Permit IN n CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
Pe COMMUNITY MEC2013 -00356
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/01/2013
Parcel: 1 S134DB11200
Jurisdiction: Tigard
Site address: 11326 SW 110TH PL
Project: Bell Subdivision: DAKOTA GLEN Lot: 14
Project Description: Install a /c. Placement of a/c unit must comply with manufacturers clearance requirements.
Contractor: ROTH HEATING & COOLING Owner: BELL, JEFFREY M & JENNIFER K
PO BOX 1265 11326 SW 110TH PL
CANBY, OR 97013 TIGARD, OR 97223
PHONE: 503 - 266 -1249 PHONE: 503 - 639 -3698
FAX: 503 - 266 -3478
FEES
Specifics: Description Date Amount
Air Conditioning 07/01/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/01/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 07/01/2013 $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 Notificati. • - - - . 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 que• ions to OUN .y calling 503.232.1987 or 1.800.332.2344. -44111111 Issued By: r / ` � i / Permittee Signatu =: ,, ,• i
�. ✓iG l - G -- GC— --
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 -27 -2013 THU 11 39 AM ROTH HEATING FAX NO. 5032663478 P, 01
a. Mechanical Permit Applicatior ,Ui FOR OFFICE t!SE ONLY
City of Tigard (P �� Ferran x h c.', . / 3 —oa 5 /
JU 2 7 2013 pme/(iy:
11
't 13125 SW Hall Blvd., Tigard, OR 9722 plan Revi
Phone: 503.718.2439 Fax: 503.598.1960 p a Other Permit:
I" t L A It D Inspection Lisa: 503.639.4175 �BrY p u o�N pnle/Py: � p Ready /By: Juri 0 See Page 2 for
Internet: www,tigard- or.gov BU8 \o qi i 'Neti(er/Met m, SupplemeutalInformation
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Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials, equipment, labor, overhead, and profit.
Value; $
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® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building _ For special Information use checklist
❑ Multi- family ❑ Master builder El Other: Description L Qty, Ea. Total
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Air conditioning 1 46. 46.75 _
Job site address: 11326 SW 110 P1 Furnace 100.000 BTU (ducts/vents) 46.75
City /State /ZIP: Tigard, OR 97223 Furnace 100,000+ BTU (ducts /vents) 54.91
Beat pump 61,06
Suite /bldg. /apt. no.: Project name: Bell/46803 Duct work 2332
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) _ _ 2 ' 3.32 _T—
Unit heaters (fuel -type, not electric),
— in -wall, in - duct, suspended, etc. 46.75
-
Flue/vent for any of above 2132
Other. 23.32
Subdivision: ,Lot no.:
Other fuel a • fiances:
"Tax map /parcel no.: ` Water heater 23.32
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�,'llf,,, .-;i I ,.,, 7 � ] I l i'.11�i�; ;?,: i-! �!'i i�' ( s !'ii • �r,li:fi'lil4'li�l, Gas fireplace /Insert _ 33.39
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`� `' , �.., Flue vent for water heater or gas
installation of air conditioner fireplace 23.32 ,
Log lighter (gas) 23.32 -
Wood /pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
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r'r..•:!,..:I.PR j'l,..,,k,,,,,.l ; ;,i; Ii•'I! la,t.' {', ",, "' Environmental
Name: Jennifer Bell Range hood /other kitchen
equipment 33.39
Address: 11326 SW 110 Place Clothes dryer exhaust 33.39
City /State /ZIP: Tigard OR 97223 Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
Phone: (503)639 -3698 Fax: ( ) Attic/crawlspace fans 23.32
11 ..1pp. S Y . ,;, l I : .I u; y( .. 1 , I;r r;j ;1 Other. 23.32
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Fuel 'bin,:
Business name: Roth Heating and Cooling $14.15 for first four, $4.03 for each additional
Contact name: Angela McCraw Furnacetc. _
Gas heat pump
Address: PO Box 1265 Wall /suspended/unit heater
City /State /ZIP: Canby, OR 97013 _Water heater
Phone: (503) 266-1249 J Fax. : (503) 266 -3478 - Fireplace _
Range
E -mail: angelam( roth- heut.com _Barbecue ,
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Other:
Business name: Ruth Heating nd Cooling T';' ;.r i I ;1, I ,;f;' I ''' 1 1!''1'{ 1 i ; liiM6
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Address: PO Box 1265 Subtotal 46.75 T
City/State/ZTP: Canby OR 97013 Minimum permit fee (590.00) 90,00
Plan review (25% of permit fee)
Phone: (5113) 266 249 Fax: (503) 266 State surcharge (12% of permit tee) 10.110
CCI3 lie,: 14008 'l TOTAL PERMIT FEE 100.80
4 'this permit application expires If a permit is not obtained within 1X0
1 days after it has been accepted as complete.
Authorized si, r I A t 1 r . Fee melliodology set by Tri County' ltuilding industry Service hard
Print name.rMeGra ` J Date: 6/27/13
l\Buualns\Permiis\ iaC rermltnpn_o4ott3.ac 440 -462 Tr (1I/02/COM/WEB)