Permit ppi!
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00439
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/21/2012
IIGARD 9 Parcel: 1S125DC08400
Jurisdiction: Tigard
Site address: 7120 SW ASH CREEK CT
Project: Nagy Subdivision: ASH CREEK ESTATES Lot: 17
Project Description: Install A/C. Unit must meet 5' minimum side yard and applicable rear yard setbacks.
Contractor: TRI COUNTY TEMP CONTROL INC Owner: NAGY, BRENT J & CHRIS
13150 S CLACKAMAS RIVER DR 15877 SW CENTURY DR
OREGON CITY, OR 97045 SHERWOOD, OR 97140
PHONE: 503 - 557 -2220 PHONE: 971- 242 -9836
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Air Conditioning 08/21/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 08/21/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 08/21/2012 $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: ,4 - Permittee Signature: d /970/0 e_41 -770/i
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.
CEIVED Mechanical Permit A t t lira IJ; FOR "'''('' 11S' "" .'
• CI o T i a nal Reced {' ' Permit No 4 -/ � y3 .
�' g AUG 2 0 2012 Date ' ��
13125 SW Hall Blvd Tigard, OR 97223 Pbm Re
Ili
Phone: 503.639.4171 Fax: 503 5911.1960 Dote/By Other Permit:
I I ; A R l� Inspection Line: 503.639.4175 CITY Dale Ready /By: ® Page 2 for
Internet: www.tigard- or.gov BUILDING DIVISION Notified/Method: BE 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
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
® 1- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building . For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea I Total
JOB �� SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 71 // _b 8W .14h 0'0: (Wirt Air conditioning
(requires site plan showing placement) I 46.75
City/ State/ZIP: QQrd a? Furnace 100,000 BTU (ducts/vents) 46.75 _
V - Furnace 100,000+ BTU (ducts/vents) 54.91
SuitelbldgJapt. no.: I Project name: Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
I-lydronic hot water system 23.32 . -
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, inzduct, suspended, etc. 46.75
Subdivision: I Lot no.: Flue/vent for any of above _ _ 23.32
Other: • 23.32 [
'fax map /parcel no.: Other foal appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace , 33.39
Flue vent for water heater or gas
uv ' I1 61r CO r r Qtt r fireplace 23.32
1 Lrj4th1 IJtA / I�, t' ICJ Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplacc/insert 23.32
Chimney/liner /flue/vent 23.32
PROPERTY OWNER I ❑ TENANT Other. 23.32
Name: bra* MC18 y Environmental exhaust and ventilation
Address: WO Range hood/other kitchen
equipment 33.39
City/State/ZIP: . Clothes. dryer exhaust . , 3339
Phone: (,�` Fax: ( )
1 ) ,, ` ,� ^ Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Other: 23.32
Business name: Same as contractor
Fuel piping
•
Contact name: Diane Mason $14.15 for first four; 54.03 for each additional
-
Address: Furnace, etc.
- Gas heat pump
City/ State/ZIP: WalVsuspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
Fireplace _
E -mail: Range
CONTRACTOR Barbecue
Business name: Tri County Temp Control Clothes dryer (gas)
. - Other: _
Address: 13150 S Clackamas River Drive MECHANICAL PERMIT FEES'
City/State/ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee ($90.00)
PERMIT FEE �� one: (503) V CCI3 557.2220
Fax: (503) 557.0919 Plan review (25% of permit fee)
tic.: 72623 • State surcharge (12% of permit fee)
TOTAL
Authorized signature: . d'4SI This permit application expires if a permit Is not obtained within 180
da ys a It has been accepted as complete.
I Print name: v eAn V moon I Date: • Fee methodology set by Tri-County Building Industry Service Board
1:1.fuildingWmnite\MEC- PermitApp doc 10/01/09 4404617r(11/07/COM/WEa)
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AUG -20 -2012 01:15P FROM: TO:5035981960 P.2
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