Permit v CITY OF TIGARD MECHANICAL PERMIT
I! COMMUNITY DEVELOPMENT Permit #: MEC2012 -00419
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/08/2012
Parcel: 25111 CD08500
Jurisdiction: Tigard
Site address: 15925 SW SERENA CT
Project: Stewart- Sheets Subdivision: KERWOOD ESTATES Lot: 2
Project Description: (1) NC installation Must be placed within 5' side yard setback and approved rear yard setback.
Contractor: ABLE HEATING & COOLING LLC Owner: STEWART- SHEETS, FRANCESCA L
16285 SW 85TH AVE #105 15925 SW SERENA CT
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: 503 - 579 -2250 PHONE: 503 - 968 -6092
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Air Conditioning 08/08/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 08/08/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 08/08/2012 $43.25 .
Occupancy Grp:
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: Permittee Signature Oki A U C A rl Qkl.
____,A2L____ - 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 ApplicationPCEIVED roa or rRCF. I `ll. O:\ 1,1
III City of Tigard Received
/9Y awn � Permit N 9 , (EG1Dlt1 - 00W
• 131 25 SW Hall Blvd., Tigard, OR 97223 AUG 0 8 2012 Plan Review
a ' Phone: 503.7182439 Fax: 503.598.1960 p �c/g y: Other Pamir
l I G .t is o Inspection Line: 503.639 /� nT Datc Rcadyitly: June H See Page 2 for
Internet: www.tigard- or.gov CITYOFTIGARD Notified/Met od 14 0 Supplemental Information
BUILDING DIVISIO -
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* am based on the value of the work
1:1 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.
Value: S
CATEGORY OF CONSTRUCTION EQUIPMENT / SYSTEMS FEES'
®1 - and 2- family dwelling ❑Commercial/industrial 0 Accessory building For speda/Worn:Won use checklist
❑ Multi - family ❑ Master builder ❑ Other. Description Qty. I Ea ! Total
JOB SITE INFORMATION AND LOCATION Heating/Cooling:
Air conditioning .
Job site address: 15925 SW SERENA COURT (requires site plan showing placement) I , 46.75 46.75
Furnace 100,000 BTU (duers/venis) 46.75
City /State/ZIP: TIGARD, OR. 97224 Furnace 100,0004- BTU (ductskents) 54.91
Suite/bldg. /apt no.: Project name: STEWART - SHEETS Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Ductwork 23.32
Hydronic hot water system 23.32 i
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel-type, not electric), i
in -wall, in-duct, suspended, etc. 46.75
Subdivision: Lot Flue/vent for any of above 23.32 I
Other: 23.32
Tax rnaplparcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
INSTALL NEW A/C UNIT Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
• Wood/pellet stove 33.39
Wood fireplace/insert 23.32
® PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 23.32
Other 23.32 _
Name: LAURIE STEWART- SHEETS Environmental exhaust and ventilation:
Address: 15925 SW SERENA COURT Range hood/other kitchen
equipment , 33.39
City/State/ZIP: TIGARD, OR. 97224 Clothes dryer exhaust 33.39
4)92 Fax: ) toilet co
Single-duct compartments, (bathrooms,
rooms) (503-)968-6092 mpartrrtents, utility r000
ms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans ' 23.32
Business name: Other: 23.32E I
Fuel piping:
Contact name: $14.15 roe first four: $4.03 for each additional
Address: Furnace. etc.
Gas heat pump ,
City/ State /ZIP: Wall /suspended/unit heater .
Phone: ( ) I Fax: : ( ) Water heater
Fireplace
E -mail:
Range i
CONTRACTOR . Barbecue •
Business name: ABLE HEATING & COOLING LLC
Clothes dryer (gas)
Other:
Address: 16285 SW 85" AVE. SUITE 105 MECHANICAL PERMIT FEES*
City /State/ZIP: TIGARD, OR. 97224 Subtotal 46.75
Minimum permit fee ($90.00) 90.00
tone: (503) 579 -2250 Fax: (503) 620 -3980
Plan review (25% of permit fee)
/one:
tic.: 184392 State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80
Tlds permit application expires if a permit is not obtained within 1SD
Authorized signature: f days after it has been accepted as complete.
Print name: KELLY W Date: 8 - 08 - 12 • Fee methodology set by Tri -County i Building industry Service Board
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Air Conditioning Site Plan
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16285 SW 85''' Aye, Suite 105
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Ti aril OR 97224
rt (503)579-?250 Fax(503)620-3980
u_c Email: info@ableheatingandcooling.com
Cal#184392
Customer: L biz.) 57-61.01-kb- 5 Ha
Address: ( 5i5 51.1.1 5 EIZEND4- CT City 17p12-) Zip:
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