Permit (140) CITY OF TIGARD MECHANICAL PERMIT
.71--- q
31 COMMUNITY DEVELOPMENT Permit#: MEC2017-00165
13125 SW Hall Blvd.,Ti Date Issued: 03/08/2017
TEtA[t. and OR 97223 503.718.2439 9
Parcel: 2S112BB09800
Jurisdiction: Tigard
Site address: 14375 SW FANNO CREEK LP
Project: DALTON Subdivision: COLONY CREEK ESTATES NO.3 Lot: 80
Project Description: Gas furnace replacement.
Contractor: A ACTION APPLIANCE&HEATING INC Owner: DALTON, DANNY E&SHIRLEY J
18245 SW TV HWY DALTON,JOSHUA EDWARD
ALOHA, OR 97006 14385 SW FANNO CREEK LOOP
TIGARD, OR 97224
PHONE: 503-649-3524 PHONE:
FAX: 503-649-6095
FEES
Specifics: Description Date Amount
Furnaces< 100K BTU 03/08/2017 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 03/08/2017 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 03/08/2017 $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 dire uestions to UNC by calling 503.232.1987 or 1.800.332.2344.
Issue By: / `" 4 / Permittee Sign tures
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.
MAR-03-2017 17:24 From: To:5035981960 Paae:1/2
Mechanical Permit I .p licat101 FOR OFFICE USE ONLY
City;of Tigard Receives
r 4 13125 SSW Hall Blvd., igard,OR 97223 Irk i ,2 i;1 ` Date/By: AA
^ (� /37._
( PemtitNo.c
:a Plan]review / PFS( 7--
Phoue:1503.639.4171 Fax: 503.598.19§0 Other Permit:
Ins don Lino: 503.39.4175 ? ' r, Datc/Bye
TIGARD l
Internet www.ti and-d DaleReady/By: Juris:
g r.gov Cd See Page 2 for
s ! .r Notified/Method:
s .1-1,1:77?-1I,, $upplehrCntal Tnforatatlo
TYPE OF WORK_ COMMERCIAL FEE* SCHEDULE -
C1SL C:HEC +LIST
❑New construction Il dditiort/alteration/replacerttient Mechanical permit fees*are based on the value of the wor
❑Demolition Ot}m ; performed.Indicate the value(rounded to the nearest dopa)of alt
r mechanical materials ui mcnt,labor,overhead,and ro�,t_ -
_ j CATS ORY O1 CONSTRUCTION Value:$
�-and 2-famiip dwelling [ Commercial/industrial 0 Accessory building RESIDENTIAL EQUIPMENT/SYSTEMS FEES
Multi-family f (Master buildor 0 Other: For special Informalion use checklist.
Description Qty. 1 )a fatal
-JOB SIFE' NFORMATION AND LOCATION HeatIng/cooling
Job site address: L ' / , b • Air conditioning
.. ` (requires site plan showing.placement) 46.75
City/State/ZIP: 0,--12:2_,-- Furnace 100,000 BTU(ducts/vents) .1 46.75
Furnace 100,000'' BTU(duclt/ve,lts} 54.91
Suite/bldg-/apt.no.:i Project name:
Heat pump 61.06
Cross street/directions to job site: Duct work - 23.32
Iiydronic hot water system 23.32
Residential boiler(radiator or'—�
hydronic) 23,32 •
. - Unit heaters(fucl-type,not electric),
in-wall,insuspended,etc- 46.75
Subdivisipn: Lot no.: Flue/vent for any of above 23.32
— --- Other: 23.32
Tax map/parcel no.:, Other fuel ambiances
UEISCRIPTION OF WORK Water heater 23.32
ItiGas fireplace _.' - 33.39
1 �/fY1� Cs_ - Flue vent for water heater or gas
Ifireplace • 23.32--
: I • Log lighter(gas) - 23.32
Wood/pellet stove 3139
IWood fireplace/insert 23.37-
ROPERTY OWNE�i ❑ TENANT• _ChimneY/liner/flue/vent -- 23.32
(-' -- Other: 23.32
Name: Atik. 1 Environmental exhaust and ventilation
Address; Range hood/other kitchen
,c-,(71.41-•_S c4uiimtcnt 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
''_ 3) p2L - A t i _ vini e corn sen s utbatluoo{trs.
t it ms ___ 23,32
0 APPI„[CANT 0 CONTACT PERSON Attick rawlspace fans 23.32
Other:
Business name: 23.32 I}
I 1,11e1 _ I ' Fueli in
Contact name: . P j� £
: A 1 s 1 $14.15 for first four;$4.03 for each additional
Address: ALO* A,OREGON 97006 Furnace,etc'
— Gas heat pump
City/Slate/ZIP: Wall/suspended/unit heater ' •
Phone:( ) I Fax::( ) _Water heater •
F--- - - Fireplace
E-mail: /- a} — Ct Tl C JV {�-n
FA 12angc
(CONTRACTOR _ Barbecue
Business name: j A-ACT 0 ' I t ' 1 Clothes dryer(gas)
Address: 18'r '. • • ' — Other:
ALOT,OREGON 9 006 _-- MECR.ANICAI,PERMIT FEES*
City/State/ZIP: - ____
Subtotal
Phone.-1'3? 1011 O(-..35Q 4 Fax; )_�jt+� Minimum permit fee($90.00)
F ,J �C l- � Plan review(25%of permit fee)
CCB lie.:—17c
7tp,6 I o2 bf State surcharge(12%of permit fee) ,
I ( — TOTAL PERMIT FEE _
Authorized signature; ; 1' All' Thls permit application expires if a permit is not obtained wiiius]8A
days after it has been accepted as complete.
Print name: Date: W Fee methodologyactTri-Cour Buildingindustry Service lie rd
T.�i <r.. ��. _ � -- �� �� by Tri-County Y.
tAneildiaeNimiO\MEC-PenlilAvv.duc torol/Og I ' 440.4517r111/07/rvtM/Wpm