Permit CITY OF TIGARD MECHANICAL PERMIT
;' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00356
T1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/28/2011
Parcel: 1 S 134CA00708
Jurisdiction: Tigard
Site address: 11945 SW SUMMER CREST DR
Project: Desimone Subdivision: Lot:
Project Description: Install new heat pump. Unit must meet 5' minimum rear and side yard setbacks.
Contractor: ABLE HEATING & COOLING Owner: DESIMONE, PATRICK
16285 SW 85TH AVE #105 11945 SW SUMMER CREST DR
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 579 -2250 PHONE: 503 - 936 -8406
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Heat Pump 07/28/2011 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 07/28/2011 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 07/28/2011 $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, 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: - 1 - Permittee Signature: ( 9 A / - v��[ / C/9- - j /p/
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 ApplicatiooEC FOR OFFICE USE ONLY
e Phone: 503.718.2439 Fax: 503.598.1960 City of Tigard Received
�7 Ivo.
• 13125 SW Hall Blvd., Tigard, OR 97223 {1 Date/By: < oZ� ��. Permit �C'��f Q��
JUL G '101 Plan Review
Date/By: Other Permit:
TI GARD Inspection Line: 503.639.4175 TIGARD Read ,B
Internet; www.tigard- or.gov OF TIGARD y y fa See Page 2 far
BUILDING DIVISION 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: $
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/ SYSTEMS FEES"
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special inforrnation use checklist
❑ Multi family ❑ Master builder ❑ Other: Description I Qty. I Ea I Total
JOB SITE INFORMATION AN LOCATION Heating/cooling:
Air conditioning
Job site address: 11945 SW SIIVEVIERCREST DRIVE (requires site plan showing placement) 46.75
City /State /ZIP: TIGARD, OR. 97223 Furnace 100,000 BTU (duets/vents) 46.75
Furnace 100.000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: DESIMONE Heat pump
Cross street/directions to job site: (requires site plan showing placement) 1 61.06 61.06 l
Duet 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 _
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
INSTALL NEW HEAT PUMP Gas fireplace 33.39
Flue vent for water heater or gas ,
fireplace ?3.32
_ Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
® PROPERTY OWNER ❑ T ENANT Chimneytliner /tlue! vent 23.32
Other: 23.32
Name: PATRICK DE9iM01+1E Environmental exhaust and ventilation:
Address: 11945 SW SUMMERCREST DRIVE Range hoodiother kitchen
equipment ; 33.39
City /State/ZIP: TIGARD, OR. 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)936 -8406 Fax: ( ) toilet compartments, utility rooms) 23.32
APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: Other: 23.32
Faelpiping:
Contact name: 514.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump .
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail:
Fireplace
Range
CONTRACTOR Barbecue
Business name: ABLE HEATING & COOLLNG LLC Clothes dryer (gas)
Other.
Address: 16285 SW 85 AVE. SUITE # 105 MECHANICAL PERMIT FEES*
City /State/ZIP: TIGARD, OR. 97224 Subtotal 61.06
Phone: (503) 579 -2250 i Fax: (503) 620 - 3980 Minimum permit fee (590.00) 90.00
Plan review (25 %of permit fee)
CCB lie.: 184392 State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80 /
Authorized signature:, / 14 0 . 7 7 1 /
This permit application expires if a permit is not obtained wi 18
days after it has been accepted as complete.
tnt name: ILLY W 1 rE Date: 07 -27 -2011 " Fee methodology set by Tri County Building industry Servi Boar d
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Email: ablehvac2@aoLcorn
CCB #18439Z
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