Permit CITY OF TIGARD MECHANICAL PERMIT
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• a COMMUNITY DEVELOPMENT Permit #: MEC2013 -00258
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/20/2013
Parcel: 25111 DD14400
Jurisdiction: Tigard
Site address: 15779 SW 87TH AVE
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Project: Lambert Subdivision: MILLMONT PARK Lot: 21
Project Description: Installation of ductless heat pump.
Contractor: ABLE HEATING & COOLING LLC Owner: LAMBERT, KATHRYN L
16285 SW 85TH AVE #105 15779 SW 87TH AVE
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: 503 - 579 -2250 PHONE: 503 - 915 -4623
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Heat Pump 05/20/2013 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 05/20/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/20/2013 $28.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
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Total $100.80
Required Items and Reports (Conditions)
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1.
' 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 questi s o C by calling 503.232.1987 or 1.800.332.2344.
Issued y: Permittee Signatur :
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.
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Mechanical Permit Ap Iicatio „RECEIVED
P FOR OFFICE USL ONLN
City of Tigard MAY 16 2013 Received : 5 /le 1 3 , Permit No.: ► / e da l_?- DD,7,?57 b
' 2;
13125 SW Hall Blvd., Tigard, OR 972 Phone: 503.718.2439 Far. 503.598.1960 Plan Revie
Inspection Line: 503.639.4175 CITY OF TIGARD DereBy. Other Permit:
T 1 GA K 17 Date Ready /By: finis El See Pa e 2 for
Internet: www.tigard BUILDING DIVISION Notited Method: g
�' � Snpplemeotal Information
1 TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alteration /replacement
petfomtelL Indicate the value (rounded to the nearest dollar) of all
Cl Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: S
1 -acrd 2-family dwelling 0 om r RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
mercra., industrial ❑Accesso bu ildin
❑ Accessory building Far special information use rlaect.IisL
Multi - family Cl ❑Master builder
❑ Other Description j Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: 15779 SW 87 AVE., Air conditioning 46.75
Furnace 100.000 BTU (ducts /vents) 46.75
City/State/GIP: TIGARD, OR. 97224 Furnace 100 000+ BTU (dusts/vents) --- 54.91_ -
Suite/bldg./apt. no.: Project name: LAMBERT PAP 1 61.06 61.06
Duct work 23.32
Cross street/directions to job site: Hvdronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
I Unit hearers Ifuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Flue/vent for any of above , 23.32
Subdivision: 1 Lot no.: Other: I 23.32 I
Other fuel appliances:
Tax map /parcel no.: Water healer I
23.32 I
DESCRIPTION OF WORK Gas fireplace.inse.t 3330 ,
IN NEW DL C CLESS HEAT PUMP SYSTEM Flue vent for water heater or gas
fireplace 23.32 _
Log lighter (gas) 23.32 _
Wood /pellet stove 3339
Wood fueplace /insen 23.32
t
Chimney /iineriflue/vent 1 23.32
® PROPERTY OWNER ❑ TENANT Other 1 23.32
Environmental exhaust and ventilation:
Name: KATHERINE LAMBERT Range hood/other kitchen I
I
Address: 15779 SW 87 AVE. equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: TIGARD, OR 97224 Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 2332
Phone: (503)915 -4623 Fax: ( ) Attic/crawlspace fans _ 23.32
❑ APPLICANT ❑ CONTACT PERSON Other
t 23.32
Business name: Fuel piping:
I S14.15 for first funr, 54.03 foreach additional
Contact name: Furnace, etc.
Address: Gas heat pump r
Wall /sus ended /unit beater
City/State/ZIP: P
Water heater
Phone: ( ) Fax :: ( ) Fireplace
E -mail ! Range
I
Barbecue
CONTRACTOR Clothes dryer (gas)
Business name: ABLE HEATING & COOLING LLC Other: I
Address: 16285 SW 85 AVE. SUTTE 105 MECHANICAL PERMIT FEES'
Subtotal I 61.06
City/State/ZIP: TIGARD, OR 97224 Minimum permit fee ($90.00) 90.00
Phone: (503) 579 -2250 Fax: (503) 620 -3980 Plan review (25% of permit fee)
State surcharge (12% of permit fee) 10.80
CCB lie.: 184392 TOTAL PERMIT FEE 100.80
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This permit application expires if a permit is not obtained within 180
Authorized signature days after it has been accepted as complete.
• Fee methodology set by Tri -County Balding Industry Service Board
1 Print • name: KELLY 1 HITS I Date: 5 -16-13
1 : 1 Building 'Pcrmits\MEC2crmitApp_040113 doc 4404617[' (11102/C°M/1WEB)
L 086£029£05 6u!l000 v 6uiieeH env e£9:0 I. £ l, 91, IeW