Permit n CITY OF TIGARD MECHANICAL PERMIT
y
; r COMMUNITY DEVELOPMENT Permit #: MEC2012 -00554
T [ GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/24/2012
Parcel: 2S109BA02500
Jurisdiction: Tigard
Site address: 13947 SW ALPINE VIEW CT
Project: Rodrigues Subdivision: HILLSHIRE SUMMIT Lot: 10
Project Description: (1) furnace installation
Contractor: ADVANCED HEATING & AIR CONDITIONING INC Owner: RODRIGUES, DENNIS A
5825 SE FOSTER RD 13947 SW ALPINE VIEW CT
PORTLAND, OR 97206 TIGARD, OR 97224
PHONE: 503 - 774 -0161 PHONE: 503 - 367 -4853
FAX: 503 - 774 -4391
FEES
Specifics: Description Date Amount
Furnaces '< 100K BTU 10/24/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 10/24/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 10/24/2012 $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. , I
Issued By: Permittee Signature: D•.: A PPL iC T7 ei
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 Application FOR OFFICE USE ONLY
City of Tigard WEIN/ED i of Permit Received
natelly: 4 ; i 3 5r
,...- .. 13125 SW Hall Blvd.. Tigard. OR _
Plan Review
.4 ' Phone: 503.718.2439 Fax: 503.598.1' Oilier Permit.
-
Inspection Line: 503.639.41 75 Itr 2 Date By
3 2012
TIGARg Date Ready/By: Anis lii See Page 2 for
Y . Internet: www.ttgard-or Ws' Notified/Method 41 C Supplemental Information j
CITY CIF TIGARD
- NPE lit11141MGDIVISION i CONINIERCIAL FEE* SCHEDULE - USE CHECKLIST
" i Mechanical permit fees* are based on the value of the %%ork
.- s . .
1_ 1 N. :s% cimstruet ion Ad d i i ion /a Iteration/replacement I pertormed Indicate the value (rounded to the nearest dollar) of all
Iii Dentolnion 0 Other: L mechanical materials. equipment, labor, overhead, and profit.
I Value S
l _
_.- C F OTEGORN: O CONSTRUCTION .
RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
I
and 2- Tamil) rh% ell ing D (..:om n fere i a Windust ria 1 D Acccssoi- bui lding L Fur speciakiuformation use cliecUisr.
Li j Multi-family 0 Master builder D Other: ! Description _ Qt■ L t a ! - - - 1(7, --- Lai
k _ __
.10B SITE INFORMATION AND LOCATION . 1 ifeatin lig:
Air conditioning .
jot, site address: 41 stoAup NI E \RB Cr . _tit site plan sbowiug &cement) 46.75 ___,,. --,
Furnace 100000 BTU (duets/venti) 46.75 i(c ( I''
Ci t■ 'State/ZIP: • A _ ill . ,,, 0
, _ Furnace 100.000+ BTU (ducts/vents) 54.91
Suite/bld no.: Project twine: Heat pump
• - --- - ------- --- -- — _. __ . -- (requires site plan showing placement) 61 06
_
Cross street. direct ions to job site: Duct stork 23.32
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 .
Flue/vent for any of above I 23.32 I •
Subdk ision: I.ot no.:
Othei: s -; -
1=- -
I ,i. map 'paro.:1 no.:
— Other fuel appliances:
DESCRIPTION OF WORK Water heater I 23 32
L Gas liteplace:insert 33.39 1
W N a _Pc Rk2-_PC LiE _
I Flue %eta for wiiter heiner of gas
1
I_ fireplace 23.3: -I-
--
I Log lighter (gas) 23.32
i Wood/pellet stove 33.39
• _ — _ _____ _
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
[94 OWNER 0 TENANT ---
Other: 23.32
\ dine: D___ j w ( c - R o -- DRA _ Euk;E s - _ Environmental exhaust and ventilation:
Address: \ Sky j oApip CX . Range hood/other kitchen
equipment 33.39
Cit ■ t a t eft IP: --r G p....___ Clothes dryer exhaust 33 39
Sinde-duct exhaust (bathrooms.
Plionc:S6 Fax: ( I toilet compartments. utility rooms) 23 32
0 APPLICANT 0 CONTACT PERSON Attic/crawlspace fans 23.32
Other: 23.32
Business 'mine:
Fuel piping:
Contact name: 514.15 for first four; S4.113 for each additional
_ _ ____
_______ ____ __. _ ___
Furnace. etc
Address:
Gas heat pump
Git■,State/ZIP:
Wall/suspended/unit heater
l'hone: ( ) I Fax: : ( ) Water heater 1
J
,,,place
I -mail:
Range _t
CONTRAcroR Barbecue I ____.
_ _
_
I tW,1 IleSS Ilillnli&DVAN C.E2D__kijatlatska Clothes dryer (...'Ss) —
s) 1 ----- .-
Other: 7___i
. , ddre,s: c-6,? . F 6 •_sie P...Z, I_ MECHANICAL PERMIT FEES*
_
Cii■ iStatelZIP: "1::› (.. tap_ O- zoc sublet:1i
. -0---, Minimum permit fee (S90.00) GI 0. o_c_...
, Phone: ( 6 i Fax: s _-- i -Aq_ k.A I
Plan review (25% of permit lee)
CCU -- lie.: n „..,-- 1 - ,,,,i,., - State surcharge (12% of permit fee) ID •SD
' TOTAL PERMIT FEE 100 ' 1:50
Authorized signature: / /'" ' iz A • -- This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
; Print name: R Date: ( oj hl t --- . Fee inethodolol/y set by Tri-Coiliiii. Building Inthear■ So ice Board
I iluiidinn' P e rn ' il `' \ 11( -Per.iiApp doe (J3,1i7 12 4411 i i 1,02('ONtiwEB)