 e
F umace 100,000+ BTU (duets/vents) 54.91
Suite/bldg /apt. no.: Project name:
Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (time) -type, not electric),
in -wall, in-duct, suspended, etc. 46.75
Subdivision: F Lot no.: Flue/vent for any of above 23.32
Other 1 23.32
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK . Water heater 23.32
^ ^ Gas fireplace 33.39
l� J � a Flue vent for water heater or gas
Q XY1(�JLQQ Q ��- fireplace 23.32
Log lighter (Ras) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
PROPERTY OWNER ❑ TENANT •
Other 23.32
Name: •) (/.lJ Environmental exhaust and ventilation
Address: Range hood/other kitchen
r . v l h _ II II • . ■ • d '' equipment 33.39
City/Stat Al' : t, ,n. S `I `j — Clothes dryer exhaust 33.39
w � Single -duct exhaust (bathrooms.
Phone • b ) ' Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT . •❑ CONTACT .PERSON; . � Attidcrawispace fans 23.32
Other. i 23.32
Business name: A-ACTION HEATING & A/C Fuel piping
Contact name: ALOHA, OREGON 97006 1 1 18245 S.W. T.V. HWY $14.15 for first four; $4.03 for each additional
Address: LOH Furnace, ete. 1
Gas beat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR ,... Barbecue
Business name: Clothes dryer (gas)
A- ACTION I IEATINC & A/C Other
Address: 18945 S W TV HwY MECIH ANICAI.PER F ,: ,
City/State/ZIP: ALOHA, OREGON 97006 Subtotal /!i 7. (s.
Phonei 3 5
9 -3 I Fax. O3)64q - to09 5 Minimum permit fee (S90.00)
Plan review (25% of permit fee) . —
CCB lic.� State surcharge (12% of permit fee) ; ,
TOTAL PERMIT FEE .1; I�
Authorized signs . )6 This permit application expires If permit Is not eb . ' within ; . ,
�_ days after It has been accepted as comp etc.
Print name J�-I.I - . p I Date I . ) ( • Fee methodology set by 1H -County Building Industry Service Board
07/01/2017 07:53 FAX Q002/003
A- Action Heating & Cooling, Inc.
18245 SW Tualatin Valley Hwy
Aloha, OR 97006
503- 649 -3524 office
503 -649 -6095 fax
www. a- actionheatin. com
SITE PLAN:
O
ADDRESS OF INSTALLATION: .
g 440 SW Sun' ,rnwr-F c Dr