Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2013-00496
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/27/2013
Parcel: 2S103DB09400
Jurisdiction: Tigard
Site address: 11370 SW ERSTE PL
Project: Abeyta Subdivision: GENESIS NO.3 Lot: 81
Project Description: Replacement of a/c. Placement of a/c unit must comply with manufacturer's clearance requirements.
Contractor: HEAVENLY HEAT DBA P. SHAMBERG Owner: ABEYTA,THOMAS J AND DEBORAH L
PO BOX 647 11370 SW ERSTE DR
DONALD,OR 97020 TIGARD,OR 97223
PHONE: 503-678-3089 PHONE:
FAX: 503-678-2405
FEES
Specifics: Description Date Amount
Air Conditioning 08/27/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 08/27/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/27/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
•
Total $100.80
Required Items and Reports(Conditions)
•
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: .0.7952411a---/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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Mee lanical Permit AppliRECEIVED FOR OFFICE USE ONLY
C Received
City of Tigard Date By: `' .A7 /3 A• Permit No.: N3 . �'&
" 13125 SW Hall Blvd..Tigard,OR 972 IG 26 2013 Plan Review
Phone: 503.718.2439 Fax: 503.59$. 9VQ IYaIdRy: Other Permit:
�� h
Inspection Line:8503.63 84175 CITY TIGARD Date edits Ready/By: +uric' Supplemental See
Page 2 for
Internet: Ww'W.ti frd or. Ov R1' /± 1/c D Notified/Method loformatioo
-- BUIUDINC oIVISIOI'' COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
TYPE OF WORK Mechanical permit fern*arc based on the value of the work
❑1 Ii H construction Addition alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit.
❑U,.nv tlition ❑Other: Value:S
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
IX'1-al 12-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑PM.11 -family ❑Master builder ❑Other: Description Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job:;i e.ddress: 1 1 31 D /. W e 51 2 ->L Air conditioning _i, 46.75 4(„'7��
City'SLa e!ZIP: 'j`y,.t,r( r717ft ei -7 ZZT-3 Furnace 100,000 BTU(ducts/vents) 46.75
Suit'_ll g./apt.no.: / Project name: 4 b,y1 y.i Furnace 100.000+BTU(dom./vents) 54.91
Crot s sI act/directions to job site: Heat pump 61.06
Duct work 23.32
`- Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
-- Unit heaters(fuel-type,not electric),
Subtli,'i :on: I Lot no.: in-wall,in-duct,suspended.etc. 46.75
Tax tr al 'parcel no.: Flue/vent for any of above 23.32
DESCRIPTION OF WORK Other: 23.32
r, F !r,C1yr��:n-�- r A • Other fuel appliances:
J-4- Water heater 23.32
Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
❑ PROPERTY OWNER 1 ❑ TENANT Log lighter(gas) 23.32
Wood/pellet stove 33.39
Narr c
-- Wood fireplace/insert 23.32
Add
Chimney/liner/flue/vent 23.32
City.'Sta :rLIP: Other 23.32
Photic_( ) Fax:( ) Environmental exhaust and ventilation:
-_ ❑ APPLICANT p CONTACT PERSON Range hood/other kitchen
Busin:s name: equipment 33.39
-- Clothes dryer exhaust 33.39
Coma:t ame: (�t� I Ste, . L , Single-duct exhaust(bathrooms,
Add:c;s
t toilet compartments,utility rooms) 23.32
-- Attic/crawtspace fans 23.32
City:$Ia :!LIP: Other: 23.32
Phot.e:( --r ) 3 r 0-- -4.1si Fax::(563 ) L-7 S% 2,4 O Sr Fuel piping:
h-m li_ 514.15 for first four:$4.03 for each additional
CONTRACTOR Furnace.etc. _
Busi it•s: name: NPyA V4,tin1 j k 14{'c� Gas heat pump
Addres e r) 1 4941 Wall/suspended/unit heater
City Sia :/ZIP: V DL.ct,ttA. / O/2- "/70 L0 Water heater
Phore ( ;7,3) 1r2-7�30,/,7 Fax:(s--4,3 ) �,�g'.� 740 6""
Fireplace
CCB lie i y 7 Z L/Q//.5" Range
Barbecue
Autho-i; :d signature: ,______-le. Clothes dryer(gas)
Print rat c: pL,Cu - f _ I Date: �s,2 Z- /_, ,Other:
f4�_ MECHANICAL PERMIT FEES*
raunaain,A nniuUNF.0 PmvitApp_040113.doc 440-4617T(11/e2/COM/WEB)
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—_ Subtotal q(t.ii
Minimum permit fee($90.00) . 9',Q0
Plan review(25%of permit fee)
State surcharge(12%of permit fee) /040 •
TOTAL PERMIT FEE /00•60 X
This in rini application espires if a permit is not obtained within 180'
days after it has been accepted as complete.
• Fee iicth Jology set by Tri-County Building industry Service Bo
I:1Bui din 1Pcrmits1MEC ItennitApp_040113.dnc 7