Permit CITY OF TIGARD MECHANICAL PERMIT
3 COMMUNITY DEVELOPMENT Permit#: MEC2013 -00003
T f GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/02/2013
Parcel: 1 S125DB09400
Jurisdiction: Tigard
Site address: 7042 SW LOLA LN
Project: Isaacs Subdivision: RAZBERRY PATCH, THE Lot: 14
Project Description: (1) gas furnace replacement
Contractor: ABLE HEATING & COOLING LLC Owner: ISAACS, RONALD R AND DONNA
16285 SW 85TH AVE #105 7042 SW LOLA LANE
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 579 -2250 PHONE: 503 - 244 -6249
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 01/02/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 01/02/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/02/2013 $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. p /1 p Issued By: dilLat 9 Permittee Signature: l- 4 UC 4 I eYk
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 ApplicationREIVED I OR 01 I l i 'L 1 F_ °NI.,
City of Tigard JAN 0 2 Received i _ 3
• 13I25 SW Hall Blvd., Tigard, OR 97223 2013 nmus Permit "° NBC �Fi(3 DDe X03
Phone: 503.718.2439 Fax: 503.598.1960 Ran Review
Inspection L ine: 503.639.4175 Date/By: Other Permit:
I I (, ;t : t> CITY OF TIGARD Date Reaefy, By: ,�ti See Page 2 for
Internet www.tigard-or.gov BUILDING DNISIO "oti d: sho .� & Supplemental
TYPE OF WORK COMMERCIAL FEE' ` SCHEDULE – USE CHECKLIST
Mechanical permit fees* are based on the value of the work
ID New construction ® Addition/atteration,'replacement
perfoIndicate ed• Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other:
mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: S
RESIDENTL4L EQUIPMENT / SYSTEMS FEES*
® 1- and 2- family dwelling 0 Commercial /industrial 0 Accessory building For *nein!information are cgs
❑ Multi - family Q Master builder
❑ Other: Description I Qty. I Ea. I Total –
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: 7042 SW LOLA LANE Air conditioning
(requires site plan showing placement) I 46.75 46.75
City/State/ZIP: TIGARD, OR. 97223 Pomace 100,000 B IU (darts veils) 46.75
Furnace 100,000+ BTU (duets/vents) 5 4.91
Suite/bldgiapt. no.: f Project name: ISAAC Heat pump
Cross street/directions to job site: (requite, site pine showing placement) 61.06
Duct work 23.32
Hydronic hot water system 23,32
Residential boiler (radiator or
hydronic) 2332
Unit heaters (fuel -type, not electric),
in -wall. in -dact, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent for any of above 23.32
Tax map/parcel no.: Other. 2332
Other fuel appliautes:
DESCRIPTION OF WORK Water heater f 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 fireplace/insert 23.32
® PROPERTY OWNER 1 ❑ TENANT Chimney /finer /flue/vent 23.32
Name: RON ISAAC Other 2332
Eavironmental exhaust and ventilation:
Address: 7042 SW LOLA LANE Range hood other kitchen
equipment 33.39
City/State/ZIP: TIGARD, OR. 97223 Clothes dryer exhaust 33.39 .
Phone: (503)244-6249 Fax: ( )
Single-duct exhaust (bathrooms,
❑ APPLICANT toilet compartments, utility rooms) _ 23.32
❑ CONTACT PERSON Alticicrawispace fans 23.32
Business name: Other. 23.32 _
Contact name: Fuel piping:
514.15 for first four; 54.03 for each additional
Address: Furnace, etc.
City! State /ZIP: Gas heat pump _
Wall /suspended/unit heater
Phone: ( ) I 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*
;ty/StatezlP: TIGARD, OR. 97224
Subtotal 46.75
Pace' (503) 579 -2250 ,Fax: (503) 620
Minimum permit fee (390.00) 90.00
I CCB lie.: 184392 Plan review (25% of permit fee)
State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 1 100.80
Authorised signature: ( 'This perm* cant) expires if a permit is rot obtained within ISO
I Print name: KELLY HITS
days alter it leas been accepted as complete
Date: Ol - - • Fee methodology set by Tri Building Industry Service Board
liauildineensief l/ 03/07/12 440 4617T(I 1/(77/C0M/WEBi
6'd 086£029£09 6up000'g Bw ;eeH env d8£ £0 £ l ZO ue