Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2013-00596
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/09/2013
TIGARID Parcel: 1S133CD03500
Jurisdiction: Tigard
Site address: 13567 SW ASHBURY LN
Project: Sexton Subdivision: COTSWALD MEADOWS Lot: 33
Project Description: Replace gas furnace
Contractor: ADVANTAGE HEATING&AIR CONDITIONING LLC Owner: SEXTON, BRIAN
2355 HYACINTH ST SE 13567 SW ASHBURY LN
SALEM, OR 97301 TIGARD, OR 97223
PHONE: 503-393-5315 PHONE:
FAX: 503-393-2253
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 10/09/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 10/09/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 10/09/2013 $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: zi/ ,y`J e__/M-T/o^/
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.
Oct 04 2013 01:07PM HP FaxAdvatage Heating 5033932253 page 1
Mechanical Permit Application " FOR OFfl( l USE O) [l. .. __
City of Tigard ' Da c/sy: /d 9 /3 4 Permit NWEC�d/3 ODS9(o. 13125 S W Hall Blvd.,Tigard,OR 9 'IN
Phone: 503.7152439 Fax: 503.59: �tt raj Plan Review
�O� Daie'By: Other Permit:
1 c;�R p Inspection Line. 503.639.4175 C.., Jdr
Irllemel: tvww.ugard-or.gov \. OC� • ��® Date ReadyiBy. 65 See Page 2 for
�� �,,,��� \®1 Notified/Method Supplemental Information
TYPE OF WORKP\. \c®,'v CONAIE CIAL FEE* SCHEDULE - USE CHECKId6T -
❑New construction �\� Mechanical permit fees"are based on the value of the work
®Addition/alteratiorlDent performed, Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$3,317.00
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT I SYSTEMS FEES'
0 1-and 2-family dwelling ❑Commercial/industrial ❑ Accessory building For special information use checklist.
❑Multi-family ❑Master builder
❑ Other: Description Qty. 1 Fa. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Lc-e:
Air conditioning 46.75
Job site address: 155— l 6.`, h bu�V riCG Furnace 100,000 BTU ducts/vents
( ) / 46.75 t/(r.7�
CitylStatelZfP: `�=� v C` Furnace 100,000+BTU(ductslvenis) 54 91 _
I c.-0j. (i 7-7 22�
Heat pump 61.06 _
Suite/bldg./apt.no.: Project name: SC'x, )i�
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,induct,suspended,etc. 46/5
Flue/vent for any of above _23.32 _
Subdivision: Lot no.: -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 heater or gas
r-r- lt�1:— C-!�_y - ;1� �1 fireplace 23.32
�J Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32 _
❑ PROPERTY OWNER I ❑ TENANT _Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23,32
Phone:( ) Fax:( ) Attic/ctawlspacefans _ 23.32
❑ APPLICANT 0 CONTACT PERSON Other: 23.32 _
Business name: Fuel piping:
S14.15 for first four;$4.03 for each additional
Contact name: -Furnace,etc.
Address: ,Gas heat pump
City/State/ZIP: r Wall/suspended/unit heater
Water heater
Phone:( ) 1 Fax: :( ) -Fireplace -
E-mail: Range
Barbecue
CONTRACTOR -Clothes dryer(gas)
Business name:Advantage Heating&Air LLC Other:
MECHANICALPERMIT FEES*
Address:2355 Hyacinth NE Subtotal 44-]S
—City/State/ZIP:Salem,OR 97301 Minimum pennit fee(590.00) 90.00
Plan review(25%ofpetmit fee)
hone: (503)393-5315 Fax:(503)393-2253 State surcharge(12%of )
tg ( permit fee 10.80
CCB lie.: !74260 TOTAL PERMIT FEE 100.80
This permit application expires If a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signatur
` Fee methodology set by Tri-County Building Industry Service Board
Print name:Connie ZAZI.._--L ` Date:�U/ii/r3 P 13 doe f�� 40-4617T(I I,52cotr'WEB) 1 / , N/