Permit • u CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2013 00325
T (G AR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/13/2013
Parcel: 2S 103C D08900
Jurisdiction: Tigard
Site address: 13543 SW PIPER TER
Project: CULVER Subdivision: 2008 -074 PARTITION PLAT Lot: 2
Project Description: NC installation. Placement of NC unit must comply with manufacturer's clearance requirements.
Contractor: ABLE HEATING & COOLING LLC Owner: CULVER, BILL & CHERYL
16285 SW 85TH AVE #105 13543 SW PIPER TERRACE
• TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 579 -2250 PHONE: 503 - 329 -5468
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Air Conditioning 06/13/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 06/13/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 06/13/2013 $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: /!
I/
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.
Mechanical Permit A lie cElt'ED
pp a FOR OFFICE 15E ONLY
City of Tigard JUN 1 2 2013 Receives
1
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3125 SW Hall Blvd., Tigard, OR 97223 DateBY: 0 " = . r.• Plan N
e Phone: 503.718.2439 Fax: 503.598.19 ®ITT v OF TIGARD Dare/By: ew Other Permit
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TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
ID New construction ® Additionlalteration/replacement
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
- ❑ Other: mechanical materials, equipment. labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value:
® 1 -and 2- ftunil dwellin RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
Y g ❑ Commercial /industrial ❑ Accessory building For
❑ Multi-family El Master builder species /frtjonmrlonrrserlreck/lr1
❑ Other: Description I Qty. I Ea. I Total
' JOB SITE INFORMATION AND LOCATION HeatioWcooling:
Job site address: 13543 SW PIPER TERRACE Air conditioning I 46.75 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City/State2 [P: TIGARD, OR. 97223 Furnace 100,000+ BTU (ducts[ ents) 54.91
Suitc/bldglapt. no.: I Project name: CULVER Heat pump
61.06
Duct work 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 my 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
INSTALL NEW A/C UNIT Flue vent for water heater or gas
fireplace 23.32
Log lighter (Gas) 23.32
Wood/pellet stove 33.39
•
Wood fireplace/insert 23.32
Chimney/liner /flue/vent 23.32
® PROPERTY OWNER 1 ❑ TENANT Other.
23.32
Environmental exhaust and ventilation:
Name: BILL AND CHERYL CULVER Range hood/other kitchen
Address: 13543 SW PIPER TERRACE equipment 33Address:
Clothes dryer exhaust 33.39
City/State/ZIP: TIGARD, OR. 97223 Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32 I
Phone: (503)329 -5468 Fax: ( ) Attielcrawlspace fans 23.32
❑ APPLICANT ❑ COIITACT PERSON Other.
23.32 t
Business name: Fuel piping:
S14.15 for first four, $4.03 for each a dditional
Contact name:
Furnace. etc.
Address: Gas heat pump
City/State/ZIP:
Wall/suspended/unit heater
Water heater
Phone: ( ) Fax: : ( ) Fireplace
E -mail: Range
Barbecue
CONTRACTOR Clothes dryer (gas)
Business name: ABLE HEATING & COOLING LLC Other:
Address: 16285 SW 85 AVE SUITE 105 MECHANICAL PERMIT FEES"
i Subtotal 46.75
City/Slate/ZIP: TIGARD, OR. 97224 Minimum permit foe (890.00) 90.00
Phone: (503) 579 -2250 / _ + Fax: (503) 620-3980 Plan review (25% of permit f ee) '
State surcharge (12% of permit fee) 10.80
CCB lie.: 184392 TOTAL PERMIT FEE 100.80
This r, permit ycate expires if a permit Is MD obtained within D
days after r it t has been accepted as complete.
Authorized signaLUre: • Fee methodology an by Tri- County Building industry stry Service Board
Print name: KELLY WI ITE Date: 6 -12 -13
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