Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00385
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/11/2013
Parcel: 1 S133CD03800
Jurisdiction: Tigard
Site address: 11704 SW SWENDON LP
Project: Werner Subdivision: COTSWALD MEADOWS Lot: 36
Project Description: Install a/c unit. Placement of a/c unit must comply with manufacturer's clearance requirements.
•
Contractor: OREGON HEATING & AIR CONDITIONING Owner: OLSON, LINDSEY
19300 SW 118TH AVE WERNER, GEORGE
TUALATIN, OR 97062 11704 SW SWENDON LOOP
TIGARD, OR 97223
PHONE: 503 - 691 -9699 PHONE: 707- 599 -2345
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Air Conditioning 07/11/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/11/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 07/11/2013 $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: r Permittee Signature:
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. 9. 2013 5:16PM No. 0100 P. 1
Mechanical Permit A FOR OFFICE. USE ONLY
pp 1 Received 7 / ,✓
City 0 Tigard P N o. : 2 3 f J
13125 S
Blvd., Tigard, 012 977,2 Dale/6y: / 3 �L��l J
1 1 1 11 DO 9 Plan Review
Phone: 503.718.2439 Fax: 503.59 MO a 2 • Date/By: Other Permit:
11C;ARD Inspectio Line: 503.639.4175 Date Ready/By: furi E7 See Page 2 for
Internet: www.tigard•or.gov CITY OFTIGARD Notified/Method: Supplemental Information
. BUILDING DIVISION .
TYpE op, 'VVowc •::.(,0r0ERCIAL FEEi' SCHEDULE — USE CHECKLIST,.'.' .
' Mechanical permit fees* arc 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, aid profit.
Value: S
CATEGO (Y P ..CONSTRUCTION , • .
0'1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other Desc ption Qty. Ba. I Total
•, 1' .- '..1• ORMATI Q AND.' LOCATION' ;:., '`. " Iltatinq/in • �..,
' Air conditioning r / 46.75 r VC
Job site address: r I 0 I St:V � � 1Z , _ Furnace 100,000 BTU (ducts/yenta) 46.75
Ci ty /State /ZIP: 77 n Qp 972 27 Furnace 100 ,000+ BTU (ducts /venta) 54.91
Heat pwnp 61.06
Suite/bldg. /apt. no. Project name: WBti r ... riff a /1 Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler (radiator or
• • hvdronic) 23,32
Unit heaters (fact -type, not electric),
in - wall, in - duct, suspended, etc. 46,75 .
Flue /vent for any of above 23.32
Subdivision: . I Lot no.: Other: 23.32
Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
igs:o iii — iON OF I Gas fireplace/insert 33.39
/�f/ . ' ` ' ' Flue vent for water heater or gas
2 , fy - 4 ff /4 / ✓: Gionrr'f- ia+t fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
Chimney /liner /flue/vent 23.32
Other: 23.32
'- PROPERTY OWNER ❑ .TENANT ., Environmental exhaust and ventilation:
Name: /'� a Worn Range hood/other kitchen
l� Br t d Z , - „, ,f eift
. equipment 33.39
Address: /I T vy f� „ Fi./er7<fo , h 4 o1y► Clothes dryer exhaust 33.39
Cit /State/ZIP: 7
Single-duct exhaust (bathrooms,
y ! jar d Q 7 9 7 2 toilet compartments, utility rooms) 23.32
Phone: (7u. 3 _ 27_4,r5— Fax: ( ) Attic/crawlspacc fans 23.32
El. APPLICANT'.: ❑ CONTACT•P40O Other. 23.32
Fuel piping:
Business name: O1, on rf a i $14.15 for first four; S4.03 for each addlttooal
Contact name: L: a t �f. e, Furnace, etc. L.
Oa heat pump
�
Address: , 7300 Stir 1 1 Ave l Wall /suspertderUunitteeater
City /State/ZIP: rcdaflif o , q ZOc2 Water healer
Phone: (Os ) Fax:: ( ) Fireplace
3 Gql — � yq Range
Email: Barbecue
` 6ONTBA CTQn: Clothes dryer (gas) •
Other: 1 I
Business name: D / „�� +, ea ph �
Address: 19 hfECIIANIICALP)rlZMI [t �S` *.
' Q d S W /�� r� A Subtotal V' G • -I
City/State/21P: /State/ZlP: Minimum pennit fee ($90.00) '� O.
y GA fyt;, 1 Of' 9 Oti Plan review (25% of permit fee) ------
Phone: ($b3 ) CV—. 9Gyq Fax: ( ) State surcharge (12% of pennit fee) / ()
CCB lie.: 1 p 2 r TOTAL PERMIT FEE �,,, a ),
'
This permit application expires tea permit le not obtained wit fitn 150 �""
days after it has been accepted as complete.
Authorized signature : t� `, , / ✓ + Pe e methodology set by I}i County Building Industry Service Board
Print Dame: :; ',",,,,1 �� //,4,aA.. Zr• „1 I Date: ,5-1-2;/.;,70/7