Permit •
TIGARD 1.! j MECHANICAL PERMIT
.., y y CITY OF TIVA�® f o
Ilk
' -- . COMMUNITY DEVELOPMENT Permit #: MEC201300048
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/24/2013
Parcel: 25111 DD13700
Jurisdiction: Tigard
Site address: 8722 SW HAMLET ST
Project: Draper Subdivision: MILLMONT PARK Lot: 14
Project Description: Replace existing furnace and existing a /c. (Reprinted 1/28/13 to correct description of work.)
Contractor: ROSE CITY REFRIGERATION HEATING & AIR LLC Owner: DRAPER, YVONNE C & KRISTEN
PO BOX 19207 8722 SW HAMLET ST
PORTLAND, OR 97280 TIGARD, OR 97224
PHONE: 503 - 636 -5371 PHONE:
FAX: 503 - 655 -4669
FEES
Specifics: Description Date Amount
Air Conditioning 01/24/2013 $46.75
Type of Use: SF Furnaces-< 100K BTU 01/24/2013 $46.75
Class of Work: ALT Type of Const: FlueNent For Any of Above 01/24/2013 $23.32
Occupancy Grp: 12% State Surcharge - Mechanical 01/24/2013 $14.02
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $130.84
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 Notif• - on Ce -r. 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 t estions to OU • b • • I g 503.232.1987 or 1.800.332.2344.
Issued ;y: G / 44/ .4 / / PermitteeSig a re: / � � 6T 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.
k'n
Iii v CITY ®I= - IC�AR MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit #: MEC2013 -00048
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/24/2013
Parcel: 25111 DD13700
Jurisdiction: Tigard
Site address: 8722 SW HAMLET ST
Project: Draper Subdivision: MILLMONT PARK Lot: 14
Project Description: (2) branch circuits for furnace and A/C 1/22/13 REPRINT Add(1) branch circuit service outlet
Contractor: ROSE CITY REFRIGERATION HEATING & AIR LLC Owner: DRAPER, YVONNE C & KRISTEN
PO BOX 19207 8722 SW HAMLET ST
PORTLAND, OR 97280 TIGARD, OR 97224
PHONE: 503 - 636 -5371 PHONE:
FAX: 503 - 655 -4669
FEES
Specifics: Description Date Amount
Air Conditioning 01/24/2013 $46.75
Type of Use: SF Furnaces < 100K BTU 01/24/2013 $46.75
Class of Work: ALT Type of Const: FlueNent For Any of Above 01/24/2013 $23.32
Occupancy Grp: 12% State Surcharge - Mechanical 01/24/2013 $14.02
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $130.84
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: „ j4 p ermittee Signature: a A.P�jC 0, Ur �.c r
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.
ICU/ LL/ 2171J id: L17 717.hbD4bby I'<UbtL1 I Y 1 171 / 174
ih
Mechanical Permit ApplicatiR - n -1 Fall OFFICE LSE ONLY
1 14 City Of Hall BF Tigard ', . �!S7 omit No.: r i ✓C%, Da 4
° 13125 SW Hall Blvd., Tigard, OR 97223 J ,_ ` r Review ' I
Phone: 503.718.2439 Fax: 503.598.1960 Ut` 2i ateJ ' '
T1 G A RD Inspection Line: 503.639.4175 u . une: n Sec Page 2 for
Internet www.tigard -or.gov en D (R310 •upplemeatal
.. Flrl-' DIVISION .. - ---- -.
TYPE o •'' i .' ' . DIVISION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
F or special? ormation use checklist
New construction dition/alteration/r� lacement �
Demolition tOTcr: Description I Qty. I Ea. Total
. CATEGORY OF ,CONSTRUCTION . .. Heating/cooling:
Air conditioning
1- and 2- family dwclli : Commercial/industrial Accessory building (requires site plan showing placement) I 46.75 0r75
Multi- family Master builder Other: Furnace 100,000 BTU (ducts /vents) I . 46.75 '/(o,7S.
Furnace 100.000+ BTU (ducWvents) , 54.91
JOB SITE INFORMATION AND; LOCATION .. Heat pump
:requires site plan showing placement) 61.06
ob site address: 8 72 2 .sw W40 It t - St~ r t: La's Duct work 23.32
ity/State/ZIP: 1— i 5 amid C* ci 72.2 4' Hydronic hot water system 23.32
Residential boiler (radiator or
uite/bldglapt no.: Project name: Ora p '.r hydronic) 2 3.3 2 2
ross street/directions to job site: Unit heaters (fuel -type, not electric),
in -wall. in -duct, suspended. etc. 46.75
Flue/vent for any of above I 2332 21', ga _
Other: I 23.32
Other fuel appliances:
Water heater 23.32
Subdivision: ILot no.: Gas fireplace /insert 33.39 I
ax map /parcel no.:
Flue vent for water heater or gas 23.32
DESCRIPTION.;OF WORK : ' Loa Iiahter (gas) 23.32 •
Rzp/atc, ( - cornaLe wi h1A 4/ent Wood/pellet stove 33.39
/G Wood fireplace/insert 23.32
Chimney/lin :r /fluefVent i 23.32 ,
j'Gg /6Ce Other; 23.32
Environmental exhaust and ventilation:
PRUPERTY.:OWI\ER TENANT - o kitchen 3
Rance hood/ they k't hen �9
Clothes drvcr exhaust 33.39
.
'anc; Yu 0,,,,'O DEa p tt r Single -duct exhaust (bathrooms,
toilet compartments. utility rooms) , 23.32
Address: -
.5 Al L~
Attic /crawlspttce fans 23.32
ity /State/ZIP: Other. 23.32 I
•hone: (S-63) 699.. 3305 Fax: ( ) Fuel piping:
APPLICANT , ' :.. PERSON..' S14.15 for first four; S4.03 for each additional
Furnace. etc.
:usiness name: R a e Gi E r - . /n . , 41,- Gas heat pump
ontaet name: .1—ap idsin , b , r Wall /suspended/unit heater
n
Address: r 0 13 if 207 Water heater _
Fireplace
ity/State/ZIP: Pa r -.- f , a2 9 72 8a Rance
Phone: (-0) 6 .36 - 5-37/ 1Fax:: ( s ° 3 ) 6 SS - 4/64 9 Barbecue —
-mail:
Clothes dryer (gas)
CONTRACTOR Other:
/ 7o .. ' MECHANICAL PERMIT FEES*
:usmeSs name: A, 5 e Ghy 1 (41 6-1/75 dd A /I Subtota_ // f), 62
• ddress: Minimum permit fee ($90.00)
Plan review (25% of permit fee)
ity/State/ZIP: State surcharge (12% of permit fee)
' hone: (3-p3) 673 -,137/ , Fax:(5i3) 655 TOTAL PERMIT FEE 1 30/63
CB lic.: / e,/32 q(Lf I1L( This permit applicadon
clays 'after It has been e ptedas pl t t e� withint80
• Fee methodology set by Tri•Couuty Building Industry Scrvico Board
Authorized signature: /
Print name: �j e_ FF 14/7510m Pate; ate; 1/2 /1 1 3`�- $ T
M
COMERCIAL FEE* .SCHEDIJLE. -• USE CHECKLIST 1
TO/TO 390c(
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