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Permit a CITY OF TIGARD MECHANICAL PERMIT IIIII g COMMUNITY DEVELOPMENT Permit #: MEC2011 -00142 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/06/2011 Parcel: 2S112BA03100 Jurisdiction: Tigard Site address: 14080 SW 80TH CT Project: Sandlin Subdivision: WAVERLY MEADOWS Lot: 23 Project Description: Gas furnace replacement. Contractor: AAA HEATING & COOLING Owner: SANDLIN, JAN 5017 NE GRAND AVENUE 14070 SW 80TH CT PORTLAND, OR 97211 TIGARD, OR 97224 PHONE: 503 - 284 -2173 PHONE: 541 - 915 -8797 FAX: 503 - 284 -1552 FEES Specifics: Description Date Amount Furnaces < 100K BTU 04/06/2011 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 04/06/2011 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/06/2011 $43.25 Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas Gas Pressure: Total $100. 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 forth in OAR 952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. \ Issued By: _ •ermittee Signature: E� -iii - _.6 /f.__.L_A.. 4l // Call 503.6 '.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. From: 04/04/2011 09:21 11191 P. 001/002 Mechanical Permit Application 10R 0141( r I Sr OM 1 I I City of Tigard Received t • 13125 SW Hall Blvd., Tigard, OR 97223 �� t� Phone: 503.639.4171 Fax: 503.598.1960 P Other Permit: Daa t e e /By/By: : T I It n Inspection Line: 503.639 Date y /By: ® See Page 2 for Internet: www.tigard - or.gov Notified/bfethod: l i g iM Supplemental Information g i s OF ,WORK - • .. M1Yw JAL FEE' SCHED . � . ♦CO .. :.... �ULE ;- USE C13ECKLIST I3 New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work ❑ Demolition ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all mechanical materials, equipment, labor, overhead, and profit. y 6 O Y OF CONSTRU ON ': Value: S Accessory building RESIDENI7AL EQUIPMENT / SYSTEMS; FEES• 1- and 2-family dwelling Commercial/industrial ID Multi-family ❑ Master builder 13 Other: For special information use checklist. Description 1 Qty. I Ea. I Total . • JOB - SPfE INFORMATION AND LOCATION " Heating/cooling Job site address: b ` -ip2'0 .at,) 8' 1 ` 0.,,t- Air conditioning ��� (requires site plea showing placement) 46.75 City /State/ZIP: Furnace 100,000 BTU (ducts/vents) 46.75 Furnace 100,000+ BTU (ducts/vents) 54.91 I t Suitt/b(dg ✓ apt. no.: Project name: (��V� j Heat pump 61.06 Cross street/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, in-duct, suspended, etc. 46.75 rrt� Subdivision: Lot no : Flue/vent for any of above 1. aC 23.32 3. 3e3, Other: 23.32 Tax map /parcel no.: Other fuel appliances SwF ' { . r , : DESCRWflON OF a w : Kam ' T` Water heater 23.32 �ip , t! te,e O 1(XvvClM _� Gas 5re vent 33.39 C _ JI �� ���f�� Flue vent for water heater or gas fireplace 23.32 Log lighter (g,as) 23.32 - Wood/pellet stove 33.39 _ Wood fireplace/insert 23.32 M PROPERTY OWNER I © TENANT : 4 ,`; Chimney/liner /flue/vent 23.32 23.32 ^ `Dr Other Name: OW •_ti' W `C Environmental exhaust and ventilation Address: 1 t 4D7t> � likp P (- Range hood/other kitchen equipment 33.39 City /State/ZIP: Ct 7U C q - 221-4 Clothes dryer exhaust 33.39 �) /y c Sing duct exhaust (bathrooms, Phone: ( ) — ,R "1 Fax: ( ) toilet compartments, utility moms) , 23.32 ®APPLICANT ; = ❑ ;:CONTACT PERSON Attic%tawhpace fans 2332 Business name: AAA Heating & Cooling Other 23.32 , Fuel piping Contact name: Victoria Allen $14.15 for first four; 34.03 for each additional Address: see below Furnace etc. City /State/ZIP: Gas heat pump Wall/suspended/unit heater Phone: ( ) I Fax:: ( ) Water heater - . E -mail: Fireplace Range CONTRACTOR Barbecue ' Business name: AAA Heating & Cooling Inc Clothes dryer (gas) Other. Address: 5017 NE Grand Ave IWECHANwiL PERIYItTFEES• City /State/ZIP: Portland OR 97211 Subtotal . Phone: (503) 284 -2173 Fax: (503) 284 -1552 Mw pern it fee ($90.00) a Plan review (25% of permit fee) CCB lic.: 222 State surcharge (12% of permit fee) j V 9 TOTAL PERMIT FEE 1 Dp. V D Authorized signature: This permit application expires if a permit Is not obtained within 180 days after it has been accepted as complete. Print name: Victoria Allen Date: * Fee methodology set by Tri -County Building Industry Service Board ' • t: \Buildingg \Permits \MEC- PennitApp.doc ID /01/09 440.461 (11/0 COM/WEB)