Permit CITY OF TIGARD MECHANICAL PERMIT
a' COMMUNITY DEVELOPMENT Permit#: MEC2013-00536
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/24/2013
Parcel: 2S109BA01700
Jurisdiction: Tigard
Site address: 14353 SW BENCHVIEW TER
Project: WILSON Subdivision: HILLSHIRE SUMMIT Lot: 2
Project Description: Gas furnace and NC installation.Placement of NC unit must comply with manufacturer's clearance requirements.
Contractor: ROTH HEATING&COOLING Owner: WILSON,JOSHUA W&CHRISTIE A
PO BOX 1265 14353 SW BENCHVIEW TER
CANBY, OR 97013 TIGARD,OR 97224
PHONE: 503-266-1249 PHONE:
FAX: 503-266-3478
FEES
Specifics: Description Date Amount
Air Conditioning 09/24/2013 $46.75
Type of Use: SF Furnaces< 100K BTU 09/24/2013 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 09/24/2013 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
5032663478 11:23:55 09-23-2013 1 /2
Mechanical Permit Application FOR OFFICE USE ONLY
_1,1 ......\\*10„, RDearivedy:
City of Tigard )..) / 4,,, Permit No.:
III q 13125 SW Hall Blvd.,Tigard,0,44.;7;,....
Plan Review
' I • Phone: 503.718.2439 Fax: 503. . '.4 . ''
1(\.\' Date/By: Other Permit:
Inspection Line: 503.639.4175 I'''''. GI Z, t.---
TIGARD Date Ready/By: Juris: 121 See Page 2 for
Internet: www.tigard-or.gov 0 tj eyo Notified/Method: las6 Supplemental Information
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-N,V .- Mechanical permit fees*are based on the value of the work
0 New construction El Addition/altertgQ• ement performed.Indicate the value(rounded to the nearest dollar)of all
El Demolition El Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
.--`A-i4._teatliNg1-104$0. riggietW-tr4-140gailiMMON. pmgogovfrgg,,kmamgt*y,-f,-§wo:. coin
1:0 I_and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
El Multi-family 0 Master builder ID Other: Description I Qty. I Ea. I Total
Heating/cooling:
''rIVI"°"H'"TBM"'"Rlt4P1'*"it*:g:Kita"ISRNMML' Air conditioning 1 46.75 46.75
Job site address:14353 SW Benchview Terrace Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: I Project name:Wilson/49513 Duct work 23.32
Cross street/directions to job site; 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
Other: 23.32
Subdivision: I Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
'),', :':1:!j'it....................................................................................................................... Gas fireplace/insert , 33.39
Flue vent for water heater or gas
installation of gas furnace and air conditioner fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove _ 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
abilliN1500-KtailOOMMIIMIMICH60"16-it;IRM Environmental exhaust and ventilation: 23.32
Name:Christine Wilson Range hood/other kitchen
equipment 33.39
Address:14353 SW Benchview Terrace Clothes dryer exhaust 3339
City/State/ZIP:Tigard,OR 97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)939-5439 Fax:( ) Attic/crawlspace fans 2332
Z;Iiia..................................................................................................... Other: 23.32
Fuel piping:
Business name:Roth Heating an d Cooling
$14.15 for first four;$4.03 for each additional
Contact name:Angela McGraw Furnace,etc.
heat pump
Address:PO Box 1265 Gas ,
Wall/suspended/unit heater
City/State/ZIP:Canby,OR 97013 Water heater
Phone:(503)266-1249 I Fax::(503)266-3478 ilace - - -
Range
E-mail:a ngelam@roth-heat.com Barbecue "
4.;i141..................................................................................................................................................... Clothes dryer(gas)
Other:
Business name:Roth Heating and Cooling
rANALROOF.g.g.Migaritkilrifdr.g.WINER
Address:PO Box 1265 . Subtotal 93.50
City/State/ZIP:Canby,OR 97013 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)266-1249 Fax:(503)266-3478
State surcharge(12%of permit fee) 11.22 4/
CCB lic.:14008 TOTAL PERMIT FEE 104.72
This permit application expires if a permit is not obtained within 180
ir days after it has been accepted as complete.
Authorized signature: - kb 0 * Fee methodology set by Tr-County Building Industry Service Board
■-.. . 40' ..." . _Aa. ...
Print name:An I.-,431r7-aw • Date:9/23/13
-
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