Permit a CITY OF TIGARD MECHANICAL PERMIT
''� a COMMUNITY DEVELOPMENT Permit #: MEC2013 -00308
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/06/2013
Parcel: 2S103CA04000
Jurisdiction: Tigard
Site address: 11615 SW TERRACE TRAILS DR
Project: FORDICE Subdivision: TERRACE TRAILS Lot: 12
Project Description: Gas furnace installation
Contractor: ROTH HEATING & COOLING Owner: FORDICE, SCOTT MATTHEW & MEGAN L
PO BOX 1265 11615 SW TERRACE TRAILS DR
CANBY, OR 97013 TIGARD, OR 97223
PHONE: 503 - 266 -1249 PHONE:
FAX: 503 - 266 -3478
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 06/06/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 06/06/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 06/06/2013 $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 questions to OUNC by calling 503.232 1987 or 1.800.332.2344.
Issued By: _ermittee Signature: _ _
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.
JUN-05-2013 WED 02:04 PM REEffivED FAX NO. 5032663478 P. 01
Mechanical Permit Application. FoR ()11 ust, ONLY
JUN 0 5 2013
City of Tigard it cocived
Dateilly. . ) . 12:11MWMAIR
II
' 13125 SW Hall Blvd., Tigard, OR 9 - 2 Mon Review
' I . • Phone: 503.718.2439 Fax; 503.41* 'f4 OFTIGARD Other Permit.
DotefflY:
Inspection Line: 503.639.4175 13 I I Al INGDIVISIM
T I G A RD Date Ready/By: Juris: RI Sec Mize 2 for
Internet: www.tigard-orgov Notified/Method: /.;C(5 2 Supplemental Information
. 41-i
Mechanical permit fees* are based on the value of the work
0 New construction 18) Addition/alteration/replacement pertbrmcd, Indicate the value (rounded to the nearest dollar) of ail
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
‘. 1 .: ,, -,AT-- ' -"'''- ''''," ' ' ' ..,1,' ''."'" ""' - - — - ' "‘.."
'' ''''' '' '' ' '''' " '' ' 'VI `, ....7.4' 4.
1:8] 1- and 2-family dwelling El Commercial/industrial 0 Accessory building For special lafornutllon use checklist
1:1 Multi-family 0 Master builder 0 Other: Description 1 Qty I Ea. I Total
•: .00. iik*Si Heatingic°°"ng:
Air conditioning 46.75
Job site address: 11615 SW Terrace Trails Dr Furnace 100,000 BTU (ducts/vents) 1 46.75 46.75 _
City/State/Z1P: Tigard, OR 97223 Furnace 100,0001- BTU (duers/venis) 54.91
Heat pump 61.06
Suite/bldg./apt. no.: Project name: Fordice/45380
Duct work 23.32
Cross street/directions to job site: Hydmnic hot water system 2.3.32
Residential boiler (radiator or
hydronic) 23.32
Unit healers (fuel-type, not electric),
in-wall, in-duct suspended, etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
.--,, z :',..I.i,Lt.; .. - ..,- ,.:-.1:" - ;,.. - AvA :::::'',-.“;.• --- " - --- ''''P'''' '""- l t y4.1 3 .3 1i'IL'' . r. )- '' . .P:j■ii 1:4 ' '''!"
Gas fircPlueefinsert 33.39
'' Fluo vent thr water heater or vas
installation of gas furnace fireplace 23.32
Log lighter (gas) 23.32 ,
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimnev/liner/flucivent 23.32
23.32
a 2 01 : :#0;4*';' , 1 :' . i . :1 1 4 : 1 Vi'!i,:l :. iiii . Other:
Environmental exhaust and ventilation:
Name: Scott Fordice Range hood/other kitchen
equipment 33,39
Address: 11615 SW Terrace Trails Dr
Clothes dryer exhaust 33.39
City/State/ZIP Tigard, OR 97223 Single-duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
Phone: (971)344-1894 Fax: ( ) Attic/crawlspace fans 23.32
:...,:: • ..: ., ' ' - ' - '.,i 11..1. _ 23.32 _
1). K
: i Other :
piping: Business name: Roth Heating and Cooling Fuel pip -
514.15 for tint four; S4.03 for each additional
Contact name. Angela McGraw Furnace, etc.
Address: PO Box 1265 _Gas heat pump
WalVstispcnded/unit heater
City/State/ZIP: Canby Or 97013 Water heater
Phone: (503) 266-1249 I Fax: : (503) 266-3478 ,. Fireplace
Range
E-mail: angelam @roth-hent.com
Barbecue
'
i ' ' I;.' .:$,:'dd:iAt'itA t *t5ii"1;1:.:;g:,f1'e : j%:;;; : :i:01;Hg,-Vlig; j iii,4 Clothes dryer (gas)
Other:
Business nume: Roth Heating and Cooling
;
Address: PO Box 1265 Subtotal 46.75
City/State/ZIP: Canby, OR 97013 Minimum permit fee ($90.00) 90.00
Plan review (25% of permit fee)
Phone: (503) 266-1249 Fax: (503) 266-3478 -
State surcharge (12% of permit fee) 10,80
CCB lie,: 14008 I TOTAL PERMIT FEE 100.80
'fhb permit application expires if a permit is nut obtained within 180
ill I I
days a
Milk! I li
Authorized signI a gi , i T . _ 1 I. .. after It has bean accepted vs complete
• Fee me thodology set by Tri-County Building lndusuy Service Bond
Print name: 015Pr Date: 6/5/13
..
..
wulidins■ParmitakMaC parrnilApp_040113 dm 440-4617T (11/02/CW4/WU)
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11615 SW TERRACE TRAILS DR, TIGARD, OR,
97223
Residential - Mechanical
699 Mechanical final
06/20/2013 00:00
MEC2013-00308
PASS - No C of O
Minor Label # ELS367622
Violation Summary:
Inspector Contractor