Permit 11 q CITY OF TIGARD MECHANICAL PERMIT
111 It CO MMUNITY DEVELOPMENT Pe rmit #: MEC2012 00538
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/17/2012
Parcel: 1 S 134AD09200
Jurisdiction: Tigard
Site address: 10787 SW 106TH AVE
Project: Wolff Subdivision: WINDSOR PLACE Lot: 29
Project Description: Remove and replace gas furnace.
Contractor: AAA HEATING & COOLING INC Owner: WOLFF, STEVEN A
5017 NE GRAND AVE DIEKER, ELIZABETH J
PORTLAND, OR 97211 10787 SW 106TH AVE
TIGARD, OR 97223
PHONE: 503 - 284 -2173 PHONE: 503 - 318 -4990
FAX: 503 - 284 -1552
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 10/17/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 10/17/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 10/17/2012 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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 qu- • to OUNC by calling 503.232.1987 or 1.800.332.2344. /'
Issued = r ,c��P7 '
�� / Permutes Sign lure Q ��
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.
From: 10/17/2012 11:10 #349 P. 003/003
Mechanical Permit ApplicatRECEIVED roi, OFFICE USE ONLY
1 • City of Tigard OCT 17 2012 :L : I' e y d : A 41 ON I I la Permit No.: /--/f.z g
1 • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
' " • Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
TIGAR 1 ) insPection Line: 503.639.4175 CITYOFTIGARI) Date Ready/By: kris: RI See Page 2 for
Internet: www.tigard-or.gov
BUILDING DIVISM N°fificd/Mcth°d' Supplemental Information
Mechanical permit fees* are based on the value of the work
0 New construction El Addition/alteration/replacement perfonnoi. Indicate the value (rounded to the nearest dollar) of all
El D,emolition 0 Other: mechanical materials, equipment labor, overhead, and profit.
Value: $
7gAtitOli.-W04 M5',41,17:::TREsingstirtigibiirdwiiri
181 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building For !pedal information use checklist.
El Multi-family 0 Master builder 0 Other: Description I Qty. I, Ea. I Total
liea
Aq1 mr di
ti :
Job site address: 10787 SW 106 AVE (requires site plan showing placement) _ 46.75
Furnace 100,000 BTU (dixar/vents) 1 ... 46.75 46.75
City/State/ZIP: Tigard Oregon 97224
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt no.: I Project name: WOLFF Heat pump
(requires site plan 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: I Lot no Flue/vent for any of above , 23.32
Other 23.32
Tax map/parcel no.: , Other fuel appliances:
Fairfaile#1 Water heater 2332
Gas fireplace/insert 3339
Remove and Replace Gas Furnace
Flue vent for water heater or gas
fireplace . 23.32
Log lighter (gas) 23.32 •
II
Wood/pellet stove 33.39 .
Wood fireplace/insert 23.32
,1 ti Chinmey/liner/flue/vent
ggligial NO ER:. -- " ..:ffi l l2tegai I aftglil 0 4, P iii . ' 23.32
— .
23.32 .
Name: Steve Wolff
Environmental exhaust and ventilation:
Address: 10787 SW 106th Range hood/other kitchen '
equipment 33.39 •
•
City/State/ZIP: Tigard Oregon 97224 Clothes dryer exhaust 33.39 •
Single-duct exhaust (bathrooms,
Phone: (503-3)318.4990 Fax: ( ) toilet compartments, utility rooms) 23.32
: : : ReigigglarAtritTIFICM _ A fans 2332 • .
Business name: AAA Heating and Cooling Other: 23.32
- Fuel piping:
Contact name: George Martinez $14.15 for first four; $4.03 for each additional '
Address: 5017 NE Grand Ave Furnace, etc.
, Gas heat pump .
City/State/ZIP: Portland, Oregon 97211 Walllsuspended/unit heater . •
Phone: (503) 284-2173 I Fax: : ( ) Water heater
Fireplace •
E-mail: george@saniaq.com
A Barbecue
Business name: AAA Heating and Cooling ,, Clothes dryer (gas)
Other:
Address: 5017 NE Grand Ave TITZIRWIdtEilffiRtilrifEWAVV:1A1V:
City/State/ZIP: Portland, OR 97211 Subtotal 46.75
Minimum
Phone: (503) 284-2173 I Fax: (503) 284-1552 permit fee ($90.00) 90.00
Plan review (25% of permit fee)
CCB lic.: 222 State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80
This per application expir es ff a permi t Is not obtained within 180
Authorized signature: Am ilic..., days after ft hts been accepted as complete.
, I Print name: George Martinez I Date: 10-18-2012 • Fee methodology set by Tr-County Building Industry Service Board
1:113uilding \ PermilitMEC-ParniiApp.doe 03/07112 440-4617T (I I (0 2/COM/WEB) .
10/17/2012 11:10 11349 P.001/003
From:
V V V
FAX COVER
AAA Heating & Cooling Inc
HEATING AND 5017 NE Grand Ave Portland, OR 97211
COOLING
Phone: 503-284-2173 Fax: 503-284-1552
To: ;4,4-- PQA-6A-1 -- Det From: rot
Fax: sns /? Pages:
Phone: 5 -7 4 ,1- / Ira t i .39 Date: /0 - / V
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