Permit n CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2012 -00495
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/27/2012
Parcel: 1 S133DB11100
Jurisdiction: Tigard
Site address: 13382 SW SUMMERWOOD DR
Project: Girdler Subdivision:3CHOLLS FERRY ROAD TOWNHOME; Lot: 37
Project Description: (1) gas furnace replacement
Contractor: ABLE HEATING & COOLING LLC Owner: GIRDLER, SANDRA
16285 SW 85TH AVE #105 13382 SW SUMMERWOOD DR
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 579 -2250 PHONE: 503 - 746 -5682
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 09/27/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 09/27/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 09/27/2012 $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: oAl 1'TPP 6477"1.
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.
Sep 271211:29a Able Heating & Cooling 5036203980 p.1
Mechanical Permit Applicatio i �Y
� FOR OFFICE USE O \'1:1
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City of Tigard � `_ � s ceive
. : ° 13125 SW Hall Blvd., Tigard, OR 97223 2 DazRee�B . /a—se Permit IVo.:��i �1� DO�f(>�S
' Phone: 503.7182439 Fax: 503.598.1960 SEP 2 d 2012 Da n Review
Inspection Line: 503.639.4171 Dam/By: Other Permit:
r I c,� R n _ Date Rendy!By. Jun
Internet www.tigardor.gov ' t �" � t¢L ors �� ®Sx Page 2 far
Cr t Y Q i Ytiii iD NOhSed/Method' 'n (, Supplemental Information
1 iii i'Vlin il±:TtOfor'0!
TYPE OF WORK - -- ` °niter'' • COMMERCIAL FEE* SCHEDULE — USE CHECKLIST 1
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alteration /replacement
❑ Demolition performed indicate the value (rounded to the nearest dollar) of all
❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: S
® 1 -and 2- family dwelling 0 Commercial/industrial ❑ Accessory buildin RESIDENTIAL EQUIPMENT MENT /SY�MS FEES"
building For
❑ Multi- family ❑ Master builder 1lnformarlon use dretJaflsr.
❑ Other: Description I Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: 13382 SW SUMMERWOD DR Air conditioning t
(requires site plan showing placement) 46.75
City/State/ZIP: TIGARD, OR. 97223 Furnace 100,000 BTU (ducts/veotc) I 46.75 46.75
Furnace 100,000+ BTU (duetshents) 54.91
Suite/bldgfapt no.: I Project name: GIRDLER Heat pump
Cross street/directions to job site (requires site plan showing placement) 61.06
Duct work 23.32
Hvdronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not elearic),
in• in .du s usp end ed etc. 46.75
Subdivision: ! Lot no.: Flue/vent for any of above 23.32
Tax map/parccl no.: Other. 23.32
Other fuel appliances:
DESCRIPTION OF WORK Water heater i 23.32
REPLACE EXISTING GAS FURNACE 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 ftreplaczJinsert 23.32
® PROPERTY OWNER ❑ TENANT �iey/lirter /fluelverrt 23.32
Name: SANDY GIRDLER Other 23.32
Environmental exhaust and ventilation:
Address: 13382 SW SUMMERWOOD DRIVE Range hood/other kitchen
equipment 1 33.39
City/State/ZIP: TIGARD, OR 97223 Clothes dryer exhaust
33.39
Phone: (503)746 -5682 I Fax: ( ) Single -duct exhaust (bathrooms,
❑ APPLICANT ❑ CONTACT toilet compartments, utility rooms) 2332
TACT PERSON Attic/crawfspace fans 2332
Business name: Other: 2332
Contact name: Fuel piping:
514.15 for first for 54.03 for each a dditional
Address: Furnace, etc.
City/State/ZIP: . Gas heat pump
Phone: ( ) Wall/suspended/unit heater
Fax:: ( ) Water heater
E-mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: ABLE HEATING & COOLING LLC Clothes dryer (gas)
Address: 16285 SW 85 AVE. SUITE 105 Other:
MECHANICAL PERMIT FEES*
City/State/VP: TIGARD, OR 97224
Subtotal 46.75
Phone: (503) 579 -2250 I Fax: (503) 620.3980 Minimum permit fee ($90.00) 90.00
Ct B tic.: 184392 Plan review (25% of permit fee)
State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 10020
Authorized signatures
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
I Print name: KELLY WI L I Date: 9 - - I • Fee methodology set b • TO Building industry > tY S Service Batted
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