Permit CITY OF TIGARD MECHANICAL PERMIT
C COMMUNITY DEVELOPMENT Permit #: MEC2013 -00336
Date Issued: 06/18/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S110AD07300
Jurisdiction: Tigard
Site address: 14917 SW 106TH AVE
Project: Rutz Subdivision: LANG HILL NO.2 Lot: 65
Project Description: Installation of NC. Placement of A/C or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: RUTZ FAMILY REVOCABLE TRUST
19300 SW 118TH AVE 14917 SW 106TH AVE
TUALATIN, OR 97062 • TIGARD, OR 97224
PHONE: 503 -691 -9699 PHONE: 503 - 639 -8293
FAX: 503 -691 -8556
FEES
Specifics: Description Date Amount
Air Conditioning 06/18/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 06/18/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 06/18/2013 $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: e. _ Permittee Signature: ew n / (7-1-7-7o,
d
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.
06/17/2013 09:45 503 - 691 -8555 OREGON HEATING PAGE 01/03
IRE�CENED
Mechanical Permit App
Iicat1O FOR OFFICE USE ONLY
City of Tigard !E �� !t!I ' ettn IN o. : ���3 X033 IN
- 13125 SW HlvdTigard, OR 97223 JUN 1 7 2 013
. Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit
Inspection Line: 503.639.4175 CITY OFTIGARD Date Ready/By: In El See Page 2 for
`' `' ^ r. D Internet: www.tigard- ar.gov BUILDING DIVISION Notified/Method; Supplemental Information
TYPE OF wOWC . : ('Ol► $CCALFEE* sCHEDIJiE, :- Yi ::c'1 C.PA T
Mechanical permit fees* are based on the value of ire work
❑New construction ,l Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition CI Other m echanical materials, equipment, labor, overhead, and profit
6i4... Value: $
CA 'R G0RX OF` CO1�S RIJCTi WESVTYAI. bQV /!SYSTEMS liF! s " .
IR 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special Infor nation use checklist
❑ Multi- family ❑ Master builder ❑ Other: Dcsc . on Qty. Ea_ Total
JOB . '.S1T II0,0,RMA ' O Air c ( 46.75 VC s
Job site address: pig I 7 S`/ fOG . /"(vE Furnace 100, 000151U(duots/veats) 46.75
City /State/2JY: / . DA. 9 • 2-2 q Furnace 100,000+F;TUJ (ducts/wnte) 54.91
Heat pump 61.06
Suite/bldg. /apt.no.: Project name: Ductwork _ 23.32
Cross street/directions to job site: lydronic 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 -
Other: 23.32
Subdivision: riot no.: Other fuel a 'lances:
.
Tax map /parcel no.: Water heater 2332
DESCRIPTION OF Gas fireplace insert 33.39
Flue vent for water heater or gas
/ i fireplace 23.32
_ „.Ln t - tgii Art G. ,t.J#/1r, 2332
Log lighter (gas)
Wood/pellet stove 33.39
Wood tireplace/iosert 23.32
-
Chimney/liner/flue/vent - 23.32
Other: 23.32
APROPERTY OWNER. Q 7 ENAlV I< E nv i ronmen tal exhaust and ventilation: —
Name: Pelee %#" SA; fie ,,4- Range h ood/other kitchen
equipment 33.39
Address: /lig 1 4 ,_j fr' / 0-I ,4 Clothes dryer exhaust 33.39
City /State /ZCP: Single-duct exhaust (bathrooms,
ar , 9 (� Of? 9 _12.�� toilet compartments, utility rooms) 23.32
Phone: (S c-,..??... f Z F air: ( ) _Attic%rawlspacc fa ns f 23,32
1 CI• .CANT O t h er . 23.32
IF3 APPLICANt r
. CT PERSON r
A..
Fuel piping:
Business name: OP a a ki f,�,,, — 514.15 for first four: $4,03 for each aanittonai
Contact name: J . Furnace, etc. .
t C �: ,/ Gas heat . um ,
Address: / /,300 .S jr / -s1 Az Wall/sus. • nded/urut heater
City/State /LIF: ? 4 fah + Oi f 7 OC2 Water heater
Fire lace
Phone: ( 01) Gq f- q6 99, Fax: : ( ) R : e
E -mail: Barbecue ■
CON A C7I OR ; . Clothes . er .. as
O . t r . Other
name: VY 9 �n 17 P. 4 F • . ' 1► CHAN PUT FEES
-� Subtotai 6._ 7's-
Address: 113g0 ..57,./ /44,_ A
City/State/ZIP: 7 P Minimum permit fee ($90.00) -
/ t4 � st:,� ' �. 4 Z Plan review (25% of .ermit fee) ,••••-'
Phone: (Sy3) " ?j_ ey, Fax: ( ) _ State surcharge (12% of permit fee) p. Ec7..
C CB lie.: TOTAL PERMIT EE o . o ✓
/ 6 This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: ,, — ; Fee methodology set by Tri-County Building Industry Service Board
. 1 . A —6 D ate : .S./ 2 S ' /. air
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
14917 SW 106TH AVE, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
06/26/2013 00:00
MEC2013-00336
PASS - No C of O
Minor 368040
Violation Summary:
Inspector Contractor