Permit CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit#: MEC2014-00409
T
[GA R.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/05/2014
Parcel: 2S103AA02500
Jurisdiction: Tigard
Site address: 10525 SW CLYDESDALE PL
Project: Perry Subdivision: CLYDESDALE Lot: 6
Project Description: Replace gas furnace
Contractor: ACE ALL CLIMATE ENGINEERING LLC Owner: PERRY, JACOB E&ANGELA M
PO BOX 3733 10525 SW CLYDESDALE PL
SALEM,OR 97302 TIGARD,OR 97223
PHONE: 503-991-5580 PHONE: 503-750-0414
FAX: 888-296-0121
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 08/05/2014 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 08/05/2014 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/05/2014 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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-- OUNC by calling 503.232.1987 or 1.800.332.2344.
Issue By: .i/eurvt Permittee Signature: A-- C.-
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 Application FOR OFFI( I ‘,1 c)\ ti
City of Tigard Date/By: t 5 14 t ,\.,� Permit No.:H c.s�/ _�j '/
13125 SW Hall Blvd.,Tigard,0 7l7
.11,1_. Plan Review
: II. Phone: 503.718.2439 Fax: 503.598.1960 Date/By: other Permit:
T I G A R D Inspection Line: 503.639.4175 AUG 5 2014 Date Ready/By: Jens: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY Of[K AHU -
TYPE me mom. COMMERCIAL FLEE* SCHEDULE— USE CHECK ST
Mechanical permit fees*are based on the value of the work
❑New construction CO Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUfT 1 SYSTEMS FEES*
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special Information use checklist
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
JOB SITE DIFORMAT1ON AND LOCATION Heatiug/cooling.
• Air conditioning 46.75
Job site address:10525 SW Clydesdak P1 Furnace 100,000 BTU(ducts/vents) 1 46.75 46.75
City/State/ZIP:Tigard, OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: 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
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
Changeout/Replace Gas Furnace fireplace 23.32
Log lighter(gas) 23.32 _
Wood/pellet stove . 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER I 0 TENANT Other: 23.32
- Environmental exhaust and ventilation:
Name:Jacob&Angela Perry Range hood/other kitchen
equipment 33.39
Address:10525 SW Clydesdale PI
Clothes dryer exhaust 33.39
City/State/ZIP:Tigard, OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)750-0414 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT 1 ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:ACE All Climate Engineering,LLC 51415 for first four;54.03 for each additional
Contact name:Mike Furnace,etc.
Address:PO Box 3733 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Salem, OR 97302 Water heater
Phone:(971)209-8757 Fax::(888)296-0121 Fireplace
Range
E-mail:ace4miket)hotmail.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:ACE All Climate Engineering,Ilc Other:
MECHANICAL PERMIT FEES*
Address:PO Box 3733 Subtotal 46.75
City/State/ZIP:Salem, OR 97302 Minimum permit fee($90.00) 90.00
Plan review(25%of permit fee)
Phone:(503)991-5580 Fax:(888)296-0121
_ State surcharge(12%of permit fee) 10.80
CCB lic.:194023 7 �/( /it TOTAL PERMIT FEE - 100.80
This permit application espirea if a 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
I - • I
min— EL 9%7 a7%t