Permit CITY OF TIGARD MECHANICAL PERMIT
1111 P #: MEC2013 -00423
e COMMUNITY DEVELOPMENT
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/25/2013
TIGARD 13125 2S104AB03500
Jurisdiction: Tigard
Site address: 13367 SW SCOTTS BRIDGE DR
Project: Richardson Subdivision: MORNING HILL NO.3 Lot: 68
Project Description: Replace furnace and A/C. Placement of NC or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: TRI COUNTY TEMP CONTROL INC Owner: RICHARDSON, RONALD R
13150 S CLACKAMAS RIVER DR 13367 SW SCOTTS BRIDGE DR
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503 - 557 -2220
PHONE: 503 - 805 -0934
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Air Conditioning 07/25/2013 $46.75
Type of Use: SF Furnaces < 100K BTU 07/25/2013 $46.75
Class of Work: ALT Type of Const: FlueNent For Any of Above 07/25/2013 $23.32
Occupancy Grp: 12% State Surcharge - Mechanical 07/25/2013 $14.02
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $130.84
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: O /V ' �r) L. / 1 76'1
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 -25 -2013 08:54A FROM: TO:51335981960 P.
E CE II E .I Mechanical Permit Applieati [ , FOR OFFICE ,;, , sr: Liwl.�
City of Tigard JUL 2 5 2013 Received , ,
Ball Blvd., Tigard, OR 97223
Date/B 7 Zj 44 " "P erm i t No.: E� _ _BO to/ 3
I N
® 13125 SW Phone: 503.639.4171 Fax: 503.598. I . Revie
. _.: . Date/By: Other Permit:
Inspection I C n it I) nspection Line: 503.639.4175 r
• Internet: www.tigard -acgov / I . 4ritCA Date Ready/By; See Page 2 for
�.., i _. ! / r . �C�l�►ftl Notified/Method: Supplemental Information I
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USECIIECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alteration/replacement
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
❑ O ther: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
® I - and 2- Family dwelling ❑ Commercial /industrial RESIDENTIAL EQUIPMENT /SYSTEMS FEES"
❑ Accessory building
Multi .For special information use checklist.
y ❑ Master builder ❑ Other:
Description
I Qty. I Ea. I Total
JOR SITE INFORMATION AND LOCATION Heating/cooling
Job site address: I 5(71 V vg ` h id / �°'� Air conditioning
+`�'�!� �P7``�.'' 46.75
City /State/ZIP: g� Furnace 100,000 BT U( duets /vents) 46,15
Suite/bldg. /apt. no.: Project name:
Furnace 100,000+ I3 (duels/vents) 54.91
Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
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
Subdivision: Lot no.: Flue/vent for any of above _I 23.32
Other. 1 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 2332
Gas fireplace 33.39 _
Flue vent for water heater or gas
ij /1rie r fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39 ~
Wood fireplace /insert 23.32
0 PROPERTY OWNER
Name: l >�� 1 0 TENANT Chimney/liner/flue/vent 23.32
Other. 2332
Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIP: Clothes.dryer exhaust _ 33.39
may 0 Y) 4 toilet exhaust (bathrooms,
Phone: ( �JVilCJL Fax: ( ) toilet t comp compartmrtmentss rooms) utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Altic/crawlspace fans 23.32
Business name: Same as contractor Other: 23.32
Fuel piping
Contact name: Diane Mason $14.15 for first four; 54.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZEP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: 'f ri County Temp Control Clothes dryer (gas)
Other: I
Address: 13150 S Clackamas River Drive MECHANICAL PERMIT FEES*
City /State /ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee ($90.00)
P one: (503) 557.2220 Fax: (503) 557.0919 Plan review (25% of permit fee)
C C[3 I io.: 72623 State surcharge 02 °/a of permit fee)
TOTAL PERMIT' FF.E I�t
Authorized signature:A----' This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: D I w �y�p 1V moon - Date: 010 • Fee methodology set by Tn- County Building Industry Service Board
� � I l Building \PcrtnitelMEC- PermitApp doe 10/01/00 440-4617r(1'I/02/COM/WEB)
15°.