Permit V CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2013 00519
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/12/2013
Parcel: 2S 103DA04000
Jurisdiction: Tigard
Site address: 10860 SW PARK ST
Project: Epeneter Subdivision: DERRY-DELL NO.2 Lot: 37
Project Description: Install gas furnace with gas line,install a/c,add duct run to bedroom. Placement of a/c unit must comply with
manufacturer's clearance requirements.
Contractor: EASTSIDE HEATING&AIR CONDITIONING Owner: EPENETER, FREDERICK J& BEVERLY
7200 SW JOHNSON CREEK BLVD 10860 SW PARK ST
PORTLAND, OR 97206 TIGARD, OR 97223
PHONE: 503-774-3281 PHONE: 503-639-6468
FAX: 503-774-3057
FEES
Specifics: Description Date Amount
Air Conditioning 09/12/2013 $46.75
Type of Use: SF Furnaces<100K BTU 09/12/2013 $46.75
Class of Work: ALT Type of Const: Fuel Piping 09/12/2013 $14.15
Occupancy Grp: 12%State Surcharge-Mechanical 09/12/2013 $12.92
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.57
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.
From: 09/12/2013 08:49 #162 P.002/002
Mechanical Permit Appli •,"■-' 'r" . • : FOR 01:110E LSE ONLY ,. , .;,H.-
.1' - City of Tid .
Permit No..
. Rpeacieenaiyeyd, 94erffina .
Hie, 6/55/dr
14 • ,3125 SW Hall gar Blvd.,Tigard.OR 97223
Plan Review
Phone: 503.639.4171 Fax: 503.598.1St@P 1 2 2013 Date/By Other Permit• A-in,..1 f.,
:IA G
AR 0 Inspection Line: 503.639.4175
Dale Ready/By: LOA fa See Page 2 for
', ...' . • Internet: www.tigard-or.gov
CITY OF TIGARD Notified/Method: Supplemental Information
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Mechanical permit fees*are based on the value of the work
0 New construction 2rAdditiontalteration/replacement
performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
. ,',:•:''114.,S11:1E.StIALttIii*MEIVT%SYSTEMS FEES*
71-and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
D Multi-family 0 Master builder 0 Other:
Description I Qty. I Ea I Total
. . .„. • , . . - . : -.-- .- ,,-.-.....,._ ,-..„-..---, ,, - _, .-...-„ • .. .:.,,. ,
-• .•,;'-..,.: -,;IOW SITE INFORMATION'AND,LOCATION' . , ' '',,. : '-' . Heating/cooling
Air conditioning
Job site address: )(:)ao O SV1 .PC>.:1/4- e-s. .%‘-
01125
City/State/ZIP: 7 csos-a, ifir9, °I 1 2-23 Furnace 100,000 BTU(ducts/vents) i 46.75 k-\10..7g
Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: I t k 2.9
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
Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Tax map/parcel no.:
Other fuel appliances
23.32
Gas fireplace 33.39
I\t-ss\--0.\\ O\OCS C-L-k.‘"-Yv).' Lli1./t\C\_ Ccke-, \.\v.e . Flue vent for water heater or gas
fireplace 23.32
S VC)`C\ .01 C . KAA l.11\)1 Log lighter(gas) 23.32
Au....c* N-Uor-■ "\--O V 3 e_c_ ,C-- y '\.-\. Wood/pellet stove 33.39
Wood fireplace/insert 23.32
•‘: ' • id,iiRiiiiiii* Ovv-sirtit . .I '', 1.,..-':',','-' : 'Ll,'tiii4j4iir.,:.',: ::::::M['. ,:‘‘" cohthimerney/liner/flue/vent - 23.32
23.32
Name' F-7 v E pe__\r\e,--V C_C Environmental exhaust and ventilation _
Range hood/other kitchen
Address: 1 0 q)La 0 e \13, pck.,.._\z, st
,equipment 33.39
City/State/ZIP: -r' --A, OTe__ ci"7 Z 2_:: Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
Phone:(So3) (as -La L\Lps Fax:( ) toilet compartments,utility rooms) 23.32
0:AlinAti.„10';..A':'7 :,:,:..'... .,- :. ':.',,::'L'.13i..cositAa.fiii,§-itv:;:::-:,...:,.:':,:. Attic/crawlspace fans 23.32
Other: 23.32
Business name: E,.sk c kl.t. kr\ea..1,kv. -h- 0■ -c- r cr.rVIr.cv,■v.ci
1 Fuel piping
Contact name: --s-0\,..,n E\\N A - $14.15 for first four;54.03 for each additional
Furnace,etc. 1 14.1S I 4.1c.
Address: -"zoo SE --&-c,‘„,,r‘st),..\ e: c -gvick._
Gas heat pump
City/State/ZIP:' \A 0.y.Nia 07, enzots Wall/suspended/unit heater
Phone:( 03).--1-1 Lk.- .3 ze‘ Fax::(s 0 3)-71 U,-30 s 1 Water heater
Fireplace
E-mail: .1 ■r\cc) Q, e-a-s-Isie_\.-Ne_c..-\-\v\3 a C 0 r\-■ Range
CONTRACTOR Clothes dryer(gas)Barbecue
Business name: eo_s si e. e v\e,,v-,,,,,,,,: 4 iv,,, c_tnsk,v-,,,,,,‘,,.,cs
Other
Address:
Sck-Nr-••-.e._
,
City/State/ZIP: Subtotal 1 01,LDS
Minimum permit fee(590.00)
Phone:( ) Fax:( )
Plan review(25%of permit fee)
CCB lie.: -s/s g
State surcharge(12%of permit fee) 12_92.
Authorized signature: 1 .,,,..: _\ ..„,..---------
M TOTAL PERMIT FEE )10,5/
This permit application expires if a permit is not obtained within ISO
days after it ha!'been accepted as complete. fri
Print name:T -: ,c-S Date: ci- 12.- fS . Fee methodology set by Tri-County Building Industry Service Board
I\Building\Permits\MEC•PerrnitApp doe 10131/09 440-4617T(1)/021COMMEB)
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