Permit CITY OF TIGARD MECHANICAL PERMIT
• - • COMMUNITY DEVELOPMENT Permit #: MEC2013 -00203
T (GA R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/15/2013
Parcel: 2S104DD07800
Jurisdiction: Tigard
Site address: 12866 SW MORNINGSTAR DR
Project: McCaarthy Subdivision: MOUNTAIN HIGHLANDS NO.3 Lot: 36
Project Description: (1) A/C installation Placement of NC must comply with manufacturer's clearance requirements
Contractor: ROTH HEATING & COOLING Owner: MCCARTHY, JUSTIN C & MICHELE M
PO BOX 1265 12866 SW MORNINGSTAR DR
CANBY, OR 97013 TIGARD, OR 97223
PHONE: 503 - 266 -1249 PHONE: 503 - 888 -4377
FAX: 503 - 266 -3478
FEES
Specifics: Description Date Amount
Air Conditioning 04/15/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 04/15/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/15/2013 $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.
�yG
Issued By: AL S- - Permittee Signature: D Li AM -, CAVO .I .)litAhy
Call 50 3..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.
APR -12 -2013 FRI 10:32 AM ROTH HEATING FAX NO, 5032663478 P. 01
Mechanical Permit Applica> ECE7IVED i OR 0141(1.: , ti,? ON!,l
City of Tigard homed g uttte/oy: (-1 15 1 3 `r Permit No.: , t x - 4:: ::,0,jaj
III e " 13125 SW Hall I31vd„ Tigard, OR 972215, PR 1 5 2013 P1enReview
Phone: 503.718.2439 Fax: 503.598.1%
n s ection Line: 503.639.4175 Date/Br; Other Permit
l I Ci A R D I p Date Reacl Ji
/B . urs:
Internet: www.tigard- or.go CITYOFT y e RI p l ePene3for
BUILDING DIVISION Notified/Moiled: ' / ��p Supplemental Informat 1
' 'TYPE OF WORK COMMERCIAL FEE* SCI {EnuLE - US CHECKLIST
❑ New construction Mechanical permit fees* are based on the value of die work
® Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, e ui.men labor, overhead, and •rotit.
Value: $
CATEGORY OF. CONSTRUCTION
RESIDENTIAL EQUIPMENT / SYSTEMS PEES*
® I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special informurlun use checklist. '
(] Multi- family ❑ Master builder ❑ Other Description Qty. Ea. Total
. JOB SITE INFORMATION AND LOCATION Hentin: coolie
Air conditioning
Job site address: 12866 SW Morningstar Dr (ref aims site .Ian showin •lacement) 1 46.75 46.75
City/State/ZIP: Tigard OR 97223 Furnace 100,000I3TU duels/venls) 46.75 Furnace 100,000+ BTU (ducts/vents 54.91
Suite/bldg. /apt. no.: Project name: McCarthy /43581 Hcat pump _
— (r . wins site Ian slinwin. .Incement 61.06
Cross street/directions to job site: Duct work 23.32
FI dronic hot water system IINEI Residential boiler (radiator or
It dronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, sus, ended, etc. 46.75
Subdivision: Lot no.:
Flue/vent for an of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel a I Ilancea:
DESCRIPTION OF WORK Water heater 23.32 ME
installation of air conditioner Gas tirc.lace / insert _
Flue vent for water heater or gas -
fire lace 23.32
La: li•hter ;as) 23.32
Wood /.ellet stove 33.39
Wood fire.lacc/inscrt 23,32
IIMMIMM
12 PROPERTY OWNER ❑ TENANT 23
Other: 23.32
Name: Justin McCarthy Environmental exhaust and ventilation:
Address: 12866 SW Morningstar Dr Range hood/other kitchen -
e ui mcnt 33.39
City /State/ZIP: Tigard, OR 97223 Clothes d er exhaust 33.39
Phone: (503)888-4377 I Fax. ( ) Single -duct exhaust (bathrooms, -
toilet coin.. eras, utili rooms
® APPLICANT I • ❑ CONTACT PERSON Attic/crawls.ace fans I—
Business name: Roth Heating and Cooling Other 23.32
-- Fuel i in_:
Contact name: Angela McGraw 514.15 for first tout; S4.03 for each additional
Address: PO Box 1265 Furnace, etc. MI
— Cias heat .utn.
City/State21P Canby OR 971113 WulVaus ndcd/unit heater
Phone: (503) 266 -1249 Fax: : (503) 266 -3478 Water heater �—
NMI
E - mail: angelam@roth-heat.com Firn.lacc
a
Raft . e —MEI
CONTRACTOR Barbecue
Business name: Ruth Heating and Cooling Clothes dryer (.as) __
Address: PO Box 1265
—` Other:
' MECHANICAL PERMIT FEES! ; . ' .
City /Slate/Z1P: Canby OR 97013 Subtotal 46.75
Phone: (503) 266 -1249 Fax: (503) 266 -3478 Minimum permit fee ($90.00) 90.00
CCB lie.: 14008 Plan review (25% of permit fee)
State surcharge (12% ofpermit fee) 10.80
TOTAL PERMIT FEE 100.80
Authorized sign, A 1 'dais permit application expires it a permit is not obtained within 180
,���� _ �� .• flays utter it has been accepted as complete.
Print name: 1111 " P , P - cG raw Date: In * Foe tnethodulouy set by Tri -County Building Industry Service Board
I U3 uIIdInelFunnits \MEC.PermiiApp cs /a 7/12 4As.4e ITT (1IIaVCOM/W6e)
APR -12 -2013 FRI 10:32 AN ROTH HEATING FAX NO 5032663478 P. 02
Outdoor Unit Site Plan
S' - El -9 3b'+
House
Street Address: l'2 x r . `
City, State Zip: „ : � • �.
Front
Street
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