Permit CITY OF TIGARD MECHANICAL PERMIT
111 • COMMUNITY DEVELOPMENT Permit#: MEC2015-00496
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/22/2015
Parcel: 25111 CA10400
Jurisdiction: Tigard
Site address: 15259 SW 98TH AVE
Project: Duvall Subdivision: TAMI PARK Lot: 11
Project Description: Replace gas furnace
Contractor: ACE ALL CLIMATE ENGINEERING LLC Owner: DUVALL,GREGORY W
PO BOX 3733 DUVALL, MARCIE A
SALEM, OR 97302 DUVALL, PAMELA G
15259 SW 98TH AVE
TIGARD,OR 97224
PHONE: 971-209-8757 PHONE: 503-670-7480
FAX: 888-296-0121
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 07/22/2015 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 07/22/2015 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 07/22/2015 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issu-•.-, or i is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
U' ty Notification Ce -r. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You - obtain a copy of the rules
• direct questions to OU . all g 503.232.1987 or 1.800.332.2344. —
Is ed By: "Al ti 1 Permittee Signature:
` / /111P
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit AunitEKIVEP FOR OFFICE USE ONLY
Received
City of Tigard Permit No.: 4V
Date/By: /d,7- /S C. ) �C���/�5 Z/� S!/
Er
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.59 602 2 2015 Date/By: Other Permit:
T I GARD Inspection Line: 503.639.4175 Date Ready/By: Juris• ® See Page 2 for
Internet: www.tigard-or.gov
CITY OF [K ARI) Notified/Method: Supplemental Information
TYBt$ Jak DIVISION 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 EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46.75
Job site address: 15259 sw 98TH Ave 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/bldgiapt.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
co/Replace Gas Furnace fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
NOTE: minor label# ELS481284 Chimney/liner/flue/vent 23.32
® PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Gregory,Marcie&Pamela Duvall Range hood/other kitchen
equipment 33.39
Address:15259 SW 98"'Ave Clothes dryer exhaust 33.39
City/State/ZIP:Tigard, OR 97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)670-7480 Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ❑ CONTACT PERSON Other: _ 23.32
Business name:ACE all climate engineering llc Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Mike Dudycha 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)2%-0121 Fireplace
Range
E-mail:ace-hvac @hotmail.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:ACE all climate engineeringllc 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:(971)209-8757 Fax:(888)296-0121 State surcharge(12%of permit fee) 10.80
CCB lic.:194023 0 t/ 7 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 signature ' ',/ _ �/ 1 • Fee methodology set by Tri-County Building Industry Service Board
Print name:MICHAEL UDYCHA I D: .:
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15259 SW 98TH AVE, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00496
David Young
Minor label # ELS 481284
Violation Summary:
Inspector Contractor