Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00368
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/08/2013
Parcel: 1 S135DB07100
Jurisdiction: Tigard
Site address: 11320 SW 94TH AVE
Project: King Subdivision: O'NEEL ACRES Lot: 11
Project Description: Replacement of a/c unit. Placement of a/c must comply with manufacturer's clearance requirements.
Contractor: A TEMP HEATING & COOLING INC Owner: KING, DOUGLAS A
16000 SE EVELYN ST 11320 SW 94TH AVE
CLACKAMAS, OR 97015 -9519 PORTLAND, OR 97223
PHONE: 503 - 650 -5014 PHONE: 503 - 320 -1735
FAX: 503 - 557 -2990
FEES
Specifics: Description Date Amount
Air Conditioning 07/08/2013 $46.75
Type of Use: COM 12% State Surcharge - Mechanical 07/08/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 07/08/2013 $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 qu ions to O C by callin. 503.232.1987 or 1.800.332.2344.
Issued y: / P ermittee Signatu `� �l�J��j
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.
•
07/03/2013 14:17 5035572990 A TEMP HEATING PAGE 01
Mechanical Permit AnnlicRiCEIVED 011.1( F. List oNi ■
City of Tigard Received
By: 7011111Wil e A 5 36 q
13125 SW Hall Blvd, Tigard, OR 97223JUL 3 2013 Datc/ -of/
Pion Review vfmat Ne ye ei/ -00
IpL Phone: 503.718.2439 Fax 503.598.1960 Dotemy: other Permit:
inspection Line: 503.639.4175 CITY OF TIGARD Date Rendy/By• awls: li5 Sec Page 2 far
Internet rfrtw,tigard-or,gev mitineducchnu: Supplement:it inrormanon
BUILDING DIVISION
:: :::. 7. ': :•;*.,.:_:;,.. .- ' :. .:'::::,:., ,..:,. :,,': !: :-. .-: : ::::: :.:....,,;-,; :.,..... : 4::10, , 2::'
0 New construction Iti Addition/alteration/replaceinesit performed. Indicate the value (rottrided to the nearest dollar) of all
El Demolition 0 Other: _inoctianical materials. equ labor, overhca and profit.
Value: $ rx
. . • - - - - - 7.7 - ,, , •
' .:, . '' :. : : : ■ ' ' . : ' i : . : cArfr..P9Mi 9 r 'C4:11Sir:EttOWN:: ... ::::. ': , . :' ' ' ' : .: : ::: .',., -77.' '': .. it:„S '-'....teitiktriAti. • - TAME' :Ayijusitiit . - '
gi I- and 2-family dwelling 0 Commercial/industrial 0 Accessory building For rpecial Winona/ion sue thecklisi
0 Multi-family 0 Master builder 0 Other Description j Qty. I En. I Total
1 .. ':', : -• -: ., : 911.44-11.0.9a1SIAP.'ArP- 1 : : : •
Air oanditiotung•
Job site address; / I 2 s• t 1.1-1 Av -: _ di(M1 Sit0 plftn &otos pi memos) _1 .... _ , __±1t ......
Furnace 100,000 BTU (duns/vents) 46.75
City/Stec/ZIP: c g , q722 3 Pomace 100,000+ 13TU(ductvvents) 54.91
Suite/bids/apt. no.: Project name: K' :21 Heat pump
'tos site Ian sh ' imcnivajw,2_,_... 61.06_
Cross stmt./directions to job site: Duct work 23.32
.e hot water system 22__
— Residential boiler (rnifirdor or
hydronic) 23.32
Unit healers (fuel-type, not electric),
in-wall in-duct, suspended, etc. 46.75
_ Flue/Vent for any of above 23.32
Subdivision: 1 Lot no.:
Other: 23.32
Tax map/parcel no Other finel appliances:
''' :,::: • : ,':: : - ..: . ' 1': - i .. ..' :::: ::' ''Z'.:.'11•:i*§0)01ftlet)04it OR ' .:•:': .....:::.•-'::: '' :: ::' ''-. :.-,=`.:•;'' . 1 • W ater heat" 2332
i
i C ii Pk 11 Gas fi . lace
Flue vent for water heater or gas 33.39
fireplace 23.32
Log lighter (gas) 23.32
Woodlpellet
stcrilc2?.,32____,
Wood fur.place/inacrt 23.32
- '' .:::[::, • :''j'A':iIit6ttltO:tl•*"Vt::t:::.:' ''':':' :::';': :';'-':.' ':''::',:.:::•'.!. : ' C1:.. :, ,: :'"•■.- '.:::':". ChimnffilMerianetvent ' 23.32
23.32
Name: i QL4 . ik ;la Environmental exhaled and venal/dim:
Address: i 1 20 S .. 4 1' A v • I Range hood/other kitchen.
equipment 33
City/State/ZIP; 1 re
I '‘ . 1 7223 Clothes dryer exhaust 33.39
'
Single-duet
Phone: 601 ) _ 2 _ 1 7 ...‘-- E:SIIEIMIIIIMIIIII induaiirr(bntbmoms
,
toilet compartments, utility rooms) 23.32
4 :0 1 ..al0* 9 0 : : ' '•:` : :: ':. :: '::,.-'•:: .': ‘..i:.:;.!'•,, i;I• I t2:>0 t000ff • ,:: ...:-...:: ..: Aniciarawlspacc funs 2332
Other. 23.32
Business name: ___,
:' ti• . iii, e ... la "!... c A. ! ,.
Contact name: 16000SE Evelyn St $14.15 for first four: $4.03 fist each additional
. , —
Address: Clactaraaa, OR 97015 Furnace, etc.
503-6535014 Gas heat ptunp
City/State/ZIP: . Wall/suspended/unit hotter
Phone: ( ) Fax: : I () ) 6 - D Water heater
. Fireplace
1=r k ' ' - , It : , 0 vs.') Ramo
usittess name: A-173114P HEATT tilDLOOLINallIC Clotho dryer(gas) .
i Other:
Address: 16000 SE Evelyn St. - .
: - ..gtvliateAtrotigt:41W ' "- . :.•::::.-::: : : ,
a ,.1.1 :,..: • • I 11.
City/State/ZIP: ,t . Minimum 1 it (590.20)ii/z.g
Phone: ( ) Fax: (5 D g ) 54,. _I,," 0 Plan review (25% of permit fcc)
CCB lie.; 4. 1,225? State surcharge (12% of permit fee) / Of ft)
TOTAL PERMIT FEE /00 i g',41
Authorized signatle i+_±. This permit application expires it a permit In nnt obtained within ISO I
days after it hes been accented os complete.
[Print name: 15 7 1 : z... v r , Date: 7 3-13 • Fee mathodelan set by Tri-Cnunty Buil Industry Service Beard
TAnuiNnaa \ PeneinAMBC-rerneta.pp.clee nanan 0 110 IT (1 1/02ICOTWWRII)