Permit CITY OF TIGARD MECHANICAL PERMIT
111 1- e COMMUNITY DEVELOPMENT Permit #: MEC2013 -00408
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/18/2013
Parcel: 2S104BB04000
Jurisdiction: Tigard
Site address: 14060 SW LIDEN DR
Project: Cassity Subdivision: CASTLE HILL Lot: 27
Project Description: Install A/C. Placement of NC or heat pump units must comply with the manufacturer's clearance requirements.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: CASSITY, LORI A
19300 SW 118TH AVE 14060 SW LIDEN DR
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503 -691 -9699 PHONE: 503 - 579 -6114
FAX: 503 -691 -8556
FEES
Specifics: Description Date Amount
Air Conditioning 07/18/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/18/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 07/18/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: /S Permittee Signature: eN / )
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Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection. •
Jul. 17. 2013 1:19PM No.0193 P. 1 .
Mechanical Permit A lie EnTCD FOR �lhhlt,r. USE ONLY
City of Tigard • 11VV �� D ate z � �-/� Permit
N.....- 4
SW Hall Blvd., Tigard, OR 97223 aiel$y: / f 3 lT 0/3���e O
Phone: 503.718.2439 Pox so3.598.1g L 1 2013 p Review Other Permit:
TLUAl:l] Inspection Line; 503,639.4175 IhteReady/By: W !� See Page lfor
Internet; www.tigard- or•gov CI. OFTIGARD NotifiedMlethod: Supplemental Information
BUILDING DNISION _
TYPE or, WORK : _'.. FEE+ SCHEDULE , - USE CHECKLIST.::
Mechanical permit fees` arc based on the value of the work
❑ New construction X4ddition /alteration/replacement performed, Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials, equipment, labor, overhead, and profit.
Value: $
• C CONSTRUCTION •
Iiitl- and 2- family dwelling ❑ CommerciaVindustrial ❑ Accessory building For specialln,fornrarlon rise checklist
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ea. ' Total
JOB S;iTP II■FORlifATI0,1 : AND LOCA'X'IO l ' Hen att (cooling:
Air conditioning r r 46.75 '
I e-g _
Jab site address: / 510C 0 V r h/ eji/e A-, Furnace 100,000 BTU (duets/vents) Y 46.75
/ ar
City /State /ZIP: 02 f1 . X27 Furnace 100,000+ BTU (duets/vents) 54.91
fL arr < Heat pump 61.06
Suite/bldg. /rpt,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 , -
•
Fluc /vent for any of above 23.32 -
Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
DESCRIPTIQI' OF WORK .. a� fireplace/insert 33.39
_ � r- � Flue vent for water heater or gas
_ ,.J h al-a ii '4' C7r4r4'+ar769*- 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
PItOPE)I TY OWNER: J ❑ .TE11AN ,. Environmental exhaust and vendlat
Name: j ...4 , r; Casff/ Range hood/other kitchen
equipment 33.39
Address: Ay06 Q s / i1,,,r 1, Clothes dryer exhaust 33.39
City /State/ZIP: / ur i/ j C i ' I' 7227 Single -duct exhaust (bathrooms,
toilet compartments, utility lity rooms) 23.32
Phone: 0 3) 7 C Fax: ( ) Attic/crawlspacefans 23.32
®.APPLICA10',:. . . ❑ CONTACT1PER dN Other: 23.32
Fuel piping:
Business name: Op, 0., HczQ , S14.15 for first four; $4.03 for each additional
Contact name: Furnace. etc.
per �a�j Gas heat pump
^Address; I /JOo ,ph, 40 Ave Wall /suspended/unit heater
City/State/ZIP; n,[ fbai oR q 7 0C2 Water heater
Fireplace
Phone: (cog ) G9l- TG yf Fax: : ( ) Range
E -mail; Barbecue
CONTR.&CT 1R ,: Clothes dryer (gas)
Business name; Qj /�_ Other:
P_ ,r, ke_vM ' kicaANICAI Weitur F E§.
Address: //,70 0 sly /jy 4ve - Subtotal 1.l. City /State/ZIP: �,,I - „„ 9 .,OC,2 Minimum permit fee ($90.00) �o.�_
f Plan review (25% of permit fee)
/Phone; (6 ) c<l ycyf _ Fax: ( ) State surcharge (12% of permit fee) O. - 0 /
CCB lie.: / 7.. / 2 s J TOTAL PERMIT FEE /too 0 -
This permit Application expires if a pm -mitto not obtained wail tin 180
days after it has been accepted as complete.
Authorized signature: C . 1 , . • Fee methodology set by Tai- County Building industry Service Board
Print name: mlr (1 AL—, _ / ,,,, I Date: r,- tw,,q,T