Permit (77) CITY OF TIGARD MECHANICAL PERMIT
al COMMUNITY DEVELOPMENT Permit#: MEC2017-00521
T r 1 A rz.O 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/18/2017
Parcel: 2S108DB05400
Jurisdiction: Tigard
Site address: 15402 SW SEINE CT
Project: Mooney Subdivision: POLYGON AT BULL MOUNTAIN Lot: 52
Project Description: Install new A/C
Contractor: MILWAUKIE HEATING&COOLING Owner: MOONEY, MELANIE
PO BOX 220216 15402 SW SEINE CT
MILWAUKIE, OR 97222 TIGARD, OR 97224
PHONE: 503-557-5562 PHONE:
FAX: 503-557-0790
FEES
Specifics: Description Date Amount
Air Conditioning 07/18/2017 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 07/18/2017 $10.80
Class of Work: ALT Type of Const: VB Minimum Fee Adjustment-Mechanical 07/18/2017 $43.25
Occupancy Grp: R-3
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 direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: MA,/ Permittee Signature: S- n p
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 Application IOR of II( F I i' oyl.)
Received
City of Tigard V E _ Permit No.:
`.1 g � Date/By: -
13125 SW Hall Blvd.,Tigard,OR 97223
,✓ c�
8 Phone: 503.718.2439 Fax: 503.598.1960an Review
1 8 2017 Date/By: 1 Other Permit:
T I c A R u Inspection Line: 503.639.4175 JULDate Ready/By: auris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OrTIGARD
ING DIVISION
a TYPE . , cQl► ltc?rc;ne somputz. USE CHEcKUsT
Mechanical permit fees*are based on the value of the work
❑New construction /1 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$$5,850.00
CA EGURI' OF coNS RU TIiEJ►N` 1tESIIJIEl'1 Ci AI EQUIPM N / YSI EM t lE9
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description Qty. 1 Ea. 1 Total
JOB SITE INFORMATION` )'LOCATION
Heating/cooling:
Air conditioning 1 46.75 46.75
Job site address:15402 SW Seine Ct Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Mooney 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
;IR11TUl (IF € "i Gas fireplace/insert 33.39
Flue vent for water heater or gas
Add AC fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
7 O$I O Environmental exhaust and ventilation:
Name:MELANIE MOONEY Range hood/other kitchen '
equipment 33.39
Address:15402 SW SEINE CT Clothes dryer exhaust 33.39
City/State/ZIP:TIGARD OR 97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)701-7677 Fax:( ) Attic/crawispace fans 23.32
e APPk9`I' . , ❑,GACT PERSON;, ," Other: 23.32
Business name:MILWAUKIE HEATING&COOLING,INC Fuel piping:
$14.15 for first four,$4.03 for each additional
Contact name:JIM KLINK Furnace,etc.
Address:P.O.BOX 220216 Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:MILWAUKIE OR 97269 Water heater
Phone:(503)557-5562 Fax::(503)557-0790 Fireplace
Range
E-mail:INSTALLATIONS@MILWAUKIEHEATING.COM Barbecue
�iC`O COR Clothes dryer(gas)
Business name:MILWAUKIE HEATING&COOLING,INC. Other:
MECHANICAL PERMIT FEES* '
Address:P.O.BOX 220216 Subtotal 46.75
City/State/ZIP:MILWAUKIE OR 97269 Minimum permit fee($90.00) 90.00
Plan
Phone:(503)557-5562 Fax:(503)557-0790 State surcharge of permit fee)
(22(12%
of permit fee) 10.80
CCB lie.:104102 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: �. '�d:��2^' * Fee methodology set by Tri-County Building Industry Service Board
Print name:JIM KLI Date:7/18/17
1:\Buildisg\Pennits\MEC_PermitApp_0401 13 doe 440-4617T(11/02/COM/WEB)