Permit CITY OF TIGARD MECHANICAL PERMIT
11 COMMUNITY DEVELOPMENT Permit MEC2013 -00294
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2013
TIGARD Parcel: 2S110AD04204
Jurisdiction: Tigard
Site address: 14605 SW 106TH AVE
Project: Behrendt Subdivision: LANG HILL Lot: D
Project Description: NC installation. Placement of A/C must comply with the manufacturer's clearance requirements.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: BEHRENDT, ROBERT F & SHARON A
19300 SW 118TH AVE 14605 SW 106TH AVE
TUALATIN, OR 97062 TIGARD, OR 97224
PHONE: 503 -691 -9699 PHONE:
FAX: 503 -691 -8556
FEES
Specifics: Description Date Amount
Air Conditioning 06/04/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 06/04/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 06/04/2013 $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: X:V Permlttee Signature: d . / //- /0 / e
Call 503.639.4175 by 7:00 a.m. for the next available inspections 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.
05/31/2013 16:32 503- 691 -8556 OREGON HEATING PAGE 01/01
Mechanical Permit APPIRECEIVED FOR OFFICE USE ONLY •
City of Tigard Received ; . j Permit
1 ° 13125 SW Hall Blvd., Tigard, to - 3 y 8 / . ���,�� 1 - t�
� 2013 Plan Review
Phone: 503.718.2439 Pax: 503.598.190 Date/By: Other Permit:
T t C ARD Inspection Line: •!50f3- 639.4175CITYOF TIGARD Dam Ready/By:'•' - see Page 2 for - - - .
Internet www.Agard -o`.eo DUILDJNG DIVISION No ` atbo supplemental rnformanoa
1 XPE ti>~ ., • , -,'C'ON11012ClAlr FEE SCae�DULE - USE CHFC 'lf.:
Additionllteration/re laeement • Meehamcal at fees! mu based o value of the work
1:1 New construction a p performed Indicate the value (rounded to the
d to the nearest dollar) of all
❑ Demolition ❑O ther mechanical materials, equipment, labor, overhead, aid profit.
1ZLL�OF� C " - ' a ^ ''., Valle: $
C * 13 Q 3 TItLiG� • - : ' - .''' ii7i i SY 11I;i
1- and 2- family dwelling ❑ Commercial/industrial 1=I Accessory building For special La rm�ton use checklist
Multi- family ❑ Masan builder ❑ Other: Description I Qty. I Ea. ( Total
' JOB"Slit l!( d1A i�:oCAti rY ti ' i ,'. Ai rn
conditioning
�//_ /_ `'' `' ` °'' , A ir conditioning 46., 406
75
Job site address f KL1 O 5J 1018 L Furnace 100,000 BTU (duets/vents) 46.75
City/State/ZIP: ll9 i. i an 2. - Furnace 100,000+ BTU (ducts/yenta 54.91
Heat tamp Suite/bldgJapt.no.: !ilk Project name: I:wire ca fi'jCat Ductwork 23.32
Cross street/directions to job site: =� ��"` 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
Flue/vent for any of above 23.32
Subdivision: . Lot no.: Otli`r. 1 23.32
... Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
DESCRIOTION O1 WORK - ' ' Gas Brepiacerinsert 33.39
Flue vent for water heater or gas
• fireplace 23.32
• Loglightcr (Ras) 23.32
Wood/pellet stove 33.39 ,
Wood fireplace /arsert 23 32 '
Chimney/liner /flue/vent 23.32
PROPERTY OWNER I 0 AliH• ,• . Other: 23.32
/// «` Environmental exhaust and ventilation:
Name: eon eArfC i d Range hood/olher kitchen
tJ 11 equipment 33,39
Address; f 4102E' 5'V to ( Ala, Clothes dryer exhaust 33.39
City /State//ZIP: 77, Q [ • l D /2:. 2— Singlo -dud exhaust (bathrooms,
l toilet compartments, utility rooms) _, 23.32
Phone: -4 ) rl ; - ; 0 Fax: ( ) Atticicrawlspace fans 23.32
. ® APP11IC In CON'1'ACl'' AWElk)N Ocher: - 23.32
Busi ness name: � Fuel piping:
Vh2g o w H �2fil 51415 for first four: $4.03 for each additional
Contact name: ,cl( �o rtr, C - Furnace, etc.
,/ Gas heatpump
Address: I / f /, %fve Wau/suspended/unitheater ��
City/StatetLJY: ' o, q 7 C7C2 Water heater _
Fireplace
Phone: Wig ) G9 1- 74'19 Fax:: ( ) e
E Barbecue
CONTACTOR - Clothes dryer (gas)
Business name: Ord.
Other: . .
Ale •' kirzineavtc .A.l.0.1t'l�n'ill'tcs.
Address: 1930 ..s ft' Atit9 Subtotal
City/State/ZIP: n Iat-rr vr< q 7 0(2 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
Phone: (S03 G `7 /_ 76yy —I Fax: ( ) State surcharge (12% of permit fee) 42
CCB tic.: / / 2 6 - TOTAL PERMIT FEE [ 0 d .V3 .i/"
This permit Application etpires ifs permit is pot obtained within 180
days after it bas been accepted as complete.
Authorized Signature: , , Fee methodolo set b Td Co uary Building Industry Servile Board
Print name: Q (�-a ft.) a ..... L , Date: , S�.l2fr�2 ol� --