Permit CITY OF TIGARD MECHANICAL PERMIT
'`1 a ' - COMMUNITY DEVELOP Permit #: MEC2013 -00391
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/16/2013
Parcel: 1 S125CAl2300
Jurisdiction: Tigard
Site address: 7415 SW CEDARCREST ST
Project: Johnson Subdivision: 2008 -030 PARTITION PLAT Lot: 1
Project Description: Install a /c. Placement of a/c unit must comply with manufacturer's clearance requirements.
Contractor: ROTH HEATING & COOLING Owner: JOHNSON, MICHAEL WAYNE
PO BOX 1265 7415 SW CEDARCREST ST
CANBY, OR 97013 TIGARD, OR 97223
PHONE: 503 - 266 -1249 PHONE: 310- 651 -8760
FAX: 503 - 266 -3478
FEES
Specifics: Description Date Amount
Air Conditioning 07/16/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/16/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 07/16/2013 $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 Notific- - - ter. 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 • estions to O C by calling 503.232.1987 or 1.800.332.2344.
Issued =y: / �. Permittee Signat
L���"� wit// i .Ii171�/�a
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 -11 -2013 THU 10:51 AM ROTH HEATING FAX NO. 5032663478 P. 01
Mechanical Permit ApplicatiRECEIVED FOR OII''ICL USE' ONLY
aeReceived 7
lit, City of Tigard Date/By, : Permit No,: M& /5 ,O 39
• 13125 SW Hall Blvd„ Tigard, OR 97223 JUL 11 2013 ply Review
II ' Phone: 503.718.2439 Fax: 503.598.1960 Other Permit,
Inspection Line: 503.639.4175 Dat�dy,
T16 A IZ t' CITY OF TIGARD Date Ready/By: Jurle: 0 See Page 2 far
Intranet: www.tigurd- or.gov Notified/Method: Supplemental Infor'mtrtion
BUILDING DIVISION
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Mechanical permit fees* are based on the value of the work
❑ New construction in Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
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1- and 2- family dwelling 0 Commercial /industrial ❑ Accessary building For special Information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea, Total
UN R1Tl: F< *. IrXQ ',; S.1 '1(10f1'70)iig' I ∎ �,I q , li/:ating /cooling:
Air conditioning 1 46.75 46.75
lob site address: 7415 SW CethtrcrcAt St Furnace 100,000 BTU (du huts lanais) 46.75
tlifi City /Slate /ZIP: Tigard, OR 97223 Furnace 100,000+ BTU (duets/ventsl 54.91
Ileat pump 61.06
Suite/bldg./apt. no.: Project name: Johnson /46647 Duct work 23.32
Cross street/directions to job site: Iiydronic hot water system 23.32
Residential boiler (radiator or
hvdronic) 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
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a Gus fire ,39
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Flue vent for water heater or gm'
installation of air conditioner fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner /flue/vent 23.32
a i l , . Otter: 23.32
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° ' ' ' ' ' �' ` ' ' " �" " ' Environmental exhaust and ventilation:
Name: Michael Johnson Range hood /other kitchen
equipment 33.39
Address: 7415 SW Cedurcrest St Clothes Cles dryer exhaust 33.39
City /State /ZIP: Tigard, OR 97223 Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
Phone: (310)651 -8760 Fax: ( ) Attic /crawlspacc fans 23.32
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Business name: Roth Heating and Cooling Fuel piping:
S14.15 for first four; $4.03 far each additional
Contact name: Angela McGraw Furnace, etc.
Address: PO Box 1265 Gas heat pump
- Wall /suspended/unit healer
City/Slate/Z1P; Canby OR 97013 Water healer
Phone: (503) 266 -1249 Fax: : (503) 266 -3478 Fireplace
Range _
E -mail: angelam@rotlt- heat.com Barbecue
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• Business name: Roth Heating and Cooling - lothes dryer (Other:
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Address; PO Box 1265 Subtotal 46.75
City /State /ZIP; Canby OR 97013 Minimum permit fee ($90.00) 90.00
Plan review (25%ofpermit fee)
Phone: (503) 266 -124 Fax: (503) 266-3478
_ State surcharge (12% of permit fee) 10.80
...____
CCB lie.: 14011 L S TOTAL PERMIT FEE 100.80
This permit application expires It a permit is not obtained within 180
days after it hits been accepted as complete.
Authorized signs Y!1 ` a , ) " Foe methodology set by Tri- County 13ulldlog industry Service 13onrd
Print name: An _ ela M P ' w a Date: 7/11/13
I 'Iaullahtg 1X1111 IM12C PergriIApp_04011J.doc 440.461TT(11 /02/COM/W13H)