Permit CITY OF TIGARD MECHANICAL PERMIT
III I _. COMMUNITY DEVELOPMENT Permit 4: MEC2013 00389
T is GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/15/2013
Parcel: 2S 111 AA05900
Jurisdiction: Tigard
Site address: 8987 SW GREENSWARD LN
Project: Dressel Subdivision: GREENSWARD PARK NO.2 Lot: 45
Project Description: Replace existing A/C. Placement of NC or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: L & J HEATING & COOLING Owner: DRESSEL, LEONARD W /GAYNELLE J
898 N BIRCH ST 8987 SW GREENSWARD LN
CANBY, OR 97013 TIGARD, OR 97224
PHONE: 503 - 263 -4663 PHONE: 503 - 639 -0100
FAX: 503 - 263 -1896
FEES
Specifics: Description Date Amount
Air Conditioning 07/15/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/15/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 07/15/2013 $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: Permittee Signature: ` U
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.
Mechanical Permit A licati FOR OFFICE USE ONLY
City of Tigard WINED Date/By: /_5 /3 v ►' Permit N.
;� ° 13125 SW W Hall Blvd., Tigard, OR 97223 C.20 /3 — 00_5 '�
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 j I it 1 5 , 013 Date/By: Other Permit:
I I G n R D Inspection Line: 503.639 Date Ready/By: luris See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
[ �
TYPE OFC]]I�T�YWOAK TIGARD 1� GDIVISION , . COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees" are based on the value of the work
❑ New construction 0 Addition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
. Value: $
CATEGORY - OF CONSTRUCTION • RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. I Ea. Total
. JOB SITE INFORMATION AND LOCATION Heating/cooliog:
' Air conditioning 46.75
Job site address: F9 g 7 svJ 4,, 6, �S VrJ N � 1 Furnace 100,000 BTU (ducts/vents) 46.75
City /State /ZIP: 7 - 7 ,,,„,1 G (y . 1,, q -7 l d 2 Furnace 100,000+ BTU (ducts/vents) 54.91
Heat pump 61.06
Suite/bldg. /apt. no.: Project name: Duct work 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, etc. 46.75
Flue /vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace /insert 33.39
R ^ C S �� . c _ , Flue for water heater or gas
ef � � 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
Environmental exhaust and ventilation:
Name: ( ( ) iroSSC. f Range hood/other kitchen
Address: �y J �� ,,, r equipment 33.39
r7f q ] 7 ✓'t 6 GC/, /4)a/ Clothes dryer exhaust 33.39
�� `
City/State /ZIP: rvv t J [ 4 2 z 1 ({ Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
Phone: ( 5-03) ID 3 C - 6/00 Fax: ( ) Attic /crawlspace fans 23.32
❑ APPLICANT h . w Q a� (pro ,
❑ CONTACT PERSON Other: 23.32
Business name:
p[ `� �J �'1'C�Gt�( l/ L �pt Fuel piping:
f ^ f $14.15 for first four; $4.03 for each additional
Contact name: i aN £C ��\` Furnace, etc.
Address: G� I A L. a ` Gas heat pump
/ N ` or-,,,,, r Wall/suspended/unit heater
City/State /ZIP: (2 ( 7- i ' ?0 /3 Water heater
Phone: (04) j_63 w Cf` 1 � n 3 r Fax: : ( s�� 63 — f gF6 Fireplace
7Ud t(C Range
E -mail: Barbecue
'. • CONTRACTOR Clothes dryer (gas)
Business name: �35– Other:
MECHANICAL PERMIT FEES"
Address: Subtotal 9 ,
City/State /ZIP: Minimum permit fee ($90.00)
Plan review (25% of permit fee)
Phone: ( ) Fax: ( ) State surcharge (12% of permit fee) /e) , ?el
CCB lic.: /_ 7 GST Q 9w?9A3 • TOTAL PERMIT FEE X40 , e r- - 0
Ya/1--V .,
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: �. • Fee methodology set by Tri -County Building Industry Service Board
Print name: r Z D - 1,_ R c k c i_e,----- Date: -7 _ S - /3
I:\ Building\Permits\MEC_PermitApp_ 0 1 U.doc 440 (11 /02/COM/WEB)
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