Permit q CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2013-00444
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/05/2013
Parcel: 2S102BA02100
Jurisdiction: Tigard
Site address: 9935 SW JOHNSON ST
Project: Borsch Subdivision:RTH TIGARDVILLE ADDITION,AMENC Lot: 45
Project Description: Replace existing A/C. Placement of A/C or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: DR HVAC INC Owner: BORSCH, LUCILLE HUGHES AND
PO BOX 1290 JOSEPH ANTHONY
MCMINNIVILLE,OR 97128 9935 SW JOHNSON ST
TIGARD,OR 97223
PHONE: 503-474-9891 PHONE: 503-481-4024
FAX: 503-474-9897
FEES
Specifics: Description Date Amount
Air Conditioning 08/05/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 08/05/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment-Mechanical 08/05/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may 'btain a copy of t' rule
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. / /
Issued By: Permittee Signature: / "di /At,...<0
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
61't..I /- o. 1La
Mechanical Permit App lint a:,;lt. rc,RC�FFt�t 1 tip:c> L N
_ City of Tigard '• xe<e;ka _
14...., w= , I V Dao/Br (T fro_ ':. 't N� f -c 1/3 ��0 A�/
13125 SW Halt Blvd,,Tigard,OR 9 3
Plan /
Phone: 503.7182439 Fax: 503.591641 5 2013 �: otherPermlt.
T)G A B.D Inspection Line: 503.639.4175 Date Ready/By RI See Page 2 for
intoner: www.tzgard-oLgov CITYOFTIGARD Notifsed/Mcthod' Supplements'Informanon
p () A., r! 1h∎';.�7 r t 1 �J r tl Pl C +.� li.i 7 rr. "$nrercyL�...✓r� .;-r^^t ;: e . nt�
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Mechanical permit feed'are based on the value of the work
❑New corlstruCtion ,Addition/alteration/replacement performed. e value(rounded to the nwmst dollar)of all
❑Demolition El Otiie r mechanical materials.ecLuipmcot,labor,overhead.and profit.
r . e f..,t•r ..��;.... '. :t^ : • ,Jr ..
Value:
�6S. .,J $11k 4r „Mr � ra rsd iVi c` m y v ! :1r @ �; f; ' ,,,,,,,w,-.1,7_7t, e w, r r �
M r
Y
„Enf r..; � r y u17 ,''.. t T G i?,,1,- u,1a Y.U,. f . 4, ?f,;4 n::..-... i,,.;°..:w�} R L 5 . " ._ r�, a �f< , ,a{.rtp Fi p:� re titny cal,ti‘
_-and 2-fanil dwellin g ❑Commercial/industrial Uindnstrial ❑Accc�sory•building For s p sera information
use
r r v'
theckisR❑Multi family ❑Master builder ❑Other _Description lE
Ea.
,1,...57 Y i7, 4... F;r 7i tr,l i,77•7 fi t,i [f, '.T, r)u I 7.7; ,'°1124+yz,,, M y 7 l _ .
... ,-.6 d :.. .f.,z q i:s ,, ._r.,..: ,, u...(.:. ,..r. W6 aa,.Yd.:lti�n . .,,,, v.W,,°,nk.:::._.1_u w, Air conditioning
Job site address: ✓ 1� ,A._ (mutts site plan showing placement) / 46.75 /4,
Furnace 100.000 B1(ISdr .eats) 46.75 city/stat1p: 776420 007.4 7 72
Furnace 100,000+BTU(dnotee/ve+us) 54.91
Suite/bldg_/apt.no.: 1 Project name:M/A jr g fe . • Heat pump
(requires site plan showmgplacement) 61.06
Cross sneet/dirrctions to job site: ryk) theitytir 1 Vt. . Duct work 23,32
-- _ 1•Iy!dronic hot Water system -23.32
Residential boiler(radiator or
. ,,hydtonic) • • 23.32.
Unit hers(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46,75
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other` 2332-
Tax map/parcel no
s+ fuel appliances: -_ti . 1 yh u • 23.32 4 x. r �iY,} r (r,i ° ,y r x J , J �._i(J : r. :' t' Water heatez•�/� N / � Gas fireplace •_ • 33:39
A: 1,.. / Flue vent for water heater or gas
fireplace 23.32
•
-
Liog hghtcr(Sas) 23.32
Wood/pelletstove 33.39
•
. a S °
Wood f.i eplace/insett 23.32
4 77 ,-,- �=.f • 7 'n j 1 5' k� c r r ,5, Chime/ined/f uevent 23.32 i.r Ci- 7 aw .,:. :54.ukit ..k_F-_, :. 1 : i ,' r ;; .+... .L: .' v`s . ',lYOher
23.32�,e f[� �
Environmental exhaust and ventilation:
Address: . . . _.. •
Range hood/other kitchen
%h// /10)
e4e 33.39
City/State/ZIP:, 640, ar!. p"z, ,� • • • Clothes dryer exhaust 33.39
Phone 4503) y�/ -,YO Fax ( �.)�"
Single-duct exhaust(bathrooms,
toilet comps amend,utility rooms) 23.32
t Jµw.� 7:g..'(C.V, i•7:7 r pn, 7!x )!yl,yr7 ,'..?.; 0' . )F )T„3° � 77)- � e,'1,0:?1,P-F1f)
..Attl/:raW�18Co fans 23.32,...„,. .t :t . :1.+,., .44:::::25,;1r „ ,fix:k: 1,,,.,., t s[!i �.,,. rte,,;.1�^; :ie:,
Business name; Other: 2332
•
Contact name: •
Fuel .i•t:_;
$14.15 for first four$4.03 for each additional
Address Furnace,ctc. _ •
City/State/ZIP: das heat pttntp
- - - - Wali/suspended/unit heater
Phone .r • Fax:,: _ Z Water heater
E-mail: ]ace•
•
�7M' k,t 0114 C',,"i"F""+ Nr + �"S 9 i ' Range
• us._ :, tic' t.w. w r,s ') d yn rls y:'nfi !: r• ,.
,. 1 r .r. '� ,L .1 1..,. i•�._..,.,.Y., Barbecue
Business name: %pi A/v Clothes - :.) .
Address: /7r d Afk. Oder ,
city/siatc/zrp: !t'�-• /NJ�/ ,r` .�Fw._:. . : : :.: Y �.'�.. _ .,.,a,ur�r.�l, 3
_ �/�,,� 1 r' I a d� Subtotal
Fax: Minimma penult fee($90.0°) 9042.'
Phone:✓y s/ Z fC . t L/
=7' � • •Plan review:(2s%ofpernzit fee) --
/ State surcharge(12%ofpemitfee) /O.5')
TOTAL PERMIT FEE• /.0Ait
Authorized Si'. e: i` /�. This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Prim name:. L.,, Date: g.-.ar z3 Fee methodology set by Iii Covert y Building Ir atry Service Board
..
!Mauldin 1ranitiA 4 C-PexmaApp.doe 09/09/10 4e0.061? (I1/iacoMrW£x)
ZOO/100 •d EZOL# OVAH 80 L686t?L7E0c 90:9L E1.0Z/Z0/80