Permit N . � CITY OF TIGA MECHANICAL PERMIT
• .- .
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00218
1 3125 SW H all Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/09/2012
TIGARD Parcel: 2S114BA02100
Jurisdiction: Tigard
Site address: 9860 SW SERENA WAY
Project: Nelson Subdivision: PICK'S LANDING NO.2 Lot: 118
Project Description: Install furnace 80% - 90%
Contractor: AAA HEATING & COOLING INC Owner: NELSON, KRISTINE J
5017 NE GRAND AVE 9860 SW SERENA WAY
PORTLAND, OR 97211 TIGARD, OR 97224
PHONE: 503 - 284 -2173 PHONE: 503 - 443 -4164
FAX: 503 - 284 -1552
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 05/09/2012 $46.75
Type of Use: SF Fuel Piping 05/09/2012 $14.15
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 05/09/2012 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 05/09/2012 $29.10
Stories:
Fuel
Fuel Types:
Gas Pressure: .
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: -
y: Permittee Signature: eyv //171 / iCe9-17,d,"1
_0:21/2zzez Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
...---,
From: 05/01/2012 06:23 11022 P.002/003 .S f
Mechanical Permit ApplicadRECEIVED 1.01: ()I 1 l ()\1 1
City of Tigard Received ,,,...
13125 SW Hall Blvd., Tiprd, OR 97223 MAY - 1 2012 DaleiRr .11 l MIMI Permit Nrx: AlWeo A91 3. 4. 00k
Plan Review
' 12 Phone: 503.639.4171 Fax: 503.598.1960 math* Other Permit
Inspection Line: 503.639.4175
TIGA„,:, crry OF TIGARD Dee IblodP/BP: NZ EEBEESE
Internet: www.tigatd-or.gov Notified/Method:
BUILDING DIVISION
aiinitinalnaMTIVitraitE7 itges - =iff;a4M•:;rtgliga" uucti..AXISEZZ."
o New construction lai-Addition/alteralion/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other mechanical materials, equipmtmt, labor, overhead, and profit
Mgg$.T.CERVM. --77 . ' IMARPAMM Value: $ .
' B. v c;Brgfi ) ,InLCBJPP:rllrkf-,--,.._ki._- ' TfBita7A._BMBls r"-- -- 74i1
01- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special &forint:don use checkfist
0 Multi-family 0 Master builder 0 Other
Description I Qty. I Ea. I Total
NPI Headnafettoftne
Air conditioning
Job site address: ei IMO SW _s cu....,
(requires die plan showing placement) 46.75
City/State/ZIP: 71 a
(YZ - 9 7 D. 11 1 Furnace 100,000 BTU (MtatrAtats) / 46.75
%
Furnace 100,000+ BTU Wm/vents) 54.91
P roject Suite/bIdgJapt. no.: Project name:
Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydninic hot water system 2332
S (Li 4 r : t\f•A $o Cr 4 Residential boiler (radiator or
Co 014 C_-1- bpi:oak) 23.32
. Unit beaten (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 46.75
Flue/van for any of above 23.32
Subdivision: I Lot no.:
Other 2332
Tax map/parcel no.: Other fuel appliances
OW-Nria MEMEN.11 Water heater .. 2132
Gas fireplace 33.19' •-.....
..T. 4.14 fil--0,0 -.). (104 Flue vent for water heater of gas --...,
fireplace 23.32 , •
Log lighter (gas) ..2322
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
P Maltr,*::06217 `..;:-!;7:41f_•;;:lorpijava Chimney/liner/Rae/vent 23.32
23.32
Name: I< 41' vx R._ No.. b o vl Environmental exhaust and ventilation
Range ther
hood/o kitchen
Address: ? 8 - 6 c Sw Seg-e,A.0. W 0.4 equipment 33.39
City/State/ZIP: 73 15 ... 4 .. ck ac q.-71.2.91 Clothes chyer exlmust 33.39
Single-duet exhaust (bathrooms,
Phone: (rb3 ) iya_ di/ 61.1 Fax: ( ) toilet complements, utilhy rooms) 23.32
EVIMINICAW4WIWW24 rAi Allickrawis fans • 2132
Other: 23.32
Business name: AAA HEATING & COOLING INC.
Fuel piping
Contact name: Cei54. Wi ■12 $14.15 for first four; $4.03 for cads additional
.1°
Addres Furnace, etc. l
s: 9.0 i, i tie 6-.1-0,muk. 4 6....t__. -.' ""••- ,
Gas bait pump
City/State/ZIP: p ok 9 '7 2.7d Wail/suspended/unit heater
Phone: (53) - 5 / 2- 1 2:70t I I Fax: : ( ) _Water heater . .
Fireplace .
E-mail: cs..,...- : „c-g.)..t.r . . Rarlile
TANCA.A.M1 dhltirO Dr Barbecue
Business name: AAA HEATING & COOLING INC. . Clothes &yea (tas)
Other
Address: 5017 NE GRAND AVE OrZENCi*Wilre-417:PERWW24.Eigk
City/State/ZIP: PORTLAND OR 97211 , .
Subtotal - 6 o ?
Minimum permit fee (590.00) '(LI, .3
Phone: (503) 284-2173 I Fax: (503) 284-1552
Plan review (25% of permit fee)
CCB lic.: 000222 ir- State surcharge (12% of permit fee) Me 'irr7
TOTAL PERMIT FEE /00 , FrO
This permit application expires if e permit Is not obtained within 110
Authorized signature: -A
days after tt has been accepted as complete.
I Print namet-VIETORWAttEN % 4-1.0.1 Date: 5- /- 2_ • F. methodology set by Tri-Comity Building Industry Service Board
1:\Building\PermlunMEC-PermitApp.doc I0/01/09 44114617T (1 1/02/COIWWEB)
From: 05/01/2012 08: 23 1t022 P.001/003
() FAX COVER
AAA Heating & Cooling Inc
P C ECI)0111141 5017 NE Grand Ave Portland, OR 97211
Phone: 503-284-2173 Fax: 503-284-1552
To: ricSo.frk t S.rit&Aq.c 3 S) NI From: Cr....ri
Fax: 5'03- 9 60 Pages: 3
Phone: 5 Date: /- 1 0 t
Re: Neis wrt £ns
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