Permit CITY OF TIGARD MECHANICAL PERMIT
- COMMUNITY DEVELOPMENT Permit #: MEC2012 -00644
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/10/2012
Parcel: 25101 DCO2400
Jurisdiction: Tigard
Site address: 7630 SW CHERRY DR
Project: Memovich Subdivision: ROLLING HILLS NO.2 Lot: 32
Project Description: (1) heat pump replacement Must maintain 5' side yard setback and approved rear yard setback
Contractor: ABLE HEATING & COOLING LLC Owner: MEMOVICH, BARBARA J
16285 SW 85TH AVE #105 7630 SW CHERRY DR
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 579 -2250 PHONE: 971- 340 -7001
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Heat Pump 12/10/2012 $61.06
Type of Use: SF 12% State Surcharge - Mechanical 12/10/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 12/10/2012 $28.94
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: J[�1� A of 1uu11vv� /, 7 Permittee Signature: o j , PP c 4 / 7Q �
Callllll 1 5 . 0 0. 3.. 1 639.4175 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 ApplicatiRECEIVE 1 FOR OFFICE USE ONLY
City of Tigard DEC 10 2012 r (-iiv l ei sr Permit No at C avia- oo'gh'
II g 13125 SW Hall Blvd., Tigard, OR 97223 Plan Resew
Phonc: 503.718.2439 Fax: 501598.1960
TIGARD DatelBy:
TIGARD y Other Permit:
Inspection Line: 503.639.4175 CI� �' f1 f11J Date Rem IB Y r .wP E See Page
Internet: www.tigard BUILDING DIVISION Notified/Method: '71 & Supplemental l n form at ioa
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees' are based on the value of the work
0 New construction ® Addition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
O Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ i
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
10 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information urecheckIW.
❑ Multi- family ❑ Master builder ❑ Other. Description 1 Qty. 1 Ea. Total
JOB SITE INFORMATION AND LOCATION
Heating/cooling:
Air conditioning
lob site address: 7630 SW CHERRY DRIVE (requires site plan showing placement) 46.75
Furnace 100,000 BTU (duels/vents) 46.75
City/State/ZIP: TIGARD, OR. 97223 Furnace 100,000-F BTU (ducts/vents) 54.91
Suite/bldg. /apt, no.: Project name: MEMOVICH Heat pump
(requires site plan showing placement) 1 61.06 61.06
Cross streetidirections to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hvdronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
REPLACE EXISTING HEAT PUMP Gas ftreplaee/inserl 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
® PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name: BARBARA MEMOVICH Environmental exhaust and ventilation:
Address: 7630 SW CHERRY DRIVE Range hood/other kitchen
equipment 3139
City /State/ZIP: TIGARD, OR. 97223 Clothes dryer exhaust 33.39
F Single -duct exhaust (bathrooms,
Phone:
(971)340-7001 ( ) I toilet compartments, utility rooms) 2332
❑ APPLICANT ❑ CONTACT PERSON Atticicrawlspace fans 23.32
Business name:
Other: I 23.32
Fuel piping:
Contact name: $14.15 for first four, $4.03 for each additional
Address:
Furnace, etc. 1
Gas heat pump
City /StatetZlP: WalUs
tapended/tmi[ heater •
Phone: ( ) Fax : ( ) Water heater •
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: ABLE HEATLNG & COOLING LLC Clothes diver (pas)
Other:
Address: 16285 SW 85' AVE. SUITE 105 MECHANICAL PERMIT FEES*
City /State/ZIP: TIGARD, OR. 97224 Subtotal 61.06
' Phone: (503) 579 -2250 Fax: (503) 620 - 3980 Minimum permit fee (590.00) 90.00
Plan review (25% of permit fee)
CCB lie.: 184392 State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80
) ' Thu permit application expires if a permit is not obtained within 180
Authorized signature: /f days after it has been accepted as complete.
I Print name: KELLY WILHI J Date: 12 - - 2012 1 • Fee methodology set by Tri- County Building Industry Service Board
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Air Conditioning Site Plan
114g ABLE
Witt 16285 SW 8.1 Ave, Suite 105
,i' Tigard,. OR 97224
( 503)579 -2250 Fax(503)620 -3980
Heatin & coc4 �a LLC Email: info @ableheatingandcooling. com
CcB#184392
Customer 4) 14 ft {a
Address: :�( CO: 1 �- �
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