Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00413
Date Issued: 07/18/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 2S111AD14000
Jurisdiction: Tigard
Site address: 15035 SW 91ST. AVE
Project: Miller Subdivision: MALLARD LAKES Lot: 6
Project Description: Installation of electric furnace and heat pump. Placement of A/C or heat pump units must comply with the
manufacturer's clearance requirements.
Contractor: ROTH HEATING & COOLING Owner: MILLER, CONNIE M
PO BOX 1265 15035 SW 91ST AVE
CANBY, OR 97013 TIGARD, OR 97224
PHONE 503 - 266 -1249 PHONE: 503 - 318 -4807
FAX: 503 - 266 -3478
FEES
Specifics: Description Date Amount
Fumaces < 100K BTU 07/18/2013 $46.75
Type of Use: SF Heat Pump 07/18/2013 $61.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 07/18/2013 $12.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.75
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: e—� Permittee Signature: CA) -70jO _/ e / /®.1
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 -18 -2013 THU 11 31 AM ROTH HEATING FAX NO, 5032663478 P. 01
•
Mechanical Permit Appli �' of Tigard r012 OF , ii 1s oNIA' D v i ,y t FIVE ,� Pcmut
Datc/By; /3 — DO y,,_.5 , . ° 13125 SW Hall Blvd., Tigard, 0
Plan view
C ' . Phone: 503,718,2439 Fax: 503.598.1 Other Permit:
,�l nt
D
TI GARp I11spectionLinc: 503,639.4175 1 8 2 013 Date R y:
Ready /By: obis; 61 See Page 2for
Internet: www.tigard -or.gov Notified/Method: .. . Supplemental Information
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' Mechanical permit fast' are bused 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, and profit.
a ?Iq. t1.r� � ,,. .. ,. .I,,. 16idClll�.1'I' ?Ji:'I• ?%
Value: '
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�1Tty1, 1 c-o'4 I I .
LEI- and 2-family dwelling ❑ Commercial /industrial ❑ Accessory building For special irtJOrmarlon use checklist,
❑ Multi- family ❑ Master builder ❑ Other: Ucscriplion ! Qty. I Ea. I Total
.,.,. 1,.,I., ;.;,it::l;::;•;i:',ii � , iiii „�,. ,.�,,, �., ,,. Flit: ;q •:;;∎ ;;; ;P'i'll; Heatii /cuolici
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Air wndinanmF ! 46.75
Job site address: 15035 SW 91" St Furnace 100,000 BTU (ducts/vents) I 46.75 46.75
City /Stale/ZIP: Tigard, OR 97224 Furnace 100.0001- BTU (dm:Is/vents) 54.01
Heat pump 1 61.06 61,06
Su ite /hldg. /upt.no.: Project name: Miller/48043 Duet work 23.32 _
Cross streeUdirections to jab Fite: Hydronic hot water system 73,32 _
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall. in -duct, suspended, etc. 46.75
Flue/vent fnr any of above 23.32
Other. 23,32
Subdivision: ' Lot no.:
Other fuel appliances:
Tax map /parcel no.: Water heater 23,32
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,, ;. ' 'I: "9 ) r:d:; ", }I:fi'; I!`,
:, { i' :,;ii +i; dii," ',i ll Gas �;;� fireplace/insert 33.3
! DCS( dZlX' h101y A, W '„� ..a, . ' : l I l I I ru. „'
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Flue vent for water heater or gas
installation of electric furnace and heat pump fireplace 23.32
t oklighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimn /liner /flue/vent 23.32
• :';,ni;d: : •'.•�„ • .. r�,,.,..... ,I } 1 � ;; ;i:; : i `; :' ,1 ';i 1!'; y ,, '':j • , ;;T l ;;,!; 33.
Other
J I;�;::l R, ..AF,R'1 "l]W;.NE1 h i,;'t' , Si, , .;!, ; I, Il i! J•, i i,r,,r t�f :'il ' : , I !hd III_ Enorunmcntal exhaust and ventilation: _
Name: Connie Miller Range huud /other kitchen
equipment 33.39 -
Address: 15035 SW 91 St Clothes dryer exhaust 33,39
Single -duct exhaust (b
City /State /ZIP: Tigard, OR 97224 ad,roonms,
toilet compartments. utility rooms) _ 23.32
Phone: (503)318 -4807 Fax: ( ) Attic/criiwlspace fans 23.32
23
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A , P.,.....,' ; !.ii' ^1h' 'r;: r E' d4 , O
Business name: Ruth 'rl ,,., „ ,.,.
Healing and Cooling Fuel piping: ,�
usiness
$ 14.15 for first four; $4.03 for each additional
Contact name: Angela McGraw Furnace, etc.
Address: PO Box 1265 Gas heat pub
Wall /sussided /unit heater
City /Stale/ZIP: Canby, OR 97224 Water heater _ _
Phone: (503) 266 -1249 Fax: : (503) 266 -3478 Fireplace
Range
E -mail: tingclaml roth- heat.com Barbecue
, , : :;• : :., ,,,...,, ! ;:1 ?•! •••;;,,,!,,� „ae :i •.,�, ,.� ,:.c ;i1 :1:: ;iii :; .. ;li
i�'f:';1i;l ';I ::I ;:;
/ a y i J
, t �O�TRAC.' ? RI I I I I I I ! , I ; . I i , ` Clothes dryer (gas)
Other:
Business name. Ruth Heating and Cooling t l1i1; P , ' ' ' ' : i ', ' ; ” r.
- I I' l , , i' b[N�N�.�'rnfikTlr+'rr�� I ,�, ;, i, , , ,
Address: PO Box 1265 Subtotal 107,81
City /State/Z1P: Canby, OR 97224 Minimum permit fee ($40.00)
Plan review (25% of permit fee)
Phone; (503) 266 -1249 Fax: (503) 266 -3478 State surcharge (12 %ofpermit fee) 12.94 /
CCH lie.: 14008 l TOTAL PERMIT FEE; 120,75
pplication expires if a permit i6 not obtained within 180
` • 1 This permit a days aftor it has been accepted as complete.
Authorized signutur^ �.�.� • , i ` i 1 .— • Fee mti.hodology set by Tri- County Building Industry Service Board
Print name: An . / • raw ■ Date: 7/18/13
1 : \Otnidh,a4'enniwWC PanniiApp O110II 440.4617T(II /02/COM/Wla)