Permit • CITY OF TIGARD MECHANICAL PERMIT
3 . COMMUNITY DEVELOPMENT Permit #: MEC2012 -00376
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/17/2012
Parcel: 2S 109AB 17800
Jurisdiction: TIGARD
Site address: 13245 SW HOOD VISTA LN
Project: Mission Homes Lot 7 Subdivision: HIGHLAND HILLS ESTATES Lot: 7
Project Description: Install NC to existing furnace and ductwork Must be placed minimum 5' side yard setback and approved rear yard
setback
Contractor: ADVANTAGE HEATING & AIR CONDITIONING LLC Owner: MISSION HOMES NW
2355 HYACINTH ST SE PO BOX 1689
SALEM, OR 97301 LAKE OSWEGO, OR 97035
PHONE: 503 - 393 -5315 PHONE:
FAX: 503 - 393 -2253
• FEES
Specifics: Description Date Amount
Air Conditioning 07/17/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/17/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 07/17/2012 $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 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: e14 Permittee Signature: DM I 4Pell M1 MAI
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 EC IVE ! FoR Oh t IC I E ONL'
City of Tigard - Dec f` Permit No. ijge apij.,- pp 37 ,
13125 SW Hall Blvd., Tigard, OR 97223 JUL 1 6 2012 Plan Review Oilier hermit:
Phone: 503.718.2439 Fax: 503.598.1960 natclSy:
T l (; A 1 l Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By: Jars• B See Page 2 for
Internet: www.tigard -or.gov V • Notified/Method: . ( Supplemental Information
BUILDING DIVISION
.. ._.. i _ _ _ , , ',e "-'i:: .,. ;, ti.. ,, ..,- ... .i. , .i' ^ r•1.w.
.�,. �-~`- • Mechanical petmit fees" are based on the value of the work
❑ New construction Addition/alteration/replaccment performed. Indicate the value (rounded to the nearest dollar) of all
mechanical material e. i•men labor overhead, and .tofit.
❑Demolition ❑ Other:
'.,, u- `.;Y•_ :nr.- ^.rx•_:.aY:` :" - i , D „ ?�',0 i9 r i ..ltr..�;:!
k r : , 7' �+0 .; G.a -. i i i , , . - _ ;y+l .t. y ' -,. f
��, � F�' �tTC�:_' �; q: i'. '''.,)`•: ":9 ::_..�::i �� TC -'s'= _.+U/..5_. _ ._c >-• o.., '1�; n 9' s �i_ k s: � `4 5 "
0 I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information Oise checklist.
❑ Multi t'anpily [] Master builder ❑ Other: Description 1 Qty, I 6a I Total
,,' HesunpJcooltnR:
.r G; ; _ S C;,ii 3bB - _' r ': e ffi°q ' _.,..!'l � ' , n i ° .�a� Air conditioning
Job site address: 2 . (,(.) ..-. S r i
r • 'Fes site • lea showin: .lacement 1 46.75 MrPj Furnace 100,000 BTU duds/vents) 46.75
t
Suite/bldg./apt. no.: Project name: of- 61.06
Cross street/directions to job site: Duct work
Hydronic hot water system
Residential boilor (radiator or
h dronic)
. — Unit heaters (fuel-type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: ( 04 0 14 t 1 5 Lot no.: 7 Flue/vent for any of' above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel applianctet
� :4 + ;. :c .47: 5lr= tr7,�e� ..t, •In :t1..4r �' 'i: • -r z ,4�? f : �, p�.. �_'.�. S ! t Water heater 23.32
�'•.r'1:,:°_II _:�i.•..... —, f �:e1.4. 5 :�� 1 - ,n:.iss.,a._!;.,rt4s.'t ,......,i �,, 33.39
Gas fire • Iace/insert
nr, It + +J ` -1_ • , • .> --- ' r 1 ,.. Flue vent for water heater or gas
���� fi • lace 23.32
"I'• u•Y•'•« — Log lighter (gas) �
Wood!. pet stove
Wood fireplace/insert 23.32
o '.1 r� - 0" " , - - • ; _ _T Chimn /liner/Oue/vent I 23.32
' l s,:• + ,t, f_; - i 1 'Tz + - - l' - ;i∎ Y'ln„' != :,.ma: =. . �' other. 23.32
Name: Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment _ 33.39
City /State/ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) F» ( ) toilet corn. artments utili rooms 23.32
?� f. t. ^,,1 ,r //'y� :r r , _ �,_ F 4, ...- ....., _ r - � Attic /crawlspace fans 2332
w: � ,1 `3�� : :.., .. �a;',i h. • -.
Other: 23.32
Business name:
Fuel .i.i _
Contact name: SI4.1S for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat ' u ..
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater —
• Fireplace
E -mail: Ran
. AF,. . -- ice . h _ _ •. Y177: i : ••• : . :' -•.1,. �: il - , ^11 !4 fib 7, ' • its 7:��. 1 _ Barbecue
Business name: i . Age_ Clothes dryer (gas)
�crr. .!' . r� n. ! a ,.. — Other:
Address: Zd•.7O g YITN 00e 1 :' ir .. '' g 73 . n `.;‘: `.' ..:` _.. W ' . :i 5 °...1;f .�: '
/,,, •� � S °b : , .7's Y
City /$tate/ZIP
` �� Minimum permit fee ($90,00) 90-00
Phone :525 ) 393+ 5'51,- I Fax: NZ 3 ?3 2 25'3 plan review (25% of permit fee)
Pr CB lie.: Z _ Alli State surcharge (125 of permit fee) Jo. go
TOTAL PERMIT FEE 4 . : •
This permit application expires if a permit is not obtained within 180
Authorized signature: Si S . • days after it has heed accepted as complete.
Print name: # 51 air Date:
? _ • Fee methodolop set by Tri- County Building industry Service Board
, ,.. 1...__,.._..,.._- n..- ,i...t -.. a-. nxmruna 440.4617T (l1 /07/GOM/W2n)
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