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Permit (68) CITY OF TIGARD MECHANICAL PERMIT 1111 - COMMUNITY DEVELOPMENT Permit#: MEC2017-00427 13125 SW Hall Blvd.,Ti Date Issued: 06/13/2017 T[ ft8. and OR 97223 503.718.2439 9 Parcel: 1 S 136CB03100 Jurisdiction: Tigard Site address: 11265 SW 83RD AVE Project: Pimentel Subdivision: STEVE&HUGHIE'S PLACE Lot: 3 Project Description: Replace 200 amp service and(1)branch circuit. Contractor: OWNER Owner: PIMENTEL, MARK MARK PIMENTEL 11265 SW 83RD AVE 11265 SW 83RD AVE TIGARD, OR 97223 TIGARD, OR 97223 PHONE: 503-705-0321 PHONE: FAX: FEES Specifics: Description Date Amount Air Conditioning 06/13/2017 $46.75 Type of Use: SF Furnaces< 100K BTU 06/13/2017 $46.75 Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 06/13/2017 $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 st,rted within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rul:_/adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may ••(ain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.805).32. 344 Issued B_ i�[.. t 3 Permittee Signature: , !g Call 503.• •.4175 by 7:00 a.m.for the next available inspect• •:te. This permit card shall be kept in a conspicuous place on the job site until c. • etion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit Application FOR OFFICE USE ONLY .1,1111 ,1 City of Tigard N'tANReceived t Date/By: Permit No.:=MI -�� • - r 13125 SW Hall Blvd.,Tigard,OR 97 �> Plan Review 7 - Date/By. Phone: 503.718.2439 Fax: 503.598.1 Other Permit. _ �� j TIGARD Inspection Line. 503.639.4175 ep 1(11 Date Ready/By: 0 See Page 2 for Internet: www.tigard-or.gov , �A` �9 Notified/Method. INISupplemental Information �PE E)F 1'' c111 '1 RCIAL 1#EE*SCHEDULE -,€SE CHECKLIST:- ' KLISI: �� :: 'w Mechanical permit fees*are based on the value of the work ❑New construction ®Addition/alterat v6r+ t performed.Indicate the value(rounded to the nearest dollar)of all mechanical materials,equipment,labor,overhead,and profit. 111 Demolition El Other: , -: 3 , �AE( 4Ry ,� CONTRL _ i � Value $ ,.-.. .. �' . � .< �- 0 �:: :,, 1.. ' 'RE$II)EN1'41.r9v0 �IUT{Si,,,,s`IEs1FEES.s`- , ® I-and 2-family dwelling ❑Commercial/industrial E Accessory building For special information use checklist. ❑ Multi-family 0 Master builder 0 Other: Description p Qty. Ea. Total ` �f` Heating/cooling: JOB Sri INFORMt1Tli��i-Ai�D t=C1CATIpN � . g g' Air conditioning 1 46.75 46.75 Job site address: 11265 SW 83rd Avenue 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 Suite/bldg./apt.no.: Project name: Heat pump 61.06 Duct work 23.32 Cross street/directions to job site:Nearest cross street is Pfaffle Street 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 71 , .. DE CRtPTIO. Ot*iii, .. Gas fireplace/insert 33.39 Flue vent for water heater or gas Installation of new central A/C unit and replacement of existing 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 � PRERTY'OWER : TEN NT Other: 23.32© N ,_ . ''T Environmental exhaust and ventilation: Name. Mark Pimentel Range hood/other kitchen Address: 11265 SW 83rd Avenue equipment 33.39 Clothes dryer exhaust 33.39 City/State/ZIP:Tigard,OR 97223 Single-duct exhaust(bathrooms, toilet compartments,utility rooms) 23.32 Phone:(503)7050321 Fax ( ) Attic/crawlspace fans 23.32 's-® A•PPLf*,NT ❑.;CgNTACT'PERSON ' Other: r,. •.. 1, 23.32 Fuel piping: Business name: C/LtJi-st'r $14.15 for first four;$4.03 for each additional Contact name: Furnace,etc. Address: Gas heat pump City/State/ZIP: Wall/suspended/unit heater Water heater Phone: ( ) Fax: :( ) Fireplace E-mail: Range Barbecue CONTRACTOR' Clothes dryer(gas) Business name: Other ni/Af-v/ MECEIANIGALf PTR141IT PEES* Address: Subtotal 93.50 City/State/ZIP: Minimum permit fee($90.00) Phone:( ) Fax:( ) Plan review(25%of permit fee) State surcharge(12%of permit fee) 1 1.22 CCB lic.: TOTAL PERMIT FEE 104.72 y -7 This permit application expires if a permit is not obtained within 180 Authorized signature:‘--. �� days after it has been accepted as complete. d * Fee methodology set by Tri-County Building Industry Service Board Print name: .7 � � 7 �/�7Z�l Z - Date: 6/(2/f I.\Building\Permits\MEC_PermitApp_040113.doe 440-46t7T(I I/02/COM/WEB)