Permit CITY OF TIGARD MECHANICAL PERMIT
3: COMMUNITY DEVELOPMENT Permit#: MEC2013-00557
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/25/2013
Parcel: 1 S134CB10600
Jurisdiction: Tigard
Site address: 12447 SW EDGEWATER CT
Project: Fellows Subdivision: MILL VIEW Lot: 6
Project Description: Install a/c. Placement of a/c unit must comply with manufacturers clearance requirements.
Contractor: ABSOLUTE TEMP CONTROL Owner: FELLOWS, JEREMY L&PATRICIA J
2101 NE 387TH AVE 12447 SW EDGEWATER CT
WASHOUGAL,WA 98671 TIGARD, OR 97223
PHONE: 503-740-1333 PHONE: 503-887-1450
FAX: 888-340-6548
FEES
Specifics: Description Date Amount
Air Conditioning 09/25/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 09/25/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/25/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct qu-= '• = •UNC by calling 503.232.1987 or 1.800.332.2344.
Issued :.y: ' /.4! Permittee Signa ure: r
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
To: Page 2 of 3 2013-09-25 18:48:05(GMT) 888_340-6548 From: Absolute Temp Control
Mechanical Permit App 'I
� I WI ci% ro or ri E IsE oL) -_
City of Tigard t ii...- 1 lED SMARM P8mit N°. E �O/3-OO5
13125 SW Hall Blvd.,Tigard,OR 9
_ Phone: 503.718.2439 Fax: 503.59 2 2013 Plan Review
Date/By: oilier Permit:
=�_I GA R D: Inspection Line: 503.639.4175 Date Ready/By: tuns- RI See Page 2 for
'Internet: www.tigard-or.gov CITY OF j°IG//gARI.) Notified/Method: Supplemental information
TYPE.VI CITY 1J iIT L8I VISI L�ff t� 'COMMERCIAL FEE* SCHEDULE-USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION - •RESIDENTIAL rQUIPMENT/SYSfEMS'FEES*'
•® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: _Description Qty. Ea l _Total
/A 414/7 JOB SITE INFORMATION AND LOCATION Heating/cooling:
{ Air conditioning 1 46.75 46.75
Job site address; 7,-SW EDGEWATER Cl'' Furnace 100,000 BTU(ducts,'veuts) 46.75
City/State/ZIP:TIGARD,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: -`//G - -_ Heat pump 61.06
- ---e_-�-I LL��'s Duct work 23.32
Cross street/directions to job site: I 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 Ito.: Other: 23.32
_Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water beater or gas
New A/C Install fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent _- 23.32
' 12 PROPERTY OWNER ❑ TENANT Other: 23.32
- Environmental exhaust and ventilation:
Name:Jerremy Fellows Range hood/other kitchen
. equipment 33.39 -^
Address:same as above Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)887-1450 1 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT Li CONTACT PERSON Other: 23.32
i Business name:Absolute Temp Control ± Fuel piping:
$14.15 for first four;$4.03 for each additional --_
Contact name:John Sandu Furnace,etc.
Address:2101 NE 38716 Ave Gas heat/imp
Wall/suspended/unit heater
City/State./ZIP:Washougal,WA 98671 Water heater
Phone:(503)740-1333 Fax::(888)340-6548 Fireplace
-W------ Range _
E-mail:sandu.inc(iiigmuileom Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:Absolute Temp Control ,Other: I ___
. MECHANICAL PERMIT FEES*
Address:same _ Subtotal
City/State/ZIP: Minimum permit fee($90.00) 90.00
Plan review(25%of permit fee)
Phone:( ) l Fax:( )
State surcharge(12%of permit fee) 10.80
CCB lie.:166011 (&/Iotic- TOTAL PERMIT FEE 100.80
N. This permit application expires ira 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 name:John Sandu Date:9/25/13
1.l Buiidiog\Pet wits lbIEC_I'ennitApp_040113.doc 440-4617111l/M..COM WF.11)
14-. ........ ......_- ----
TO: ego Of 3 2013-09-25 18:46:05(GMT) 888-340-6548 From: Absolute Temp Control
FAX COVER SHEET
TO
COMPANY
FAX NUMBER 15035981960
FROM Absolute Temp Control
DATE 2013-09-25 18:45:44 GMT
RE Mechanical Permit Application
COVER MESSAGE
Hello,
Please mail original to homeowner. Fax or email copy to us.
: 888-340-6548
sandu.inc @gmail.com
Thank you!
John Sandu,
Tel: 503-740-1333
WWW.MYFAX.COM