Permit CITY OF TIGARD MECHANICAL PERMIT
ii
2 ' COMMUNITY DEVELOPMENT Permit #: MEC2012 -00498
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/01/2012
Parcel: 2S104DD03900
Jurisdiction: Tigard
Site address: 13634 SW AERIE DR
Project: Yap Subdivision: EAGLE POINTE Lot: 30
Project Description: Replace gas furnace and heat pump.
Contractor: ULTIMATE COMFORT Owner: YAP, DAVID L & MAI -LEE J
5946 SE LLOYD ST 13634 SW AERIE DR
MILWAUKIE, OR 97222 TIGARD, OR 97223
PHONE: 503 - 786 -0494 PHONE: 503 - 708 -6495
FAX: 503 - 821 -7423
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 10/01/2012 $46.75
Type of Use: SF Heat Pump 10/01/2012 $61.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 10/01/2012 $12.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.75
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
appli w._ All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
' uance, 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. T• • e 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 OUN •y ca i • 03.232.1987 or 1.800.332.2344.
Issued B � �-
Y / Permittee Signature. �/ L__ ��
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. I
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 Applicatii l e t _ �„ FOR OFFICE LSE ONLY
City of Tigard � +_ ', n teBy fp SMISIM Permit No.: H� j 4/ c /Fg
= 0 • 13125 SW Hall Blvd., Tigard, OR 97IIIIII 223
Phone: 503.718.2439 Fax: 503.598.196Q' . Date/By:
1 1 � . � , � Other Permit:
T I G A R D Inspection Line: 503.639 Date Ready/By: kris: ® See Page 2 for
Internet: www.tigard- or.gov CITY OF TI G } RD Notified/Method: Supplemental Information
13 [1ILDDI (DIVISION
PE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ 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: $
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special infonnalion use checklist
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 13 ( 3 1{ si , 4 2 /2 E 4 (requires site plan showing placement) 46.75
"7--; 9 4 Cj 9 Z 23 Furnace 100,000 BTU
BT (ducts/vents) r 46.75 c�I/ 77
City/State /ZIP:
T Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump
(requires site plan showing placement) 1 61.06 61 Oi
Cross street/directions to job site: Duct work 23.32
f/jC eCue d 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: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
�p� / � - a ! `
Alai/ a �9t Al/C- Flue 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
ROPERTY OWNER I ❑ TENANT Chimney/liner /flue/vent 23.32
Other: 23.32
Name: f) 4��f 4 4 L . VA- / Environmental exhaust and ventilation:
s � 7 Range hood/other kitchen
Address: 3 7 y �C,�t� 4„/; equipment 33.39
City/State /ZIP: A, J --.. 4 22:3 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: 53) 7 06 .. (• y 9 , Fax: ( ) toilet compartments, utility rooms) 23.32
'APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
^ t Other: 23.32
Business name:L £*) t. T&1 t 4 6,44....r , i * *' c 4„ \ Fuel piping:
Contact name: R L A s�� $14.15 for first four; $4.03 for each additional
Si /� Furnace, etc.
Address: cg - C (e se L / G y i / �• Gas heat um
�l pump
City/State /ZIP: ?II ) L b 2, Z - L WalUsuspended/unit heater
Phone: 67)3) g L • 0 „ Fax: : ( ) Water heater
Fireplace
E - mail: 404 IL.L.ri•44- 7f.L)I(44 I , Range
CONTRACTOR Barbecue
Business name: • i Sa -� 5, Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP: Subtotal 167.
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCB lic.: ` Y le Z 5 State surcharge (12% of permit fee) i 2.. qL
TOTAL PERMIT FEE /2 0.7 j
Authorized s' a This permit application expires i a permit is not obtained within 180
days after it has been n accepted as complete.
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