Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00181
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/11/2012
Parcel: 1 S135DA02802
Jurisdiction: Tigard
Site address: 11300 SW 90TH AVE
Project: Archer Subdivision: GRAHAM ACRES Lot: 29
Project Description: Replace gas furnace.
Contractor: AAA HEATING & COOLING INC Owner: ARCHER, CANDACE•
5017 NE GRAND AVE 11300 SW 90TH AVE
PORTLAND, OR 97211 TIGARD, OR 97223
PHONE: 503 - 284 -2173 PHONE: 503 - 997 -9794
FAX: 503 - 284 -1552
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 04/11/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 04 /11/2012 $10.80 •
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04 /11/2012 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
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 Notifi - - - - .ter. .Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direc • uestions to OU . by cal' g 503.232.1987 or 1.800.332.2344.
Issue' By: / �/ / Permittee Sig „#%I
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.
From: 04/09/2012 09:45 11989 P.002/002
- - --:
Mechanical Permit AnplicatioRECEIVED ,
l'i )IZ OFFICE USI, ()NI 1
Cit of Tigard Received
Date/By 9/6 .ermit '"A"..0107,A
l 4 13125 y SW Hall Blvd., Tigard, OR 97223 4 PR 9 2012 p .' /
ten . •
' - • Phone: 503.639.4171 Fax: 503.598.1960
Date/By: Other Permit
1 1 G A 1 i D InS Linc $°3-639 CITY OF TIGARD Date Re134/13Y: ria E See Page 2 for
Woman=
internee: www.tigard-or.gov
Supplemental
BUILDING DIVISION Ncdfiedmedm&
ti:itiMatgarartaggii*KOtiti0,4KMEMMilanii-EgiRS •A;I:j**.:41-471.*::•,..;;;Lic.g#V..1K-01(cf..:41s1.
Mechanical permit fees* are based on the value of the wait
0 New construction FrAddition/alteration/replacement
performed. Indicate the value (roualed to the nearest dollar) of all
0 Demolition 0 Other mechanical materials, equipment, labor, overhead, and profit
I'll'4'°11'11f4tivtrWiViti-thruitTo-iirdeskr-nuje-iiikkgA';,Acq-Wi'41.r.-L,:'41147=tr Value; $
i. , ..........-...... ...,....._....,L_____AL-....,•1' ,v,.:-:1,--:e..,; ..1": - ,
rik - 1 03 1 0st „ -1 : 4 5ilittill* -- rti.Y::::g - - 416 -7 41 . 141
IV 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For spedal lafirmailon use checklist
0 Multi-family 0 Master builder 0 Other
Description I Qtr. I Ea- I Total
FitaammegootivoiaToiliAtotickwatwatitioMmistagi Reatheacoolleg
Air conditioning
Job site address: 11 3 00 s ti.) 9,04A. itkA4._ (requires site pbm showing placement) 46.75
City/State/ZIP: r ej... ()GI Cry._,, Fmnace 100,000 BTU Wets/vents) 1 _ 46.75 i lb:75 -
Furnace 100,000+ BTU (dusts/vent) 54.91
Suite/bldg./apt no 1 Project name: 14 .rt k ke,i „
Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
IV 0.-afte S (4 ..) Psi 8-44 (:)90- 144 Residential boiler (radiator or
4 hydronic) , 23.32
1
1.--- q 0 -4 i k .frl---
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 46.75
Flue/vent for any of above / 23.32 7..'5.V.
Subdivision: I Lot no.:
Other 23.32
Tax map/parcel no.:
Other fud appllanas
EffrENSAM4MI4 . Water heater 23.32
Gas fireplace 33.39
p ,% L CAA 14-26 r‘.../ .01.0-0,- Flue vent for water heater oi gas
VO t it 11-0 Iry ,:a fireplace 23.32
Log lighter (ass)
23.32
Wood/pellet stove 33.39
-
Wood fireplace/insert 23.32
Chimneyfliner/fluelvent 23.32
weseprifiroylwapa woreitt: ti....twitliamm .
2332
Name: ro.,6t...0, Environmental exhaust and ventilation
Range hood/other kitchen
Address: // 00 S L,06,9 ti j r'. 4, 401....
eggiemout 33.39
City/StatefLIP: 7-; de_ 9)2.1,3 _Clothes dryer Wind 33.39
Single-duct exhaust (bathrooms, •
Phone: (SW q *7- 919ti Fax: ( ) toilet compartments, utility rooros) 23.32 •
- ,
EgaiiitOrigaikagielit elm Fl .4;iiti:ctoisFEtiortiesi At6C/ClaWISPaCe fans 2132
Other: , -
Business name: AAA Healing & Cooling 23.32
Fed olPhlit •
Contact name: isieturb-kilas 0. e..6.,a Wiab S14.15 for first four; $4.03 for each additional
-
Address: see below 1 Furnace, etc.
Gas bait-pomp •
•
City/State/ZIP: Wall/suspendedhmit heater
Phone: (51)1) *"/ 2.- I, i I Fax: : ( ) Water heater .
Fireplace
E-mail:
- •
., , .,,, Range
, , .
f tcl' Barbecue
- .
Business name: AAA Heating & Cooling Inc ' Clothes drier (gas)
Other •
•
Address: 5017 NE Grand Ave
Un'tgEF: ;.
City/State/ZIP: Portland OR 97211 ..
Subtotal .--7dre9-
e
s i g .' 1)h°n ' Fax: (503) 284-1552
4
i - Minimum permit fee (MAO) SkO,cpj
Plan review (25% of permit fee)
c.c.s
State surcharge (12% of permit fee) 4 ,, ,, 2
TOTAL PERMIT FEE 0,.. ••
Authorized si I This permit epplitation expires Ifs permit is not obtained within 180 0 ,-)
gnature: v I 1 • '' days after It bas been accepted as complete. I a(9. 5 ""f '.
e■
Print name:•-Mictoria Date: IA - 6- L.,0 • Fee methodology set by Tr-County Building Industry Service Board ..: lj
fue■iminefcrettemEc-Permilapp.oco 10 440-461n o itovcomAvEm / ,/ z '
70 e., ><.EzJ L7
re is 1 9 - y /..4.,i2N 09 ey//eh z • _
From: 04/09/2012 09:45 #989 P.001/002
FAX COVER
Al II AAA Heating & Cooling
HEATING AND g g
COOLING 5017 NE Grand Ave Portland, OR 97211
Phone: 503- 284 -2173 Fax: 503- 284 -1552
. To: 2erytt -r- Cows From:
Fax: 5 I 9 60 Pages:
Phone: stir- 6 'sq - L/ 111 Date: 5 /- `1 oZ 0
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