Permit CITY OF TIGARD MECHANICAL PERMIT
'`�! ' COMMUNITY DEVELOPMENT Permit#: MEC2016 00262
1
T IGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 04/18/2016
Parcel: 2S110DA01700
Jurisdiction: Tigard
Site address: 10616 SW NAEVE ST
Project: Altotsky Subdivision: RENAISSANCE SUMMIT Lot: 8
Project Description: Replace existing furnace and a/c unit. Placement of a/c unit must comply with manufacturer's clearance
requirements.
Contractor: AIR COMFORT INC Owner: ALTOTSKY, GREGORY&NELLY
16055 SW 74TH AVE SUITE B 10616 SW NAEVE ST
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: 503-260-7806 PHONE: 503-702-6525
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 04/18/2016 $46.75
Type of Use: SF Furnaces< 100K BTU 04/18/2016 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 04/18/2016 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, o .ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Uti • otification Cen Th.:e rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You ma obtain a copy of the rules
.r direct questions to OUN • ailing 503. .1987 or 1.800.332.2344.
Issued By: / /� Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicRECEIVED FOR of I l(-l: I sh:oyl.v
11 _,1
Other Permit:
CI Received v C(//
`, of Tigard
iii g R Date/By: /0 / �j1 Permit No.: H c9.0/l(J-10o0.613125 SW Hall Blvd..Tigard,OR 972P3 1 8 2016
Plan Review
Phone: 503.718.2439 Fax: 503.5 6 Date/By:
1 I G A R 1) Inspection Line: 503.639.4175 U FY OF 1 I ,:,ARD Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov BUILDING D1`JIS ON Notified/Method: Supplemental Information
''''*7714',4,417-1, ,-A of -'1 "•'•M . e�k ti,q: n, y^Fy",. p
---- '-- - "''" ' " "`` '' ' "" ` `" ' -----' ' Mechanical permit fees*are based on the value of the work
o New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑ Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
> ,', "GAT, F '41 UL 1t1 , .,..,_,:7-,'Yqinimportm gointriaNT t 5 £l 'sMS it' Es"
I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑ Multi-family 0 Master builder 0 Other: Description I Qty. j Ea. j Total
b . , Heating/cooling:MA 4140 LOC/ �;
Air conditioning
46.75
Job site address:
(06/6 c Al, � � �� Furnace 100,000 BTU(ducts vents) t 46.75
City/State/ZIP: 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
„ .. , .
ESCR��'ION flF,WORK.. Gas fireplace/insert 33.39
;, `' Flue vent for water heater or gas
e,�. r-t14__ �z. .�- /Z. fireplace 23.32
""'�� Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
�
�-,.d--t(� �' (!WN)!!R 0
Other: 23.32 —
• t ,, " tLT' - Environmental exhaust and ventilation:
Name: / LV n f A 1� � A Range hood/other kitchen
equipment 33.39
Address: /06 U I 17 Clothes dryer exhaust •
33.39
•
City/State/ZIP: Single-duct exhaust(bathrooms,
d, toilet compartments,utility rooms) 23.32
0
Phone:(5' ) 7 6, 2Fax:( ) Attic/crawlspace fans . 23.32 .
'A &A� " CON-a&& PERSON" - Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc. _
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
Range
E-mail:
Barbecue
`r:'-i:',:'
,.'" '.--�rQ"1i1CrpR Clothes dryer(gas)
Business name: Other:P97 , .. • .,(.
/ Ll,�j i-.ra i821�'`�a Y...,.,f„ �. er 7471.1 �F,. y..,r...twr.� v -
Address: 0,;,[4:1' 7 `v^ Subtotal u
City/State/ZIP: Q Q���7 i/li•I Minimum permit fee($90.00)
Fax: Plan review(25%of permit fee)
Phone:
(<0 3 o9 ','} A�✓ ( ) State surcharge(12%of permit fee)
CCB lie.: �' 7f TOTAL PERMIT FEE 10`1-
This permit application expires if a permit is not obtained within 180
4,1 days after it has been accepted as complete.
Authorized Isignature-4! • * Fee methodology set by Tri-County Building Industry Service Board
[-�-e
Print name: Q g29 3A Date: y, ( .c r 6
I:Building Permits MEC Permit App_040113.due 440-46171(I 102/COM WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-Famil Fee Schedule:
Tot J*luaton: , ermI#Fee
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional$100.00 or
fraction thereof,to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional$100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first$10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof,to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I: Building Pennits MEC_PennitApp_040113.doc 2
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
10616 SW NAEVE ST, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00262
Jeff Grove
Violation Summary:
Inspector Contractor