Permit CITY OF TIGARD MECHANICAL PERMIT
f'! : COMMUNITY DEVELOPMENT Permit #: MEC2013 00235
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/02/2013
T f R O 9 Parcel: 1 S 134ACO2624
Jurisdiction: Tigard
Site address: 11175 SW BOXWOOD CT
Project: David Subdivision: ENGLEWOOD NO.3 Lot: 181
Project Description: (1) gas furnace replacement
Contractor: ABLE HEATING & COOLING LLC Owner: DAVID, CHRISTOPHER J & AMBER
16285 SW 85TH AVE #105 11175 SW BOXWOOD CT
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 579 -2250 PHONE: 971 - 217 -7088
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 05/02/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 05/02/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/02/2013 $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.
L Issued By: Permittee Signature: Dkt APP ' i Ci4-1 Qkk
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 A plicati
p R E C E I V E D I r k 01.1 I t 1 . l s l i \ 1 1
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City of Tigard
13125 SW Hall Blvd., Tigard, OR 97223 Y r 3 1013 -��
Phone: 503.718.2439 Fax: 503.598.1960 . i' 1 2013 Plan Revitw
Date/
Ins Inspection Line: 503.639. Other Permit:
I I t . � 4 P. j, p Date Iteadyflty_ Tern.
Internet: www.tigard- or.gov CITY OF TIGARD N fied�Me ®fie Prue 2 fur
� /'� pplemeotal information
BU I DING DIVISION v 111
TYPE OF WORK COMMERCIAL FEE" SCHEDULE - USE CHECKLIST
❑ New construction Mechanical permit fees* are based on the value of the work
® 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 ❑ Commerciallindustrial Accessory building For --° -
❑ Multi- family 0 Master builder special information
❑ Other: Description I Qty. I Ea Total
JOB SITE INFORMATION AND LOCATION Heating/coo/Mg:
Air conditioning I 46.75
lob site address: 11175 SW BOXWOOD COURT
Furnace 100,000 BTU (ducts/veins) 1 46.75 46.75
City/StateTL1P: TIGARD, OR 97223 Furnace 100,000 +DTi3 (duasivents) 54.91
Suite/htdg./apt. no.: J Project name: DAVID - Heat p 61.06
Duct work 23.32
Cross street/directions to job site: Hydronie hot water system 23?2
Residential boikr (radiator or
hvdronic) 2332
Unit heaters (fuel -type, not electriej.
in -wall, in -duct suspended, etc. , 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other 23.32 �
Tax map/parcel no.: Other fuel appliances:
Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
REPLACE EXISTING GAS FURNACE 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
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER i ❑ TENANT Other: 23.32
Name: CHRIS DAVID
Range Environmental exhaust and ventilation:
Range hood/other kitchen
Address: 11175 SW BOXWOOD COURT equipment 3339
Clothes dryer exhaust 33.39
City/State/ZIP: TIGARD, OR. 97223 Single -duct exhaust (bathrooms,
f toilet compartments, utility rooms) 23.32
Phone: (971)217 -71}88
Fax: ( ) Attic /crawlspace fans 23.32
ID APPLICANT ❑ CONTACT PERSON Other: 2332
Business name: Fuel piping:
Contact merle:
514.15 far Brst four, $4.03 for ssmh additimi
Furnace, etc.
Address: Gas heat pump
City/State/ZIP: Wall/suspended/Imit heater _
Water heater
Phone: ( ) I Fax:: ( ) Fi , lace
' E -mall: J Range
Barbecue
CONTRACTOR Clothes dryer (gas)
i -
Business name: ABLE HEATING & COOLING LLC _Other
Address: 16285 SW 85 TH AYE. SUITE 105 MECHANICAL PERMIT FEES*
Subtotal 46.75
City/State'ZIP: TIGARD, OR. 97224 Minimum permit fee (590.00) 90.00
Phone: (503) 579 -2250 J Fax: (503) 620 -3980 Plan review (25% of permit foe)
State surcharge (12% of permit fee) 10.80
CCB iic.: 184392 TOTAL PERMIT FEE 100.80
'/ This penn It applieatioo expires if a permit is not obtained within ISO
Authorized sitmahtre / — days after it has been accepted as complete.
I I ` • Fee methodology set by Tri -Camay Building industry Service Board
Print name: KELLY I Date: 5-1 -13 f
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