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Permit CITY OF TIGARD MECHANICAL PERMIT • COMMUNITY DEVELOPMENT Permit #: MEC2013 -00200 T t GA RD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/15/2013 Parcel: 2S109BA05900 Jurisdiction: Tigard Site address: 13855 SW ALPINE VIEW DR Project: Srinivasan Subdivision: HILLSHIRE SUMMIT NO.2 Lot: 45 Project Description: (1) installation of gas furnace and A/C Placement of A/C must comply with manufacturer's clearance requirements Contractor: ROTH HEATING & COOLING Owner: SRINIVASAN, RANGANATHAN PO BOX 1265 RANGANATHAN, SHUBHA CANBY, OR 97013 13855 SW ALPINE VIEW TIGARD, OR 97224 PHONE: 503 - 266 -1249 PHONE: 206- 679 -2750 FAX: 503 - 266 -3478 FEES Specifics: Description Date Amount Air Conditioning 04 /15/2013 $46.75 Type of Use: SF Furnaces < 100K BTU 04/15/2013 $46.75 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 04/15/2013 $11.22 Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressure: Total $104.72 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 1 , f Issued By: - Lf (i1 !9 !� n ( � Permittee Signature: DM APPLICH Ql` �/ 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. APR -11 -2013 THU 04:07 PM ROTH HEATING FAX NO. 5032663478 P. 01 Mechanical Permit_ Appl ication � Fog USL: ONLY City of Tigard RECEIVED Received ,1 3 Permit II I Date /By —t S J CC l 3 " Dv -jot) • 13125 SW Ilan Blvd., Tigard, O 972 23 i tau Review : Phone: 503.718.2439 Fax: 503.598.9 p alellly: Other Perm T I C A R D inspection 1,inc, 503,639,4175 1 1 2 013 Datc Ready /By: )uric: Ea See Page 2 for Internet: www.tigard- or.gov Notified/Method: Supplemental Information CITY OFTIGARD TypE iw DIVISION,; _ i COMMERCIA `FEE' SCHEDULE - US :CHEd CU f Mechanical permit fees' are based on the value of the work ❑ New construction ® Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all 0 Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. Value S CATEGORY ;OF .CONSTRUCTION ', RESIDENTIAL EQUIPMENT /SYSTEMS FEES* ® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building Far special information use checklist ❑ Multi- family Cl Master builder ❑ Other: Description I Qty. I Ea. I Total . JOB SITE INFORMATION AND LOCATION{ HcaunF/cnoling: - Air conditioning 1 46.75 46.75 Job site address: 13855 SW Alpine View Furnace 100,000 BTU (tlii /vents) I 46,75 46.75 City/State/21P: Tigard OR 97224 Furnace 100 BTU (ducts/ventnl 54.91 Suite/bldg. /apt, no.: Project name, Srinivasan /43953 Rent pump 61. . Duct work 23,32 32 Cross streeUdireelions to job site: Hydranic hut water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fbel -type, not electric), _ in -wall, in -duet, suspended, etc. 46.75 Flue/vent for any of above 23.32 Subdivision: Lot no,: Other: 23.32 Other fuel appliances: Tax map /parcel no.: Water heater 23.32 DESCRIPTION OF WORK Gas fireplace /insert 33.39 Flue vent for water heater or gas installation of gas furnace and air conditioner fireplace 23.32 Log lighter (gas) 23.32 , Wood /pellet stove 33.39 Wood fireplace /insert 23.32 Chimney/liner/flue/vent 23.32 _ El PROPERTY OWNER . , 1 Other: 23.32 © T LNAN I Environmental exhaust and ventilation: Name: Range Srinivasan Range hood/other kitchen equipment 33.39 Address: 13855 SW Alpine View Clothes dryer exhaust 33.39 City/Stale/ZIP: Tigard, OR 97224 Single -duct exhaust (bathrooms, - - toilet compartments, utility rooms) 23.32 Phone: (206)679 -2750 Fax; ( ) Attic /crawlspacc fans 23.32 ® APPLICANT Q; CONTACT PERSON Other 23,32 Business name: Roth Keating and Cooling Fuel pipinE: $14.15 for first four; $4.03 for each additional Contact irnine: Angela McGraw Furnace, etc. Address: PO Box 1265 Gas heat pump - WaiUsuspended/unit heater City /State/Z1P: Canby Or 97013 Water heater Phone: (503) 266 -1249 Fax:: (503) 266 -3478 Fireplace — Range - E -mail: ungelam,7ralh- heakeam klarbecue • CONTRACTOR r ' . Clothes dryer (gas) _ Business name: Roth Heating and Cooling 1 Other MECHANiCAL'RERMIT FEES' : ' • ' Address: PO Box 1265 Subtotal 93.50 City /Shute /ZTP: Canby Or 97013 Minimum permit fee ($90.00) Phone: (503) 266 -1249 Fax: (503) 266 -3478 Plan surcharge (25% of permit fee) State surcharge (112 "/e of permit fee) 11.22 — CCB lie.: 14008 TOTAL PERMIT FEE 104.72 This permit application expires if a permit is not obtained within 180 days alter it has been accepted as alternate. Authorized signature: I r , , , - ,,l/ • Fen methodology set by Tri- Cnunty Building Industry Service Board P . Print name: Ang!it raw 0► Date: 4/11/13 1 O4a113.de. 440.1617r (I IIO2/cOMIWnH)