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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC201200444 T WARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/27/2012 Parcel: 25111 DB02300 Jurisdiction: Tigard Site address: 15495 SW ALDERBROOK CIR Project: Allen Subdivision: SUMMERFIELD NO.8 Lot: 482 Project Description: (1) furnace replacement and (1) A/C new installation Must maintain 5' side yard setback and approved rear yard setback Contractor: FIRST CALL INSTALLATION COMPANY Owner: ALLEN, RON 13150 S CLACKAMAS RIVER DR 15495 SW ALDERBROOK CIR OREGON CITY, OR 97045 TIGARD, OR 97224 PHONE: 503 - 231 -3311 PHONE: 503 - 504 -3599 FAX: 503 - 557 -0919 FEES Specifics: Description Date Amount Air Conditioning 08/27/2012 $46.75 Type of Use: SF Furnaces < 100K BTU 08/27/2012 $46.75 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 08/27/2012 $11.22 Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressure: Total $104.72 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. n C ,. , Issued By: 5�� Permittee Signature: ok( 4 Zt U f 7 Al 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 fi E E Vt t I (lit OP' l(1 I'SI 1IVI,1 • ll ® R eceived City SW Tigard _ Perm No.: 13125 SW Hall Blvd., Tigard, OR 97223 AUG 2 7 201 Plan Review £S , EC.apf . -/ ♦ 1 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit 1 t t 1L 11 Inspection Line: 503.639.4175 CITY OF TIGAR Date Ready/By: In ® See Page 2 for Internet: www.tigard- or.gov gDI` DING lyln5 , i Notified/Method: Supplemental Information L. -RI IJIVt TYPE OF WORK COMMERCIAL FEE" SCHEDULE - USE-CHECKLIST ❑ New construction ® Addition/alteration/replacement Mechanical permit fees* are based on the value of the work performed. indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and pmfit. CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* 0 I- and 2- family dwelling ❑ 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 Joh site address: Air conditioning 54 OW • 1` \lti V U 1 C�IJ 11 tl V (requires site plan showing placement) i 46.75 Cit /gb - rigge 412a4 Furnace 100,000 BTU(ducts/vents) 1 46.75 , "'m^ : Furnace 100,000+ BTU (ducts/vents) 54.91 Suitc/bldg./ apt no.: I project name: 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 Subdivision: I Lot no.: Flue/vent for any of above 23.32 Other: 2332 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 23:32 Gas fireplace 33.39 _ Flue for water heater or gas t 4 fireplace 23.32 '�,� Log lighter (gas) 23.32 • • n, a r co i 0 P1O Wood/pellet stove 33.39 , Wood fireplace/insert 23.32 PROPERTY OWNER I ❑ TENANT Chitnney/liner /flue/vent 23.32 n Al If t Ether. 23.32 Name: Environmental exhaust and ventilation Address: : Ai - Range hood/other kitchen equipment 33.39 City /State/ZIP: Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: (NZ) b04--et Fax: ( ) toilet compartments, utility rooms) 23.32 _ ® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32 Business name: Tri County Temp Control Other. 23.32 Fuel piping Contact name: Diane Mason 514.15 for first four; 54.03 for each additional Address: 13150 S Clackamas River Drive Furnace, etc. Gas heat pump City /State/ZIP: Oregon City, OR 97045 Wall/suspended/unit heater Phone: (503) 5571220 Fax: : (503) 557.0919 Water healer E -mail: Fireplace Range CONTRACTOR Barbecue Business name: First Call Installation Clothes dryer (gas) Other: Address: 13150 S Clackamas River Drive 119ECHANICALIPERMITfEES• City /State/ZIP: Oregon City, OR 97045 Subtotal Minimum permit fee (590:00) Phone: (503) 557.0230 I Fax: (503) 557.0919 Plan review (25 %ofpetmit fee) • CCB tic.: 182714 State surcharge (12% of permit fee) //r �]/� �y �.- TOTAL PERMIT FEE . f I o V 611/4144 / /VN+r'� This permit application expires if a permit Is not obtained within 180 Authorized signature: ` days after it has been accepted as complete. 12'. Print name: Diane Mason I .Date: / • Fen motbodulugy net by Tri- County Building Industry Service Board I.\ Building \PermtuUNE(:l'omitApp.doe 111/u1/Us 440 4617T (11/02/COM/WUB) I'd 096186S20S :01 :140dd J6S : T T 2102- t72 -Sflti AUG -24 -2012 12:00P FROM: TO:5035981960 P.2 D V3 0. 0. 1 i m m 1 z , 1 i I 1 i C') i i f v I N I I ``> I 6 I I 1 I .� I I 1- I M. i a R i •• I i ..::\ i i i i i 1 i i i ^ I , 2 m i 4 + t , i� co i m i �. 1 CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC201200444 T WARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/27/2012 Parcel: 25111 DB02300 Jurisdiction: Tigard Site address: 15495 SW ALDERBROOK CIR Project: Allen Subdivision: SUMMERFIELD NO.8 Lot: 482 Project Description: (1) furnace replacement and (1) A/C new installation Must maintain 5' side yard setback and approved rear yard setback Contractor: FIRST CALL INSTALLATION COMPANY Owner: ALLEN, RON 13150 S CLACKAMAS RIVER DR 15495 SW ALDERBROOK CIR OREGON CITY, OR 97045 TIGARD, OR 97224 PHONE: 503 - 231 -3311 PHONE: 503 - 504 -3599 FAX: 503 - 557 -0919 FEES Specifics: Description Date Amount Air Conditioning 08/27/2012 $46.75 Type of Use: SF Furnaces < 100K BTU 08/27/2012 $46.75 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 08/27/2012 $11.22 Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressure: Total $104.72 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. n C ,. , Issued By: 5�� Permittee Signature: ok( 4 Zt U f 7 Al 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.