Permit •
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00358
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/12/2012
Parcel: 2S112BD04700
Jurisdiction: Tigard
Site address: 15045 SW 79TH AVE
Project: Taylor Subdivision: 1994 -037 PARTITION PLAT Lot: 2
Project Description: (1) A/C, (1) Furnace replacement Must be placed within 5' side yard setback and approved rear yard setbacl
Contractor: OREGON AIRE INC Owner: TAYLOR, RICK
7715 NE 33RD DR STE A 15045 SW 79TH AVE
PORTLAND, OR 97211 TIGARD, OR 97224
PHONE: 503 - 335 -2222 PHONE: 503 - 504 -7641
FAX: 503 - 335 -9977
FEES
Specifics: Description Date Amount
Air Conditioning 07/12/2012 $46.75
Type of Use: SF Furnaces >= 100K BTU 07/12/2012 $54.91
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 07/12/2012 $12.20
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
•
- Total $113.86
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: AVIA1 Permittee Signature: O[ /I j (. f c.T) o J 4
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.
Mechanical Permit AiorolicaNestAia9ibithii § / I'UIt OI1 I(•I. I'11I)NI.1
City of Tigard Qedeil d0 A110 D - l Pernriit N• ., &0201 d -00 -
I I 13123 S W Hall Blvd., Tigard, OR 97223 Plan Review
• Phone: 503.718.2439 Fax 503.598.19 O Z I I l (l r may, Other Punmt:
I 1(, n R L Inspection Line: 503.639 Date Ready/By: furls: SI See Page 2 for
Internet: www.tigard- or.gov ; n9 Notified! kthod: of C Supplemental information
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lL j .. 1 ( , 11 r ! 1 : I , ( '-1 Ili i . i l'-''''''' ', 1 . I 1 t l ,l , ! r '" ' ,• ' � I, . a , , $ . ..1 ' I ,, : I., r
.. i.,i.1:;iJ, 6 S LL.W {fJh ;;!,; f f 1 ... 1,,., yl.. r.,D :.( ! , 1 , „I�,a, 4, „+'.il.. n 1 . „i d > ,, ,{ iii? ,, r4r . L . !r, .. r .f ! limier! permit fees' arc bused on the value of the work ` .
0 New construction ® Addition /alteration/replacement performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials, equipment,, labor, overhead, and profit
1 J l J ''q Value $
11 1 (
,. ® �: -.. :.i, e 1 1. �� ,. L ,. " .. ....:; , ....:GI..< .! ..:L.... . L ...
1- and 2-family dw lling ❑ Commercial/industrial ❑ Accessory building Forspedal information use d erlduirt.
❑ Multi - family 0 Master builder ❑ Other: Description I Qty, I Ea. I Total
1 , 4 L ( : 1 'J ki 1 - ':',`,.. 1 ;',:'!': . ', 0 .'‘ , ','',. '; - 1 Beatttgq/coolitrg:
i 1 I ; 1 \ J 1 1 I
1.1 \ .,..,.,.1 :.`3 �LLi1rn 1.1L.I , 1:. Jx, .!,n, J•, 1 1 , .( .• �.:('‘);;, ,1,,,11.r.. ....11,. .,,. .. „A,\: An. con
Job' site address: 15043 SW 79 AVE - site .:. ahowm : .lacemem 1 46.75 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City / State/ZIP: PORTLAND OR. 97224
Furnace 100,000+ BTU (ductslverra) 1 54.91 54.91
Suite/bldgJapt. no.: Project name: TAYLOR Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 2132
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in-duct, suspended, etc. 46.75
Subdivision: I Lot no.: Flue/vent for any of above 23.32
Other. 23.32
Tax map /parcel no.: Other fuel appliances: _
l 1 . l 1 , l ' 1 11, 1 ( 1 1 ' .' 1 1". 1f 11 • � ! ( 1 .,.„1.;::1 fl f ,, 17 1 1 f...'... 1, { Y ; 1 1 it I 1 { 1 ', Wlltcrheater 23.32 •
REPLACE GAS FURNACE AND A/C UNIT Gas place/insert 33.39
Flue vent for water heater or gas
. lace 23.32
Lo Inter (pas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
It I I .,, i.,,:. , , !, t , t, ,-,..:)..,;,;1;.,,.:1.,,:...t I?, E 11 /hner/ttue/vent 23.32
t 1 1 r L f I t 1 , 1 1 Chtmn
, Other 23.32
Name: RICK TAYLOR Environmental exhaust and ventilation:
Address: 15045 SW 79 AVE Range hood/other kitchen
equipment 33.39
City/State/ZIP: PORTLAND OR. 97224 Clothes dryer exhaust 33.39
Single -duct exhaust (baduooms,
Phonc: (503)504 -7641 Fax: ( ) toilet .. . nth rooms 23.32
t I , { 1 { , ! Atuc/crawlspece (ens 2332
Business name: OREGON -AIRE INC _ 23.32
Fuel piping:
Contact name: RON STRONG $14.15 for first four, $4.03 for each additional
Address: 7713 E3 RD,... Furnace etc I I I
I /l�l NE 33 J1L'H __-
Gas beat .y w,
City/ State/ZIP: PORTLAND OR 97211 1 __-
Phone: (360) 423 -1966 Fax: : (360) 423 -1978 Water heater
E-mail: rstrongcor'egon aire.com .lace
F' . 1
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Business name: OREGON -AIRS INC _ Clothes d r ( . as) __ - .
Address: 7715 NE 33 DR. STE A , 'v~,�1f'v�;r, r.,,T �:: 1
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City / State/ZIP: PORTLAND OR 97211 Subtotal 101.66
Minimum permit fix ($90.00)
Phone: (360) 423 -1966 Fax: (360) 423-1978
_. Plan review (25% of permit fro) -
i CCB lic.: 64233 State surcharge (12% of pt rmit fcc) 12.19
TOTAL PERMIT FEE 113.85
Authorized signature:
Thy perodi application ;spina if a permit is not obtained within 180
days attar it has been accepted as complete 11 3
Print name: RON STRONG I - 7/11/12 7 ' Fee methodology set by Tri -Cotmty Building Industry Service Board
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