Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00126
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/25/2011
Parcel: 1 S125DD02500
Jurisdiction: Tigard
Site address: 6905 SW VENTURA DR
Project: Boyer Subdivision: /ASHINGTON SQUARE ESTATES NO. Lot: 16
Project Description: Replace gas furnace.
Contractor: ABLE HEATING & COOLING Owner: BOYER, THOMAS L &
8900 SW BURNHAM F -5 FULLERTON, ANN
TIGARD, OR 97223 6905 SW VENTURA DR
TIGARD, OR 97223
PHONE: 503 - 579 -2250 PHONE: 503 - 245 -3530
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 03/25/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 03/25/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/25/2011 $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
Utilit ification 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 erect questions to OU . b -fling 503.232.1987 or 1.800.332.2344.
ssued By: /, ea_ "f Permittee Signatur C �J
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 • FOR OFFICE USE ONLY
City of Tigard Received
13125 SW Hall Blvd., Ti ,� Date /By: permit No.:
gard, OR 97223 �JI��;', L, I ; t 01 6 W ����� -���
Phone: 503.718 2434 Fax: 503.598.2960 Plan Review
.'lc,: +.r n Inspection Line: 503.639.417
Date/By: Other permit
Internet: www.tigard or.gov Date Ready/By: r�� e>.e or
Notified/Method: Its/ Sup Pa em e atat 2 I
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
0 New Construction Addition/alteration/replacement Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
® 1- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building For special infornratlen use checklist.
Q Multi- family 0 Master builder
❑ Other: Description
Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Heati ng:
Mr conditioning
lob site address: 6905 SW Ventura Drive (requires site plan showing placement) 46.75
City / State/ZIP: Portland. OR. 97223 Furnace 100.000 BTU (ducts/vents) X 46.75 46.75
Furnace 100,000° BTU (ductsheats) • 54.91
Suitelbldgfapt. no.: I Project name: Boyer Heat pump
_ (requires site plan showing placement) 61.06
Cross strect/directions to job site: Duct work
. 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, induct, suspended, etc. 46.75
Subdivision: , Lot no.: Fluelvent for any of above 23.32
Tax map /parcel no.: Other: 23.32
Other fuel appliances:
DESCRIPTION OF WORK Water heater 2332
Replace existing gas furnace Gas fireplace I 3139
Flue vent for water heater or gas .
fireplace 23.32 .
- Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
Chimney/liner/flue/vent j 23.32
® PROPERTY OWNER Q TENANT
Other: l
Name: : Tom iioyer r 23.32
I
Environmental exhaust and ventilation:
Address: 6905 SW Ventura Drive Range hood/other kitchen
equipment 33.39
City /State/ZIP: Portland, OR. 97223 Clothes dryer exhaust 33.39
Phone: (503)245 -3530 Fax: ( ) Single -duct exhaust (bathrooms,
l',::1 APPLICANT CI CONTACT toilet compartments. utility rooms) 23.32
T PERSON Attictcrawlspace tans 23.32
Business name: 23.32
Contact name: Fuel piping:
514.15 for lust four: $4.03 for each additional
Address: Furnace. etc.
City / State/ZIP:
Gas heat Pump 1
Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E-mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: Able Beating & Cooling, LLC. Clothes dryer (gas) _
Address: 8904 SW Burnham #F -5 Other:
MECHANICAL PERMIT FEES"
City / State/ZIP: Tigard, OR 97223 Subtotal I 46.75
Phone: (503) 579 -2250 1 Fax: (503) 620 -3980 Minimum permit fee ($90.00) 90.00
CCB tic.: 184392
Plan review (25% of permit fee)
State surcharge (12%ofpermit flee) 10.80
TOTAL PERMIT FEE 100.80
I This permit application expires if a permit is not obtained within IRO
Authorized signat2lre:
days after it has been accepted as complete.
Print name: Kelly Wiih' Date: 03 - 2011 1 ` FCC meclrcx'.ology set by Tn- County Building Industry Servile Board
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