Permit (3) II
CITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT7,1
Permit#: MEC2019 00723
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/10/2019
TIGARD Parcel: 2S112BD13900
Jurisdiction: Tigard
Site address: 7611 SW CORNUTT ST
Project: Elderberry Ridge, Lot 35 Subdivision: ELDERBERRY RIDGE Lot: 35
Project Description: A/C for new home. Unit must be placed per manufacturer's requirements.
Contractor: PRO HEATING AND COOLING INC. Owner: RIVERSIDE HOMES LLC
2095 NW ALOCLEK DR, SUITE 1103 17933 NW EVERGREEN PL STE 370
HILLSBORO, OR 97124 BEAVERTON, OR 97006
PHONE: 503-443-5692
PHONE: 503-645-0986
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 10/10/2019 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 10/10/2019 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment-Mechanical 10/10/2019 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
A
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specia , C ides and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not .tarter within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the ru-s a••pted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obta. a copy of the rules
or direct questions to OttP1C by calling 503.232.1987 or 1.800.332.2344.
Issued By: 1111 , v_ Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applica j a I O1 0, IRI I l ()NI.l
City of Tigard r "' ,r Received /
Date/By: (e//e/j l 4J(/ Permit No j . 6!1_cc
-7 s
1,1 . 13125 SW Hall Blvd.,Tigard,OR 97223 OCT ® Plan Review /
Phone: 503.718.2439 Fax: 503.598.1960 t 2019 Date/By: OtherPertgif1Sl /9_cRer.45
1 i G A K I) Inspection Line: 503.639.4175 � � I Date Ready/By: loris: fa See Page 2 for
Internet: www.tigard-or.gov ��� 1' I yt 116AHD Notified(Method: Supplemental Information
DikfiSlor,
TYPE OF WORK COMMERCIAL FEE* SCHEDULE USE CHECKLIST
Mechanical permit fees*are based on the value of the work
pi New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT J SYSTEMS FEES*
IN 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. Ea. Tota
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning I 46.75
Job site address: 7 L, \. %.,.... ,_ Com,',-' �j ''')Ii" Furnace 100,000 BTU(ducts/vents) 46.75
City/State/Zir: Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: t ..f\.„ 'C4 V ,) Duct work 23.32
Cross street/directions to job site: Hydropic 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
D? Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCR PTION OF of x . Gas fireplace/insert 33.39
Flue vent for water heater or gas
IN(.— v -'‘•.-N\ 42,<��-,... ,{\''''- '{‘A---,1 i.--4',1,;14-- i t eA 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
04 PROPERTY OWNER ' 0 TENANT Environmental exhaust and ventilation:
Name: p.._;\,1 q r Range hood/other kitchen
Address: 7 1j� I' 2 ��
equipment 33.39
)�,��� t'V� ��,}-�.�C„(`w-�-/\ �i>«,-vs,v��- J�' Clothes dryer exhaust 33.39
City/State/ZIP: 1 C ,t e.l , C� / 7 76(Z/; Single-duct exhaust(bathrooms,
y toilet compartments,utility rooms) 23.32
Phone:(5,:). ) &/ Fax:( )` )G Attic/crawlspace fans 23.32
''a APPLICANT 0 CONTACT'PERSON Other: 23.32
Fuel piping:
n
Business name: i_‘..1 `,:e.. \,... ,1r.._..2-5 L LC- $14.15 for first four;$4.03 for each additional
Contact name: A p"o Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:(9?/ ) Z:✓2_ 3,3S?._ Fax::( ) Fireplace
Range
E-mail:
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: pro Other:
7 ��Q -k`�S MECHANICAL PERMIT FEES*
Address: ?L)l C fL t/ C /.....�. J 0 c- ) k. t( * 1)o 5' Subtotal
City/State/ZIP: LMinimum permit fee($90.00)
ty \,� � p ?/7 Plan review(25%of permit fee)
Phone:( ) " 70 _icj/� Fax:( ) State surcharge(12%of permit fee)
CCB lic.: v /k,..! TOTAL PERMIT FEE
Zo��� f6���rC `�� K`x ( Co This permit application expires if a permit is not obtained within 18
days after it has been accepted as complete.
Authorized sign cure: * Fee methodology set by Tri-County Building Industry Service Board
Print name: MC Date: /0//Cp t
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