Permit CI OF TIGARD MECHANICAL PERMIT
�. COMMUNITY DEVELOPME Permit #: MEC2013 -00364
Date Issued: 07/02/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S134DC07800
Jurisdiction: Tigard
Site address: 11720 SW GALLO AVE
Project: Martini Subdivision: GALLO'S VINEYARD Lot: 9
Project Description: Installation of gas furnace and A/C. Placement of NC or heat pump units must comply with the manufacturer's
clearance requirements.
Contractor: ROTH HEATING & COOLING Owner: MARTINI, PETER
PO BOX 1265 11720 SW GALLO
CANBY, OR 97013 TIGARD, OR 97223
PHONE: 503 - 266 -1249 PHONE: 971 -409 -9209
FAX: 503 - 266 -3478
FEES
Specifics: Description Date Amount
Air Conditioning 07/02/2013 $46.75
Type of Use: SF Furnaces < 100K BTU 07/02/2013 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 07/02/2013 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
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: oN' PjO�,J�ON
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.
JUL -02 -2013 TUE 03 31 PM ROTH HEATING FAX NO. 5032663478 P. 01
Mechanical Permit AAAAApplicatl i ECElVED r`oli l)rricy1lsh: ONLY
City Tigard R.
hr g JUL 2 2013 oata/ey: 7 :.� , _,' 1,itNo., - , //i I _ 4
n 13125 SW Hall Rlvd., Tigard, OR 97223 Plan Review
8 Phone; 503.718.2439 Fax; 503.598.19 nCT n np� Dare/By: Other Permit:
• 1 . 1 i 0 A a D Inspection Line: 503.639.4175 C ITY OF 1 IGAf1D Date Reidy /6y; 0 See Page 1 for
Internet: www,ligard -or. gov BUILDING DtVIStOPI Notified /Method: Supplemental Informat
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�' � ecltanical permit ed an 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,
�;.;.lslhr;r;r';' s'1 lili Value: $
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® 1 -and 2- family dwelling ❑ Commercial /industrial 0 Accessory building For special In onnati'on use checklist
❑ Multi - family ❑ Master builder ❑ Other: Description 7 Qty. Ea, I Total
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Air cunditianin;L„_
Job site address; 11720 SW Gallo Ave _Furnace 100,000 BTU (dam/veins) 1 46.75 46.75
City /State/ZIP: Tigard, OR 97223 Furnace 100,000+ BTU (daces/vents) 54,91
Heat pump 61,06
Suite/bldg. /apt.no.; Project name: Martini /47283 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, c. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision; Lot no,: _
Other fuel aitpliauces:
Tax map /parcel no.: Water heater 23.32
33.39
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',�+ti�! ail ,)";' fireplace /insert -
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I � 1, ' 1 ,.r I ,i+ ) Flue vent 1 "or water heater or gas
installation of gas furnace and air conditioner fireplace 23.32
Log lighleras) 23.32
- Wood/pellet stove 33,39 -
Wood fireplace /insert 23.32
Chimney /liner /flue/vent 23.32
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2332
�,
„p J �,i %d�!1{; QR?dVl� l� �,II''� ' ll) , ?.l L +'L �l I ; ... ; 1,1 Tnv exhaust and ventilation:
Name; Pete Martini Range hood/other kitchen
equipment 33.39
— -
Address: 11720 SW Gallo Ave Clothes dryer exhaust - 33.39
City/State/ZIP: '1'igt +rd, OR 97223 Single -duct exhaust (bathrooms,
— — toilet compartments, utility rooms) 23.32
Phone: (971)409 -9209 Fax; ( ) Attic /crawlspace fans 23.32
w ,1. Il a ,. „):, 14 ;i ''' � "' I'I ii,il 23.32
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Fuel piping: _
Business name: Roth beating and Cooling 514.15 for first four; 54.03 for each additional
Contact name: Angela McGraw Furnace, etc. _
Gas heat pump
Address: Po Box 1265 t
Wall /suspended/unit heater
City /State/ZTP: Canby Oil: 97013 Water heater _ . -
Phone: (503) 266 -1249 Fax: : (503) 266-3478 Fireplace
Rang
E -mail: angelum@roth- beat.com Barbecue
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4” 'I''I:ii:ii -'i` ? ;i r "i:1: ?i,.k �' 1 if'lir l l l'.I ' l "i :', ,�. "I: :ii : I, u:: r Clothes d e osl
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Business name: Roth Heating and Cooling . Other.
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I fir, l' ! i ∎ter r'I i 1 I�n. X00 IY1lIr 01040 '� t4 41! ' 0, I trill' c) !'lh'I
Address: PO Box 1265 Subtotal 93.50
—
City /State/Z1P: Canby OR 97013 T� Minimum permit fee ($90.00)
Plan review (25% of permit fee)
Phone: (503) 266 -1249 Fax: (503) 266 -3478 State surcharge (12% of permit tee) 11.22 -
CCB lie,: 14008 TOTAL PERMIT FEE 104.72 ‘./
This permit application expirla if a permit is not obtained within ISO
days after it has been accepted in. complete.
Authorized signature: • Fee methodology set by 'Fri-County Building Industry Service Board
Print name: Angela McGraw Date: 7/2/13
l: \au Udine \Pernamac_remaAPP_040113.00 440-4617r (1 /01/COM/Wea)