Permit n CITY OF TIGARD MECHANICAL PERMIT
t; • ., COMMUNITY DEVELOPMENT Permit #: MEC2013 -00155
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/20/2013
Parcel: 1 S134CB13900
Jurisdiction: Tigard
Site address: 12129 SW ANTON DR
Project: Williams Subdivision: ANTON PARK NO.2 Lot: 66
Project Description: (1) gas furnace replacement
Contractor: ABLE HEATING & COOLING LLC Owner: WILLIAMS, ERNIE
16285 SW 85TH AVE #105 12129 SW ANTON DR
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 579 -2250 PHONE: 503 - 590 -0488
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 03/20/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 03/20/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/20/2013 $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.
Issued By: • _ . Permittee Signature: 0)4 Y-t PIQLI co 7706
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.
Mar 20 13 09:45a Able Heating & Cooling 5036203980 p.1
Mechanical Permit APpli 11LV1 +� EIVED FOR OFFICE l SL ONLY
14 City of Tigard Received
13125 SW Hall Blvd., 'ri Flate�By: I 5 Permit No.: i (,�(G / 3 -Ix/ OR 9BNI Q 7 n 1
Phone: 503.718.2439 Fax: 503.5M/980 0 " Plan Review Permit:
Ins ion Line: 503.639.4175
Date/By:
? I G A R D P Ready/By.
Read
Date Jvis: See Pag 2 for
Internet: www.tigard or.gov CITY OF TIGARD Dat Not e Read 1-1
clbod:
RI IILDING DIVISION sappkmente a "nfor,na ° °°
TYPE OF WORK r COMMERCIAL FEE" SCHEDULE — USE CHECKLIST
❑ New construction ®Addition /alteratiomlmplacernent Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
tEl dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
1- and 2- farnil
Y g ❑ Commercial/industrial ❑ Accessory buildin
❑ Multi - family ❑Masterbui[ der building For �dOl/" f °�oR+u'eekedFlla
❑ Other: Description I Qty. I Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heatirtg / cooling:
Air conditioning
Job site address: 12129 SW Anton Drive (requires site plan showing placement) 46.75 .
City/State/ZIP: Tigard, Oregon 97223 I Furnace 100,000 Bit (d°ctsrvents) 1 46.75 46,75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: WILLIAMS Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 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
Subdivision: Lot no.: Flue/vent for any of above 23.32
Tax map/parcel no.:
Other: 1 23.3 I
Other fnel appliances:
DESCRIPTION OF WORK Water heater • 23.32
Replace existing as furnace Gas fireplace/insert 3339
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove • 33.39
Wood freplaee insert 23.32 _
Chimney /liner /flue/vent 23.32
® PROPERTY OWNER ❑ TENANT
Name: Ernie Williams
Other 2.3.32
Environmental exhaust and ventilation:
Address: 12129 SW Anton Drive ' Range hood/other kitchen
equipment 33.39
City/ State/ZIP: Tigard, OR 97223 Clothes dryer exhaust 33.39
Phone: (503)590 -0488 Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Business name: Other 23.32
Contact name: Fuel piping:
S14.15 for first four, $4.03 for each additional
Address: Furnace, etc. l
City / State/ZIP: Gas heat pump
Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: Able Heating & Cooling, LLC Clothes dryer (gas)
Address: 16285 SE 85 Avenue i/105 Other:
MECHANICAL PERMIT FEES"
City /State/ZIP: Tigard, OR 97224 Subtotal 46.75
Phone: (503) 579 -2250 Fax: (503) 620 -3980 Minimum permit fee ($90.00) 90.00
Plan review (25% of permit fee)
L CCB lic.: 12R54" 6 -( p a State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80
- I
Authorized signature C �l This permit application espirev if a permit is not obtained within 180
•
days after it bas been accepted as complete.
I Print name: Kelly Willi I Date: 3 - 19 - 13 • Fee methodology set by Tri- County Building Industry Service Board
1: EC- PenmhAp,.doe 03;07/12 440 -46rrr (1 bO2/CO.WWEa)
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12129 SW ANTON DR, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
05/01/2013 00:00
MEC2013-00155
PASS - No C of O
Violation Summary:
Inspector Contractor