Permit CITY OF TIGARD MECHANICAL PERMIT
111 - COMMUNITY DEVELOPMENT Permit#: MEC2013-00500
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/03/2013
Parcel: 25111 CC14700
Jurisdiction: Tigard
Site address: 10145 SW HIGHLAND DR
Project: Johnson Subdivision: SUMMERFIELD NO.4 Lot: 198
Project Description: Gas furnace replacement.
Contractor: ABLE HEATING&COOLING LLC Owner: JOHNSON, LAURA R TRUST
16285 SW 85TH AVE#105 BY JOHNSON, LAURA R TR
TIGARD, OR 97224 10145 SW HIGHLAND DR
TIGARD,OR 97224
PHONE: 503-579-2250 PHONE:
FAX: 503-620-3980
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 09/03/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 09/03/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/03/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
/__�-./
//
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
Mechanical Permit Applicati EI .1 - =lOR-r)FF l ll I tit t)\i_ .•_ ... . .
City of Tigard eceived G
III
DatelB
• 13125 SW Hall Blvd.,Tigard,OR 97223 AUG A U G 2 9 2 013 Pia Review 7 i11 v
Phone: 503.7182439 Fax: 503•598.196A�I�OF TIGARD Dew Other Permit
-1-i GA R D Inspection Line: 503.639.4175 llr/ lfi' Date Ready/13
intcmet: www.tigard-or.gov BUILDING DIVISION Page 2 for
Y
Notified/Metirod; Supplemental Information
1,
TYPE OF WORK COMMERCIAL FEE SCHEDULE-USE CHECKLIST
con
❑New construction ®Addition'altetstion/replacemcnt Mechanical permit fees are based on the value of the work
❑New onon performed.Indicate the value(rounded to the nearest dollar)of all
❑Other, mechanical materials,equipment,labor,overhead,and profit.
CATEGORY OF CONSTRUCTION Value:$
® 1-and 2-family dwelling ❑CommerciaUindustrial RESIDEN TL%LEQUIPMENT/SYSTEMSFEES`
0 ❑Accessory building For special lnformorion use checklist.
Multi-family ❑Master builder
❑Other, Description Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Job site address:10145 SW HIGHLAND DRIVE Air conditioning 46.75
Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
City/State/ZIP:TIGARD,OR. 97224 Furnace 100,000+131U(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name:JOHNSON - Heat pump 61.06
Duct work 23.32
Cross street/directions to job site: Hydronic hot water system i 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 2332
Other::
I Lot no.: 23.32
Tax map!pancel no.: Other fuel appliances:
Water heater ' 2332
DESCRIPTION OF WORK Gas fireplace/insert 33.39
REPLACE EXISTING GAS FURNACE Flue vent for water beater or gas
fireplace 23.32
Log lighter(gas) 2332
VW'ood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32 •
® PROPERTY OWNER I ❑ TENANT Oar: 23.32
Name:LAURA JOHNSON Environmental exhaust and ventilation:
Range hood/other kitchen -
Address:10145 SW HIGHLAND DRIVE equipment 33.39
Clothes dryer exhaust 3339
City/State/ZIP:TIGARD,OR. 97224 Single-duct exhaust(bathrooms,
Phone:(503)6244191 -toilet compartments,utility rooms) 23.32
Fax:( ) Attidcrawlspace faro
• ❑ APPLICANT 23.32
❑ CONTACT PERSON Other. 23.32
Business name: Fuel piping:
Contact name: Sli 15 for arm four;$4.03 for each additional
Furnace,etc.
Address: Gas heat pump
• City/State/ZIP: Wall/suspendediunit heater
•
Water heater
Phone:( ) i Fax::( ) Fireplace
E-mail: _Range
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:ABLE HEATING&COOLING LLC Other:
Address:16285 SW 85TH AVE SUITE 105 MECHANICAL PERMIT FEES*
City/State/ZIP:TIGARD,OR. 97224 Subtotal 46.75
Minimum permit fee(590.00) 90.00
Phone:(503)579-2250 j 1 Fax:(503)620-3980 Plan review(25%of permit fee)
CCB lie.:184392
t// State surcharge(I2%ofpermit fee) 10.80
TOTAL PERMIT FEE I 100.80
//,I This H it application expires if a permit is not obtained within 180
Authorized signature days after it has been accepted as complete.
• Fee methodology set by Tri-County Building Industry Service Board
ir Print name:KELLY WT I Date:8-28-13 1
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