Permit CITY OF TIGARD MECHANICAL PERMIT
01 9 C COMMUNITY DEVELOPMENT
Permit #: MEC2013 -00268
`' Date Issued: 05/22/2013
• TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 2S102DB04000
Jurisdiction: Tigard
Site address: 13543 SW CHELSEA LP
Project: Erickson Subdivision: CHELSEA HILL Lot: 17
Project Description: Installation of A/C. Placement of A/C or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: ERICKSON, ERIC & KATHRYN
19300 SW 118TH AVE 13543 SW CHELSEA LOOP
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503 -691 -9699
PHONE: 971 -404 -8664
FAX: 503 -691 -8556
FEES
Specifics: Description Date Amount
Air Conditioning 05/22/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 05/22/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 05/22/2013 $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.
Issued By: Permittee Signature: 60A/ di-A/92 e? 7
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.
05/20/2013 13:22 503 -691 -8556 OREGON HEATING PAGE 01/03
Mechanical Permit A,pplicri CEIVED FOR OFFICE USE ONLY
•
City of Tigard ' ll !� : ' • Permit No.E 013 — ` / - , .'
t _ y 13125 SW Hall Blvd., Tigard, OR 9722 Y 2 0 2013 Plan Review
Phone: 503.639.4171 Fax: 501598.1 DatdBy: Giber Permit
T l G f D Inspection Line: 503.639 Date R
Internet: www.tigard -or.gov CITY OF TIGARD Nottfe 4ctbod upp t l rurwetton
BUILDING DIVISION
COMMERCIAL FTE� SC4ED:(1LE - ..'(J3E C1<IECKLIST
Mechanical permit fees' arc based on the value of the work
❑ New construction ' Addition/alteration / replacement
performed. I th value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials, equipment, labor, overhead, and profit
CA •
'.:•'''. :. • TIEG OIiY OX�..CONS�RUC['XON . ` : ., _ • • ::: �: i `. =':. tee
...: ': e..... ' .. . : ' . , : ..... . , • b�ENC
= 1;)ESIAi13')<'><A)1: �Q LtIP % S,1 FEES* .
12'1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
❑ Multi -fatter ly CI Master builder ❑ Other For special information use checklist.
Description Qty. I Ea. Total
: JOE silt A,TICIN PlNI LOI;:f TIOI`P
IieatinpJcooling
Air conditioning
Job site address: /351/3 _ S/[ c44 ' e, L 93 (requires site plan showing placement) / 46.75 9k,
l ity /StateJZIP: P,,,iia �� I 72 . Furnace 100,000 BTU (dacts/veate) 46.75 -
no.: Project name: p '� Furnace 100,000+' BTU (ducts/vents) 54.91
Suite/bldg./apt. ^
�3 ly (e, � 1 s!a �!1 Heat pump 61.06
Cross street/directions to job site: Duct work 2.3.32
- Hydronic hot water system 23.32
Residential boiler (radiator or
hydronio) 2332
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other 23.3
Tax map /parcel no.: Other fuel appliances
DFSCR1PTI01(T''OF-IiIORK : " ?,:c 's° ,st Water heater 2332
_Gas fireplace 33.39
4. l•-ht ii 0 ;r. co•nJr-„ena. - : . Flue vent for water heater or gas
• fireplace 2332
•
• - - - Log lighter (gas) 23.32
__ Wood/pellet stove 33.39
Wood fireplace/insert 23.32
• ;.. ,,. , f . iuer /flue/vent 23.32
� TRN
,.., ` .` -:fi '. , ..`; ,41 �i,'',. �`.` - er: 2332
Name: . E;,.. ; ,... it ' .,; .rQn )En exhaust and ventilation
Address: 115-4 -3.5W GXe it - L `Raipment hood/other kitchen
ed � equipment 33.39_
City /State/ZIP: e f / dn4 '2 7 . 7 , 727 Clothes dryer exhaust 33.39
Fax: Single -duct exhaust (bathrooms,
Phone:
(57/) Y ._ 6 y ( ) toilet compartments, utility rooms) 2332
� :A1PP)LJCAIVT. ••; . 0 .CONTAC P E$ S O1y: Articicrawkpacefans 2332
Business name: Other: 2332 t
tywi � . e tie j • Pining
Contact name: Z4 Ck c+„ //, ew L °„ • 514.15 for first fouri$$403 fbr each additional
• Address: //Too Si,/ /(8 4 , Pum.aceLet
Gas heat pump
City/State/ZIP: 7 c GI 1.06.2 Wall/Su pendedtunit heater
now= (So ) pax: : ( ) Water heater
3 6q!- 95 99 Fireplace
E -mail: • Range
•
CONTRA Barbecue •
Clothes dryer
Business name: ��//•)
�fE a� /7P.gf+
Address: /9,�pp ..f other: `
Jrk✓ //$ 4,,e 1l7EC8AIYICAI, i Er lF EES ". , .
City/State/ZIP: ruwlath _ OR 9 7 g Subtotal zit, 7s .
Fax: ( ) Minimum permit flee ($90.00) 90 e
P
CCB lie.: / � / 6 ./
ne. ( o3 ) 6q 1 — dun Plan review (25% of permit fee)
�� S tate surcharge (12% of permit fee) W'
TOTAL PERMIT FEE ( 00_ '
This permit application expires if a permit Is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: e �� / Dale' ,57_2Cy j Fx methodology net by lyi Couniy Building industry Service Board