Permit (2) CITY OF TIGARD MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT Permit#: MEC2019-00887
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/23/2019
Parcel: 2S112BB08500
Jurisdiction: Tigard
Site address: 14244 SW FANNO CREEK LOOP
Project: Adams Subdivision: COLONY CREEK ESTATES NO.2 Lot: 68
Project Description: Replacing existing gas furnace.
Contractor: ACE ALL CLIMATE ENGINEERING LLC Owner: ADAMS, ERIC EDWARD&KATHY MARIE
PO BOX 3733 14244 SW FANNO CREEK LOOP
SALEM, OR 97302 TIGARD, OR 97224
PHONE: 503-991-5580 PHONE: 503-292-1740
FAX: 888-296-0121
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 12/23/2019 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 12/23/2019 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 12/23/2019 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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 orth in OAR 2-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC ailing 503.2 2.198 1.800.3 344. n/�
Issued By: Permittee Signature: YYA � �
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 Applicaj 9"x P 5 7 f FOR OFFICE USE ONLY
Received
- City W Tigard DaleB P
13125 SW Hall Blvd.,Tigard,OR 97223 I - � Z 019 Y �Z� // / '�'�p^��7�0"`�
Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Other Permit:
Date/By:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: luris: ® See Page 2 for
Internet: WWw.tigard-or.gov >.i Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S
CATEGORY OF CONSTRUCTION _. RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
:,154,J,:, 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND I.00ATION Heating/cooling:
Air conditioning 46.75
Job site address:i (�L� /� ) � / /
/ / 5 4/ / s1.��v (r e:e Al L Furnace 100,000 BTU(ducts/vents) d 46.75
City/State/ZIP:77Q G Q 9 7 �— � . _ Furnace 100,000+BTU(ducts/vents) 54.91
f/ Heat pump 61.06
Suite/bldg./apt.no.: Project name: 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
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
/ p 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
❑ PROPERTY OWNER ❑ TENANT
/ Environmental exhaust and ventilation:
Natne4�L/ et i) 4i -� /V0 j Range hood/other kitchen
Address: [/���"JJJ J equipment 33.39
// �y S cf/ / Gr l4sy p ("- -C k Z Clothes dryer exhaust 33.39
City/State/ZIP: a 63 0,- 97a a TiSingle-duct exhaust(bathrooms,
/ I ^� toilet compartments,utility rooms) 23.32
Phone: j) e. �2 —/ / C�/6,,) Fax:( ) Attic/crawlspace fans 23.32
El APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
S CZ `/`7/J $14.15 for first four;$4.03 for each additional
Contact name: ( Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
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Phone:( ) Fax::( ) Fireplace
E-mail: Range
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:/,{ /
Other:
/ ` 'G j l! `` An{6 f Q /' 1FIECHANICA7.PERMIT FEES*
Address: q 7L7S �C,"f�L� 5 ` (l -� %e, k5 Subtotal
City/State/ZIP:: OS /e�� / Q q7 `36 Minimum permit fee(590.0e)
L Plan review(25%of permit fee)
Phone:(��)ago Q s,75-7 Fax:( ) State surcharge(12%of permit fee)
CCB lie.: /Q�r? `a.3 �-7(�'42,1 TOTAL PERMIT FEE
�� !! This permit application expires if a permit is not obtained within t80
days after it has been accepted as complete.
Authorized signature: n ) Fee methodology set by Tri-County Building Industry Service Board
Print name: / _ / Jlil/f" G 4, Date:7 -a3--1Q
li\Building\PermitNtss\/MMEC_PermiiApp_040113.dooc 4404617T(I I i02/COM/WEB)