Permit t CITY OF TIGARD MECHANICAL PERMIT
Pv COMMUNITY DEVELOPMENT Permit#: MEC2019-00515
GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 07/17/2019
T 1 Parcel: 1 S 134C B 16400
Jurisdiction: Tigard
Site address: 12467 SW ANTON DR
Project: Ross Subdivision: ANTON PARK NO.2 Lot: 91
Project Description: Installing furnace and AC.
Contractor: INTEGRITY AIR LLC Owner: VANCURA, SCHALISE
16756 SW 72ND AVE ROSS, ERRYN FREELAND PASIN
PORTLAND, OR 97224 12467 SW ANTON DR
TIGARD, OR 97223
PHONE: 503-572-3594 PHONE: 503-459-8406
FAX: 503-598-8498
FEES
Specifics: Description Date Amount
Air Conditioning 07/17/2019 $46.75
Type of Use: SF Furnaces<100K BTU 07/17/2019 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 07/17/2019 $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.
Issued By: i 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 Application FOR 0111( 1: t til oyl.v
u 9 ft
II City of Tigard I-1 4 i Received . \ k 1c Peat
No.: C .. -t•,
Date/By:
'I13125 SW Hall Blvd.,Tigard,OR 97223 Dan R
Phone: 503.718.2439 Fax: 503.598.1960 j UI L 1 P 2O1 v� Date/By:
Review
Other Permit:
T I G A R!C) Inspection Line: 503.639.4175 Date Ready/By: Juris: Fd See Page 2 for
Internet: www.tigard-or.gov 1 I , A,il,,is st >: Notified/Method: Supplemental Information
,�� .. , m°§ 1� t to
❑New construction Mechanical permit fees"are based on the value of the work
®Addition/alteration/replaeement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value $
/.1 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
0tTLl A 1QN
' 38 5 : om ( . Heating/cooling:
'` Air conditioning 1 46.75
Job site address:12467 SW Anton Dr. Furnace 100,000 BTU(ducts/vents) 1 46.75
City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
' Suite/bldg./apt.no.: I Project name:Ross 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
Other: 23.32
Subdivision: I Lot no.: Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
k „
i Gas fireplace/insert 33.39
I1E �i11'TTOI' �� p
Flue vent for water heater or gas
Install furnace and 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
�1 [ R. T � ,
` Other: 23.32
. fi1r , . . Tr,^ A � q. '
Environmental exhaust and ventilation:
Name:Erryn Ross Range hood/other kitchen
equipment
Address:12467 SW Anton Dr. 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)459-8406 Fax ( ) Attic/crawispace fans 23.32
: e:�'��1€.iee1M „ „ iCW,p Other: 23.32
Business name:Integrity Air,LLC Fuel piping:
$14.15 for first four,$4.03 for each additional
Contact name:Lori Furnace,etc.
Address:16756 SW 72ed Ave. Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Portland,OR 97224 Water heater
Phone:(503)598-0966 Fax::( )
1epldt e
Range
E-mail:lori.integrityair@outlook.com Barbecue
4.. " t " lA 4, , •.,,,,,-,4,i;,,,,::-.0.v., Clothes dryer(gas)
Business name:Integrity Air,LLC Other *** y
Address:16756 SW 72nd Ave. Subtotal
City/State/ZIP:Portland,OR 97224 Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:(503)598-0966 Fax:( ) State surcharge(12%of permit fee)
CCB lic.:203869 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signa ?' ( / * Fee methodology set by Tri-County Building Industry Service Board
Print name:Lori R, er Date:7/17/2019
I:1Building\Pernrits\MEC PermitApp 040113.doc 440-4617T(11/02/COM/WEB)
City of Tigard
Tel: 503.718.2439
Location: Inspection Date:
12467 SW ANTON DR, TIGARD, OR, 97223
Record Type: Record ID:
Residential - Mechanical MEC2019-00515
Inspection Type: Inspector:
699 Mechanical final David Young
Result:
PASS - NoCofO
Comments:
Minor label ELS 731431
Note: provide protection for copper line set tubing in contact with galvanized
clamps. M1309.2
Owner to contact contractor, prefers no re inspection.
Violation Summary:
Inspector Contractor