Permit q CITY OF TIGARD MECHANICAL PERMIT
1, .....
... COMMUNITY DEVELOPMENT Permit #: MEC2013 -00393
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/16/2013
Parcel: 1 S133DC00505
Jurisdiction: Tigard
Site address: 11655 SW WINTERLAKE DR
Project: Myers Subdivision: ASH VALLEY TRACT Lot: 5
Project Description: Install a/c. Placement of a/c unit must comply with manufacturer's clearance requirements.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: MYERS, STEPHANIE & KELLY
19300 SW 118TH AVE 11655 SW WINTER LAKE DR
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503 - 691 -9699 PHONE: 760 - 694 -7485
FAX: 503 - 691 -8556
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 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. D P ermittee Signature:
me_°
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 1:13PM No. 0133 P. 1
Mechanical Permit ,Applic • l Olt OFFR USE ONLL gealei - 3
Ci ofT CEIVED Dael8y 7 IB ! Fe''' Al
y 13125 S W Hall ]31Vd., Tigard, OR 2 Plan Review
Date/By; I III
' Phone: 503,718,2439 Fax: 503.598.1960 JUL 11 2013 Other Permit:
T I GAKL1 Inspection Line; 503.639 Bate Ready/By: mr :: El See Page 2 for
Internet; wvvw.tigard- or.gov ��{ CITYOFTIGARD Notified/Method: Supplemeo tat rnformattoa
T F E t Y.'(flt
• YP .QING DIVISION .: Fq r
,.. lRCTAL FEB* FEE* SCULE,7 USE.CiiECitLr.&T,
• Mechanical permit fees' are based on the value of the work
0 New construction At Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other; mechanical materials, equipment, labor, overhead, and profit
Value: $
CATEGOYiY' ,Qi ., 'CON ; •
Rs>DfvlA. "Qii>iyisNri ssr1►�s l�i�s�
'1- and 2- family dwelling El Commercial/industrial ❑ Accessory building For special1fornrarton use checklist._
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. I Total
JO °iavv ATXQ1 �I,; ANp 11:O Heating/cooling:
• .. " 0 Air conditioning 1 _46.75 Zi . 7.5
Job site address: //'. 5 � i ,. -. Furnace 100,000 BTU (duots /vonts) 46.75
/ /pity/State/ZIP: 7 a � 7 f ' f 7Z,2 Furnace 100,000+ BTU (duolslvenls) 54.91
U ' "y Heat pump 61.06
Suite/bldg./apt. no.: Project name: ye / D uct 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 abovo 23,32
Subdivision: w Lot no • Other: 23.32
Other fuel appliances:
Tax map /parcel no.: Water heater , 23.32
DESCRIPTION OF wow( . Gas fireplace/insert . 33.39
"' Flue vent for water heater or gas
_... 7(4_f 11 /41) -- C.- Ii✓+)e►or- 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
�PROPEItT9 OW IER: El TEWiiNT Environmental exhaust and ventilation:
Name: �� // Al
e.4" Range hood/other kitchen
J equipment 33.39
Address: // c L. i , „„. take. d,,- Clothes dryer exhaust 33.39
City/State /ZIP: 779 a, J b� 9 2.
f Single duct exhaust (bathrooms, ,
toilet compartments, utility rooms) 23.32
Phone: ( u) C Li_ 7 yK Fne: ( ) Attic/crawlspace fans 23.32
® APPLICANT- , ❑ CONTACT. +P Other: 23.32 _
Fuel piping:
Business name: Q!` a. 514.15 for first four; 54.03 for each additional
Contact namo: t k c. . a //r104 Furnace, etc.
Address: //360 SK, f L6 dye Gas heat pump
Wall /suspended/unit heater
City /State/ZIP: l ciat �, p (e _ 9 7 0C2 Water heater
Phone: (; a ) P ax:: ( ) Fireplace
3 G9 / 96 Range .
E -mail: Barbecue
ONTZACTQR : Clothes dryer (gas)
Other:
Business name; (�i" N C g F>n ' 1NE'C /S MCAT, iRRIKIT Fkg.S'
Address: �93p ,S w JI Ave Other:
z 7a
City/Slate/ZIP: � Minimum permit fee ($90.00) .70
y 1 on 9 o6z
/ G4 °r' "' Plan review (25% of permit fee) /
Phone: (5-03 ) Gl f,,. ?6Y9' Fax: ( ) State surcharge (I2% ofperm
CC13 lie.: i 1 2 G TOTAL PERMIT F'Et• ( b . Teo
- This permit application expires if a permit is not obtained with 180 04....„ V
days atter it has been accepted am complete.
Authorized signature: , ---' • Fee methodology set by Tri- County Building Industry Service Board
Print name: a w l • ,h, �,, Date: ssy�y /a