Permit (3) CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2015-00590
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/27/2015
MARE) Parcel• 2S111CC10900
Jurisdiction: Tigard
Site address: 15870 SW GREENS WAY
Project: Hurner Subdivision: SUMMERFIELD NO.2 Lot: 136
Project Description: Installing furnace and air cleaner with supply and return air ducts,due to smoke damage,like for like.
Contractor: ADVANCED HEATING&AIR CONDITIONING INC Owner: HURNER, CAROLYN K REVOCABLE LIVI
5825 SE FOSTER RD 15870 SW GREENS WAY
PORTLAND, OR 97206 TIGARD,OR 97224
PHONE: 503-774-0161 PHONE:
FAX: 503-774-4391
FEES
Specifics: Description Date Amount
Furnaces< 100K BTU 08/27/2015 $46.75
Type of Use: SFA 12%State Surcharge-Mechanical 08/27/2015 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/27/2015 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulalions contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC bbyyc calling
�503.232.1987 or 1.800.332.2344.
Issued Byl f�� C a7 f ,M ,i� ,q �] y Permittee Signature:
\��' _3��� all 503.639.4175` .41 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplAVion..
City of Tigard t I �+ Reeei�ea y r
``r g 'i '� Date,6 b a7 17 Pennit No.: e,9{j/5--ex5L)9:0
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review r
Phone: 503.7182439 Fax: 503.598.1960 Date/By. Other Permit 1 L)r2 , i 0e/p
Ti GAR D Inspection Line: 503.639.4175 A U G 2 7 2 01 5 Dale Ready/By: lulls. ® See Page 2 for
Internet www.tigard-or.gov Notified/Method: Supplemental Information
U l 5 110 i lhARI)
'1'Yfi�li®JF► _'' ,, 7\Y 4,f'.',,, COMMERCIAL FEE* SCHEDULE USE CHECKLIST
"11R81111' D Y'i II' Mechanical permit fees*are based on the value of the work
❑ New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and 7�mfit.
Value:$
CATEGORY OF CONSTRUCTION 7r --7. g
�`
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® I-and 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 LOCATION Heating/cooling:
Air conditioning 46.75
Job site address 15870 SW Greens Way Furnace 100,000 BTU(ducts/vents) I 46.75
City/State/ZIP:Tigard,Oregon 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: Project name: en Heat pump 61.06
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
Installing a furnace and air cleaner (A,, - 1.i 5f,�,�,I7 awa �y1y l^r fireplace 23.32
CC. {- ttm tom'"S D to2- # Sv lc 2 1oka yyt et e`J� Log lighter(gas) 23.32
4 Wood/pellet stove 33.39
L, s- T r o r" L c Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER Other: 23.32
❑ T'EN.4NT
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( )
Attic/crawlspace fans 23.32
0 APPLICANT ❑ CONTACT PERSON Other: 23.32
Business name: Fuel piping:
$14.15 for first four;S4.03 for each additional
Contact name: Rc, 0 Sh-e a-Ffle te--- Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:
Water heater
Phone:5-0/) 77 3 _?..C. 7 D Fax: :( ) Fireplace
Range
E-mail: is 6 P 0.ci O Cf to ( -e ci h E (.4< .1 of t ti ( . CO yy\ Barbecue
CONTRACTOR J Clothes dryer(gas)
Business name:Advanced Heating&Air Conditioning_,Inc Other:
MECHANICAL PERMIT FEES*
Address:5825 SE Foster Rd.
Subtotal
City/State/ZIP:Portland,Oregon 97206 Minimum permit fee($90.00) 90.00
Phone:(503)774-0161 Fax: (503)774-4391 Plan review(25%of permit fee)
State surcharge(12%of permit fee) 10.80
CCB lie.:98573 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 signatur
5 „) Fee methodology set by Tri-County Building Industry Service Board
Print name:Kristal Reed Date:5/27/2015
I.\Building\Permns\MEC_PermitApp_040113.doc 440-4617T(1 UO2/COM/WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15870 SW GREENS WAY, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
FAIL
MEC2015-00590
David Young
No access for inspection, lock box on front door.
Provide access code for inspection.
Violation Summary:
Inspector Contractor
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
15870 SW GREENS WAY, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00590
Jeff Grove
Violation Summary:
Inspector Contractor