Permit CITY OF TIGARD MECHANICAL PERMIT
I'"! 11 • COMMUNITY DEVELOPMENT Permit #: MEC2011 -00199 •
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/06/2011
Parcel: 2S110AD90063
Jurisdiction: Tigard
Site address: 14964 SW 109TH AVE
Project: McLester Subdivision:ANTERBURY WOODS CONDOMINIUt Lot: 63
Project Description: Install new ductless mini split heat pump system. Unit must maintain minimum 3' rear and sideyard setbacks.
Contractor: ABLE HEATING & COOLING Owner: MCLESTER, COLE AND LORI
16285 SW 85TH AVE #105 14964 SW 109TH AVE
TIGARD, OR 97224 TIGARD, OR 97224
PHONE: 503 - 579 -2250 PHONE: 503 - 913 -1998
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Heat Pump 05/06/2011 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 05/06/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/06/2011 $28.94
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 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, . ' • suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility » .tification Center. ose rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dir ct questions to OUNC by : • g 03 2.1987 or 1.800.332.2344.
Issu • d By: t Permittee Si ature: /
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 Applicatio FOR OFFICE I ONLY
Cl of Tigard R ec eived
igalr 5s Ca24ik co9q
.. 13125 SW Hall Blvd., Tigard, OR 97223 MAY - 5 2011
Date/By: Ir Per rot: No ��
s Phone: 503.718 2439 Fax: 503.598.1960 Plan Review
r I c „A, It n Inspection Line: 503.639.4175 ^t Date By: Other Permit:
Internet: www.tigard- or.gov CITY OF TiGA,1D Date Ready/By: . I RI See Page: for
BUILDING DIVISION Notified/Method: f + Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction Mechanical permit fees* arc based on the value of the work
® Addition/alteration/replacement
❑ Demolition performed. Indicate the value (rounded to the nearest dollar} of all
❑ Other,
CATEGORY OF CONSTRUCTION
mechanical materials, equipment, labor, overhead, and profit.
Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
ED 1- and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building For pedal injnnnrsaorr use checklist
❑ Multi - family ❑ Master builder
0 Other: Description I Qty. 1 Ea. j Total
JOB SITE INFORMATION AND LOCATION Heati»gcooling:
Job site address: 14964 SW 109TH AVE. Air conditioning
(requires siie_ptanshovingplacement) 1 46.75
CitylState/ZTP: TIGARD, OR 97224 Furnace 100.000 BTU (duccs veers) 46.75
Furnace 100,000+ BTU Cductslvems) 54.91
Suite/bldg./apt. no.: I Project name: McLester Heat pump
Cross streeddirections to job site: (requires siie_ptan slowing placement') 1 61.06 - 61.06
Duct work 23.32
. Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wail, in-duct, suspended, etc. 46.75
Subd " r n o r a ny of above
auwiv j , „I Flue /vet for 23.32
Tax map /parcel no.: Other i 23.32
Other fuel appliances:
DESCRIPTION OF WORK Water heater 2332
INSTALL NEW DUCTLESS MINI SPLIT HEAT PUMP SYSTEM Gas fireplace 33.39
Flue vent for water heater or gas
_fireplace 21,32
- Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert _ 23.32
® PROPERTY OWNER �— 0 TENANT Chitnne_v/linerlflue/vent 23.32
., ., Other: 23.32
(N
ame: I:UL TI L t.,LL a 1 K
C. ANVKt 1vr
Environmental exhaust and ventilation.
Range hood/other kitchen F
Address: 14964 SW 109 AVE,
equipment 33.39
City /State /ZIP: TIGARD, OR. 97224 Clothes dryer exhaust
33.39
Phone: (503)913 -1998 Fax: ( ) Single duct exhaust (bathrooms, •
d APPLICANT toilet compartments, utility rooms) 23.32
Et! CO NTACT PERSON Atticicrawlspace tans 2,3.3t
Business name: Other: 23.32
Contact name: Fuel piping:
S14.15 for that four, 54.03 for each additional
Address: Furnace, etc. I
1- I
City/State/ZIP: j , Gas heat pump I
Phone: ( ) Wan:suspended/unit heater
Fax: : ( ) Water heater
E -mail; Fireplace
Range
CONTRACTOR Barbecue
Business name: ABLE HEATING & COOL ING,LLC Clothes dryer (gas)
Address: 16285 SW 85 AVE. k 105 Other:
MECHANICAL PERMIT FEES*
City /State/ZIP: TIGARD, OR 97224
Subtotal 61.60
Phone: (503 -) 579 -2250 I Fax: (503) 620 -3980 Minimum permit fee ($90.00) 90.00
CCB I ic.: 184392 I / Plan review (25% of permit fee)
�/ a Yr f r State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE I 100.80
This permit application es
Autlweized sigtlatur
r t pins if a permit is not obtained within t
Print name: KELL% L1i11 ” days after it has been accepted as coopkte.
Date: 05 - 2011 * Fee methodology set by 76-County Building Industry Service Board
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:r te . r'' p } -- i `' ' : f IGARD, OR 97223
i ' , J J [ (503)443 -2058 Fax (503) 620 - 3980
, ... ; _ q t: _:_ __- - - Email: ablehvac2 @aol.com
CCB 41184392
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