Permit CITY OF TIGARD MECHANICAL PERMIT
11 111 1- 0 . COMMUNITY DEVELOPMENT Permit#: MEC2013 -00362
Date Issued: 07/02/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 1S135CA03600
Jurisdiction: Tigard
Site address: 11289 SW 95TH AVE
Project: Morado Subdivision: GEARHART ACRES Lot: 8
Project Description: Replace existing gas furnace.
Contractor: ABLE HEATING & COOLING LLC Owner: MORADO, SEBASTIAN
16285 SW 85TH AVE #105 11289 SW 95TH AVE
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 579 -2250
PHONE: 503 - 880 -7798
FAX: 503 -620 -3980
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 07/02/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/02/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 07/02/2013 $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: Permlttee Signature: tw - „ e , 1 1- 770 ,1
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.
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Mechanical Permit App !lir: ' 1 EIVED _-
__ __ ..:._ �OR. OFtICL ELSE ONLY
Hall Bl Clty O]TTlgard Received ( - � -
' . :)49.L 0 1 2013 Date/By: �� ��� Permit No
13125 SW vd , Tigard, OR 9
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review
Inspection Line: 503.639.4175
Date/By: Permit TI Ci,a r o n� CITY OF TIGARD Daze Ready,'By:
Internet: wvvw.tiprd- or.gov BUILDING 1 n �( g (�� ®See Page 2 for
BUILDING DIVISION NotilcdNleilmd:
Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST 1
Mechanical permit fees* arc based on the value of the work
❑ New construction ® Addition /alteration/replacernent
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor. overhead, and profit.
CATEGORY OF CONSTRUCTION Value: S
RESIDENTIAL EQUIPMENT / SYSTEMS FEES'
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special Information use checklist
❑ Multi- family ❑ Master builder
❑ Other. r Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address: 11289 SW 95 AVE- Air conditioning 46.75
Furnace 100,000 BTU (ducts'vent5) 1 46.75 46.75
City/State/ZIP: TIGARD, OR. 97223 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no,. Project name: MORADO Heat pump 61.06
Duct work 23.32
Cross street/directions to job site:
Hydronic hot water system .._23.32 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
Subdivision: Other: 23.32
Lot no.:
Tax map/parcel no.: Other fuel appliances:
Water heater 23.32
DESCRIPTION OF WORK Gas fireplace /insert . 33.39
REPLACE EXISTING GAS FURNACE 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 ! ❑ TENANT Other 23.32
Name: SEBASTIA N MORAD0 Environmental exhaust and ventilation:
Range hood/other kitchen 1
Address: ] 1289 SW 95 AVE. equipment 33.39
Clothes dryer exhaust 33.39 •
City /State /ZIP: TIGARD, OR. 97223 Single -duct exhaust (bathrooms,
Phone: (503)880 -7798 toilet compartments, utility moms) 23.32 .
Fax: ( )
Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other.
I 23.32
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Business name: Fuel piping:
Contact name: SI4.15 for first foam S4.03 for each additional
Furnace, etc. ,
Address: Gas heat pump
City/State/Z1P: Wall /suspended/unithcater
Water heater •
Phone: ( ) 1 Fax:: ( ) • Fireplace
E -mail: Range
Barbecue
CONTRACTOR _ Clothes dryer (gas) j
Business name: ABLE HEATING & COOLING LLC Other: l +
Address: 16285 SW 85 AVE. SUITE 105 MECHANICAL PERMIT FEES`
City/State/ZIP: TIGARD, OR. 97223 Subtotal 46.75
Minimum permit fee ($90.00) 90.00
Phone: (503) 579 - 2250 Fax: (503-) 620-3980 Plan review (25% of permit fee)
CCB lie.: 184392 - State surcharge (12% of permit fee) 10.08 r /
t�
-- f - TOTAL PERMIT FEE . 100.08
// This permit appfication expires if a permit is not obtained within 180
Authorized Sigl1nture 1� days after it has been accepted as complete
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I Fe e methodology set by Tri-County Building Industry Service Board
Print name: KELLY ILH ITE I Date: 6 -28-12
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