Permit v CITY OF TIGARD MECHANICAL PERMIT
IN • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00506
Date Issued: 10/08/2012
T WARD 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Parcel: 2S102BC00903
Jurisdiction: Tigard
Site address: 12815 SW GRANT AVE
Project: Eng Subdivision: NORTH TIGARDVILLE ADDITION Lot: 29
Project Description: (1) mini split ductless system installation
Contractor: BRUTON COMFORT CONTROL INC Owner: ENG, CINDY
12855 SW 22ND ST PO BOX 23086
BEAVERTON, OR 97008 -5152 PORTLAND, OR 97231
PHONE 503 - 626 -7477 PHONE 503 - 307 -9911
FAX 503 - 646 -0126
FEES
Specifics: Description Date Amount
Duct Work 10/08/2012 $23.32
Type of Use: SF 12% State Surcharge - Mechanical 10/08/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 10/08/2012 $66.68
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: JILL/ Permittee Signature: o k ,A T Pp�, 7A J
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. i'1 1 ,
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 Appli art w; FUR ( FI(F. USE i )\1.\
City of Tigard I El\IED Received Permn No
v 13125 SW Hall $Ivd., Tigard O' 9 PAY 411 / L/ECao /a -DDS'• -
II.. Phone: 503.7182439 Fax 503 598.1V t t Plan Review
Ins Line: 503.639,4175 T 0 4 2012 Date/By Other Ferran
L ' t C;.^ RD bate Ready/By. Jtuis. 0 See Pe e I for
Internet. www.tigard or.gov CIT OF TI RD Notified/Method •71, Supplemental information
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lacement Mechanical petmit fees* are based on the value of the work
❑ New construction ®Addition /al[eration/re
Addition/alteration/replacement performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition q Othci mechanical materials, equipment, tabor, overhead, and profit
Value
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Value: $
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® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special brformation use checklist.
❑ Multi- family ❑ Master builder ❑ Other: De scription I Qty Ea 1 Total
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Job site address: 12815 SW Grant Avenue (requires site elan showing placement) 46 75 _
Furnace 100,000 BTU (ducts/vents) 46.75
City/State /ZIP: Tigard, OR 97223 Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bidgJapt. no.: 1 Project name: Eng Heat pump
(requires siteylan showing placement) 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: Y I 1 or no : Flue /vent for any of above 23.32
Tax map /parcel no.: Other 23 32
Other fuet appliances:
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('# 1 . ',,'41!>.I_,', j l a �3��� 1 14:. tilt r h t t „1 W ater heater
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Installation of ductless mini split system Gas fir eplacclmseR 33.39
flue vent for water heater or gas
fireplace 23 32
Log lighter (gas) 23.32
Wood/pellet stove _ 33,39
Wood fireplace /insert 23 32
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# 114,,L13;
1i ; k� (iii lu ha; othe Chimney/liner/flue/vent 23 32
Name: Cindy Eng �� 23,32
Environmental exhaust and ventilation:
Address: 12815 SW Grant Aveneu Range hood/other kitchen
equipment 33,39
City/ State/ZIP: Tigard, OR 97223 Clothes dryer exhaust 33,39
Phone: (503)307 -9911 Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments,, utility rooms) 23,32
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ic/crawlspace fans 2132
Business name: Bruton Comfort Control Other 23.32 »
- Fuel piping:
Contact name: Matt Bruton 514.15 for first four; 5403 for each additional
Address: 12720 SW Allen Blvd Furnace, etc
^ — Ctas heat pump
City/State/ZIP: Beaverton, OR 97005 Wall/suspended/unir heater
Phone: (503) 626 -7477 Fax: : (503) 646 -0126 Water heater
Fireplace
E- mail: service @brutoneomfortcontrol .cote
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Business name: Bruton Comfort Control Clothes dryer (gas)
Address: 12720 SW Allen Blvd Other
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City/ State/ZIP: Beaverton, OR 97005 Subtotal
✓ Minimum petmn fee ($90.00)
Phone: (503) 626 -7477 Fax: (503) 646 -0126
Plan review (25% of permit fee)
CCB lie.: 65296 - __ State surcharge (12% of perrrllt fee) (O ,
TOTAL PERMIT FEE j cps. . 53-0 Authorized Signature: / ' Th perm app expires If a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Karen Normandin Date: 10/4/2012 ` bee methodology set by In- County Budding Industry Service Board
t:\nullelcgirermiliv C- PermaApp.aoe 03/07/12 440.4617r(1I /02JCOWWF.B)
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