Permit CITY OF TIGARD MECHANICAL PERMIT
111 -- COMMUNITY DEVELOPMEN Permit #: MEC2013 00347
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/25/2013
Parcel: 1 S134DB00200
Jurisdiction: Tigard
Site address: 10985 SW NORTH DAKOTA ST
Project: Dorr Subdivision: 1998 -067 PARTITION PLAT Lot: 2
Project Description: Installation of furnace and heat pump. Placement of NC or heat pump units must comply with the manufacturer's
clearance requirements.
Contractor: ROTH HEATING & COOLING Owner: DORR, KATHY
PO BOX 1265 10985 SW NORTH DAKOTA ST
CANBY, OR 97013 TIGARD, OR 97223
PHONE: 503 - 266 -1249 PHONE: 503 -639 -5037
FAX: 503 - 266 -3478
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 06/25/2013 $46.75
Type of Use: SF Heat Pump 06/25/2013 $61.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/25/2013 $12.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.75
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: tiN i�/ Zf /? 9 77
C
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.
JUN -21 -2013 FRI 01:57 PM ROTH HEATING FAX NO, 5032663478 P. 03
Mechanical Permit Applica , ,i' . , _
City of Tigard c — C E 1 V Received
g q 13125 SW Data/By: ' permit No ���43 003/7
Hall Blvd., Tigard, OR 97223
ii Phone: 503 718.2439 Fax: 503 598.196 U 2 3 Plan Review T Other Parma: Inspection Line: 503 639.4175
Date/By:
I l t:, �< D p
Date Ready /By' W 0 81 0� �BGARD .lung. See runt! 2 for
Internet: www.tigard- or.gov Notified/Method; t
1 11 men lnllnformnt i o n
SUil
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Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alteration /replacement pcilbrmed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
'i,ill ni: It _. �-i�i , {�o n ,P, 'I,'• „, „',',: , ���{ I , i , , i ,•�, 11 I Value' $
! a;, t , ± . 40'.10'ov�I err' iu0ri , ' lT.,, ;, , 1 I,,,,.
® 1 l antl 2- family dwelling ❑ Commercial/industrial ❑ Ac ..�,�I 1 � � riGl ';;'J "I:';;•�������!79!1'�� Q�l"l�'� I I�J� - 1. � I . i,Ei',,
Accessory building For special Information use c/,ecklisr.
❑ Multi - famil ❑ Master builder ❑ Other: Description Qty. Ea Tou,l
,Ti :1'J •(y1 , i „ t t; ' „ I �',�: j , 1 { •, ;k 1) ,,, , ,, r;l , l p , I •,11 ' I i'" ', Heating/carding:
/cardin ..�
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.fob site address: 10985 SW North Dakota St Air conditioning 46.75
Furnace 100,000 BTU (ducts /venial / 46 75 y( 75
City /State /ZIP: Tigard, OR 97224 Furnace 100,000+ 13TU (ducts/vents) 54.91
Suite /bldg. /apt. no.: I Project none Dorr /46643 Heat pump
Duct work 23 32
Crush street/directions to job site: Hydronic hot water system 23.32
Residential boiler (radiator ur
_ hydronic) 23,32
Unit heaters (fuel -type, not electric),
. in -wall, in -duct. suspended, etc, 46 75
Flue/vent for any or above 23.32
Subdivision' Lot no.: Other. 23.32
—
' Other file! appliances:
Tax map /parcel no.: Water heater 23,32
,• i' '�i i ?,i iP ;'1�'ll " '; , I i i; II ' i '') ( ' i l ' ���, �, 1:'ri 1 ' '�Ijl,'I ?i,;;1i "' ; i j ,m.i I ,;� .,ii ; ,� ,,, � �-
�
h' ? I ., ? ; M,,l;''ni,i -i'i ,i,l';T1Ii09 41?f1 0i �ai�1' i6 !'i ,''1'�''li'i,i;:,l it I4 ' iiik :!1,',), I Gas fireplace/insert 33,39
'1 ;, '' ' , art ,'''�I''li ,r ,r, '1' Ij (i•''''' ' i'„'I I'1,11, ,, Flue vent for water heater or 6nS
installation of electric furnace ;Intl heat pump fireplace 23.32
Loa lighter ay T_ 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23,32
Chimney /liner /flue/vent 23.32
��� `
1i 'Ji'i`li� R� � 'y , Tx' t�, kJi�'; { Il,iil filllij , 'iill r a 'l(;`i;'1i�1! IIIiiIH 'a1,11i1!I „ji1 „�,. 1 , I' �, r , I d ;;1'iljii %I i' -, ll,i Other: 2332
i � a � �1,(�i,,• I l, ,,,I74 l� ti'illl ∎,,1p,q,Iliiil '' li'''r,'{ Environmental exhaust and ventilation
' Name: Kathy Dm•r Range hood /other kitchen
Address: 10875 SW North Dakota St equipment _ 33 39
Clothes dryer exhaust 33.39
City /State /ZIP: Tigard, OR 97224 Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23 32
Phone: (503)639.5037 Fax: ( ) Attic /crawlspecc fans 23.32
;''„ I l, A.PY T' :16;;t;i,i; i',;fli-i;:l, I ,; E] i;l , T�� .,li ,( ap n',,,, i l ' ' ,, ', lp Other 23,32
Business name: Roth !fettling and Cooling Fuel plpinp
$14.15 for first four; 54.03 for each additional
Contact name: Angela McGraw Furnace, etc,
Address: PO Box 1265 Gas heat pump
Wall /sus .ended /u nit heater
City /State /ZIP: Canby OR 97013 ,,_ _ Water healer
Phone' (503) 266 -1249 Fax: (503) 266 -3478 Fireplace
W
Range
E -mail: angelnmQa Toth- hcat.com
Barbecue
6 •' 1111 11 „'I; i'll ,, ��I
,�I, R,rh,,'ll',{b ;''' ,11, ■' •'i 'il1 ; ;d '; i' i,`I Clothes dyer l ', ,��� *� 1 I of , ' i �,l U
' ' I` q , I i; i I' 1 ilf "1;11!''1,1 i I' , I ;
, I I l' ,
I I h I II yer (gas)
I`
Business name: Roth healing and Cooling Other,
• Address: 1'O Box 1265 W ' iii, ':1jl�li�iNII,j�lj�'I�l� ?I',il , 14001!4N14`�q;l 1101 '1 !Okili ,1 `1flt'`dr1�. 9
Subtotal
City /State /ZIP: Cunhy OR 97013 Minimum permit lee ($90.00) ,/
hone: (503) 266 -1249 Fax: (503) 266 -3478 Plan review (25% of permit fee) �A 7
State surcharge (12% of permit fee) 0
CCU tic.: 14008 TOTAL PERMIT F >,ae -Jttr ---
This permit applicalitm expires if n permit is not obtained within 1;11
days after it has been accepted as complete. /� ' v /
Authorized signature: • Fee methodology set by Trr- County Building Ladeshy Service Board
Print name: Angela McGraw Date: 6/21/J3 �'Of�►
I\Buddmg \Perntlte \MEC Purm,tApp_NeiII3dor 440 /0 /COM1wEB)