Permit CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit#: MEC2013 00493
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/26/2013
Parcel: 2S111AD14500
Jurisdiction: Tigard
Site address: 14827 SW 91ST AVE
Project: Merryman Subdivision: MALLARD LAKES Lot: 11
Project Description: NC installation. Placement of NC unit must comply with manufacturer's installation requirements.
Contractor: BULL MOUNTAIN MECHANICAL Owner: MERRYMAN, RONDA
13580 SW RHETT CT 14827 SW 91ST AVE
TIGARD, OR 97224 TIGARD,OR 97224
PHONE: 503-612-6677 PHONE: 503-705-0727
FAX: 503-692-3084
FEES
Specifics: Description Date Amount
Air Conditioning 08/26/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 08/26/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/26/2013 $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.
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Issued By: _I` �_ •••••" Permittee Signature:
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.
From: 08/22/2013 16:26 11956 P.002/003
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Mechanical Permit Applies•:o.�F CAVED
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ih1`331257S of Tigard W Hell Blvd.,Tigard,OR 97223 AUG 2 2 2 013 �a � Permit N1.: AA,,_ C (3-,a
. Phone: 503.718.2439 Fax: 503398.1960 Pan Review C.
T,C R I: Inspection Line: CITY�OI/F TIIG/A(RDA Da /y: , ®See Page 2 ror --
Intanet: www.tigard-or.gov BUILDING DIVISION NotiBed/Methnd:
} O -f::M Supplemental Information
r N4 ,� LVAia BYO -l0 00Tr � � MP _
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Mechanical permit fees*are lased 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,arid profit.
Valle:S
m5x � 71k....77-7. o f f C . r
IA 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For upedal information use checklist.
• Multi-family ❑Master builder 0 Other
Description I Qty. Fa I Total
rc,dal ;M I'4:1 Mom 4 i e).Fr9N, o ✓ I� ib.Co ti)r far?�(T�• Healing/000ling:
Job site address: AP,..- W - ,$--x '
Air conditioning I 46.75
Furnace 100,000 BTU(ducn/ve nts) 46.75
City/State/ZIP: f ,d, - - Furnace 100,000+BTU(ducts/vents) 54.91
SuitabldgJapt.no.: I Project name: H 61.06
' a Duct work 2332
Ala.
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydrenic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent far'any of above 23.32
Subdivision: Lot no.: Other 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
k:r?'ti1f td,f v eA �r�Yf°I � I e i o �o � �& b r 5 � �
,� 4..;,��,��`_��� F�,�:G,.,��'ti.��hf, ,,,�!.��;k�,�rl� Gas fireplacelinsett 33.39
/ J i ' Flue vent for water heater or gas
6�l t(..3j t fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace mse r 23.32
i Chin ney/line r/flue/vent 23.32 -
l' m trig--e- 0 ..A �+5 �c s�4 l ,' . =n'' -2 ~ik- t d ter n .*1 °the': 23.32
Name: �
Environmental exhaust and ventilation:
/ r ' Range hood/other kitchen
Address: a s Si. Ave- °gmp>ae°t 33.39
Clothes dryr exhaust 33.39
City/State/ZIP: s , , Single-duct exhaust(bathrooms,
toilet COMPUemeats utility rooms) 23.32
Phone: 05) 05,,, Fax:( ) Attic/aawlspace fans 23.32
ra Yin W� -�,
��LL. -,--�. 4 x...yl'"• r,,y.,^�+ � ;_ �'.�;�:.,w� Othes: 2332
Business name:Bu Fuel. 4 Frei piping:
to s a • ..• • ZA . ' a SI4.15 for first four;54.03 for each additional
Contact name: / Furnace,etc. -
Address: 024 R O Se.w16 D T • Gen heat pump
Wall/saepatde dAmit heater
City/State/ZIP: L.6_ ®s - . . , % 9 035 _Water heater
Phone:(5 6 3 3) d/2 - (o G ' Fax:: . ,$ ,9 2. 3 0J' Fireplace
E-mail: 1� �, tit I MWOL 1.i'Mrs WIe-e.�1 • Lo WI Barge Barbecue
' ._«...:F: ? k.._:. ,. 1 _Clothes dryez(tom)
Business name. °Address:
• m nte U.l'.�- 1l/1 : 1 :M3YI'etl-il`I(Cr1 Rrj; • I. J e (:.f•'a',?r` ter. 3;?-',;
5x0 11 oSe 6,0-, S Subtotal
City/State/ZIP: S ,, ( ` 0 5 Minimum permit fee(590.00) cm.w
Phone:(503 ) Z.`� Ft ( , ) G Z G'a Plan review(25%of permit fen)
3 State surcharge(12%of permit fee) 119:710.
CCB lic.: 4r TOTAL PERMIT FEE 100,130
This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete.
Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board
Print na IX f it Date: T E
41 I
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