Permit CITY OF TIGARD MECHANICAL PERMIT
�. COMMUNITY DEVELOPMENT Permit#: MEC2020 00093
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 02/10/2020
TI{'��11- g Parcel: 2S112BD13800
Jurisdiction: Tigard
Site address: 14779 SW 76TH AVE
Project: Elderberry Ridge,Lot 34 Subdivision: ELDERBERRY RIDGE Lot: 34
Project Description: Adding A/C unit. Placement of A/C unit must comply with manufacturers 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:
FAX:
FEES
Specifics: Description Date Amount
Air Conditioning 02/10/2020 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 02/10/2020 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 02/10/2020 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of O'. Sp-cialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if wor is nit started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to folio the ules adopted by the Oregon
Utility Notification Center. Those rules are se forth in OAR 952-001-0010 through OAR 952-001-0090. ou :y obtain a copy of the rules
or direct questions to OU y !ling 503.232.1 7 or 1.800 32.23 .
Issued By: Permittee Signature: -`
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. �r
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application
City of Tigard Received
u 13125 SW Hall Blvd.,Tigard,OR 97223 y �G t t � '7�1J11�I
g Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
i.i(1 A 1,i Inspection Line: 503.639.4175 Date Ready/By: Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE Ciik,CKLIST
Mechanical permit fees*are based on the value of the work
pi New construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT!SYSTEMS FEES*
[N 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist
❑Multi-family ❑Master builder 0 Other: Description Qty. Ea. Tota
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning I 46.75
Job site address: /L�7 7.... `) S . Furnace 100,000 BTU(ducts/vents) , 46.75
City/State/ZIP: l Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: ,,ri - s"�i Duct work 23.32
Cross street/directions to job site: `�•1� 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
+ ` ` /`J Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
A.�� — -/r7C, fireplace 23.32
Log lighter(gas) , 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
PROPERTY OWNER -0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: 12--'V Qr 5;�� \-\`,`,`Q(: L LC_, Range hood/other kitchen
A') equipment 33.39
Address: ) 3 5 iv t. 0- 7(-•C-41, 4 k, ; )3 Clothes dryer exhaust 33.39
City/State/ZIP: c �J ()
7 Single-duct exhaust(bathrooms,
y toilet compartments,utility rooms) 23.32
Phone:(50 S) 6ef5-., C�q G�G 6 Fax:(5;) ) (�k) .-2 C 9 2_, Attic/crawlspace fans 23.32
APPLICANT 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name: j� 1
1`- ��9,Z . Sr-`c7 --5 L L C $14.15 for first four;S4.03 for each additional
Contact name: A ,r,�o Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Fireplace
Phone:(9?! ) Z�Z_ 3-3s2_ Fax: :( ) Range
g
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: pro Other:
c /L' pi-` II. Ica ) '/ I � il 1)o 51 MECHANICAL PERMITuFbtoottal
Address: � f�-
f
City/State/ZIP: ' \ V7 b„ )- a 11._ c7 -)2 t� Minimum permit fee fee)
` Plan review(25%of permit fee)
Phone:(50.3) 2 70 '7 c7O Fax:( ) State surcharge(12%of permit fee)
CCB lie.: ao W vf2/ ' a :D's` '€ a TOTAL PERMIT FEE
I�l `�'J / ` c( .7 Co-,-- This permit application expires if a permit is not obtained within 11
days after it has been accepted as complete.
Authorized sign ture: * Fee methodology set by Tri-County Building Industry Service Board
Print name: ' _tUt Datc: 2_//0/
1:\Building\Permits\MEC_PennitApp_0401 t3.doc 440-4617T(t 1/02,COMM1VEB)