Permit (11) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2016 00745
Date Issued: 10/26/2016
TTIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 1 S134CB12500
Jurisdiction: Tigard
Site address: 12234 SW MILLVIEW CT
Project: Parsiani Subdivision: MILL VIEW Lot: 25
Project Description: Replace furnace and A/C. Unit placement must meet manufacturer's requirements.
Contractor: JEFFS HEATING&COOLING INC Owner: PARSIANI, MAHNAZ TRUST
23875 JOHNSON RD BY MAHNAZ PARSIANI TR
WEST LINN, OR 97068 16145 SW PEBBLE CT
BEAVERTON, OR 97007
PHONE: 503-557-4635 PHONE:
FAX: 503-557-3870
FEES
Specifics: Description Date Amount
Air Conditioning 10/26/2016 $46.75
Type of Use: SF Furnaces<100K BTU 10/26/2016 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 10/26/2016 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
r. fIssued By: ��3` - Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicat " FOR OFFICE ISE ONLY
e . £ , .-
- Receivedt /� /� y
City of Tigard eId 24, //e� i/� Permit �/ `(f�f "/'�
IIIf 13125 SW Hall Blvd.,Tigard,OR 97223
.1.ai (et
Phone: 503.7182439 Fax: 503.598.196 6 jj Plan By Review Other Permit.
aj C. 2 !()1 Date/
By
I G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris. El See Page 2 for
Internet www_tigard-or.gov ,f IT r OF r ?a 1 t Notified/Method: Supplemental Information
TYPE Ol INtJ DIVISION COMMERCIAL FEE* SCHEDULE- IisECHi.CKIJST
Mechanical permit fees*are based on the value of the work
❑New construction [ Addiiionlalteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
1J 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For spearil information use checklist
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB:SITE INFORMATION AND LOCATION Heatingleooting:
Air conditioning / 46.75
Job site address: /723'J S(tet) k4(t.l,(/f c,(/) Cr 11(704 40
Furnace 100,000 BTU(duets/vents) ` 46.75
City/State/ZIP: -T1 G A 1L p Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldgJapt.no.: Project name: Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydropic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 2332
Other: 23.32
Subdivision: Lot no.:
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
I°Loc6 FV K.Nd C6 06 A..'t A pP A Ir(,, fireplace 23.32
Log lighter(gas) 23.32
C.Q i t0 I T k) 'vet, Wood/pellet stove 33.39
Wood fireplace/insert 2332
Chimney/liner/flue/vent 23.32
Lid'PROPERTY OWNER 9 TENANT Other: 23.32
�1 Environmental exhaust and ventilation:
Name: /kit I 'C=J PA R.S, rt 4/y Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/Stats/LIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 2332
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
APPLICANT-" 0 CONTACT PERSON Other. 2332
Fuel piping:
Business name:J�.pp S (4 r C� Al $14.15 for first four;$4.03 for each additional
Contact name: J .6.,F- """ I`U(3G h ' Furnace,etc.
Gas heat pump
Address: 23E75- JON Ai S UK, izp
p Wall/suspended/unit heater
j
City/State/ZIP: G T /....,161./s41 01/1--- `7O4 a Water heater
Phone:(60,p 2C)I g()34i Fax::()3).5-S--7 3$-76 Fireplace
(� Range
E-mail:J(<(/IS(IA J rlTn t:AJC-; INIE47/ / E 14/.. G361-44-401/4/C,'GCjyl i Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: S i&!1/L$ Other:
M*CH Ct,L PER I *
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee),//h o22-
CCB lie.: Qq 13 Z— 257 TOTAL PERMIT FEE /0 y,.7?-
This permit application expires if a permit isnot obtained within 180
days after it baa been accepted as complete.
Authorized signature: �i * Fee methodology set by Tri-County Building Industry Service Board
J
Print name: 'y' U& /i✓ Date: id7 Si/b
13125 SW Hall Blvd.
Tigard, OR 97223
City of Tigard
Location:
12234 SW MILLVIEW CT, TIGARD, OR, 97223
Record Type:
Residential - Mechanical
Inspection Type:
699 Mechanical final
Result:
PASS- NoCofO
Comments:
Violation Summary:
Inspector
Tel: 503.718.2439
Inspection Date:
Record ID:
MEC2016-00745
Inspector:
Chip Barnett
Contractor