Permit a CITY OF TIGARD MECHANICAL PERMIT
IN 0 : COMMUNITY DEVELOPMENT Permit #: MEC2013 00326
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/13/2013
Parcel: 1 S 135CA09500
Jurisdiction: TIGARD
Site address: 11452 SW 96TH AVE
Project: WISNIEWSKI Subdivision: SOLERA Lot: 4
Project Description: NC installation. Placement of NC unit must comply with manufacturer's clearance requirements.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: WISNIEWSKI, ASHLEY KRYSTYNA
19300 SW 118TH AVE 11452 SW 96TH AVE
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503 - 691 -9699 PHONE: 503 - 887 -1495
FAX: 503 - 691 -8556
FEES
Specifics: Description - Date Amount
Air Conditioning 06/13/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 06/13/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 06/13/2013 $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: /o �.�` PermitteeSignature: _ `
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.
06/12/2013 12:11 503 - 691 -8556 OREGON HEATING PAGE 01/03
Mechanical Permit APPlic1R ' V FOR ul FlCF. USE ONLY .
D Received P ermit No.:
City of Tigard D2/03y.. ( o , J 1, V d% c ,mil a •
! a 13125 Sw Hall Blvd, Tigard, OR 9722 J N 12 2013 Ploo Review
I ' Phone: 503.718.2439 Fax: 503.59411%, Date/By: Other Permit.
Inspection Line: 503.639,4175 j'G pate Ready/By: runs RI Sec Page 2 for
t Lu:1 r, 1) Internet �vww- Tigard oz.gov BUltbl#r D'1 SION Notified/Method: -7--j::4„ Supplemental fntbrmation
. TYPE OF WflRRK :.. �/ • . . : fV . • .. "1; 1tc Po... SCOliui* •- 10§texi g CLISE
• r Mechanical permit fees' are based on the value of the work
❑ New construction $ Addition / alteration /replacement performed Indicate the value (rouffiad to the nearest dollar) of all
❑ Aernolition Q Other: mechanical materials, equipment, labor, overhead. and profit
.v, .i. v .� i. ..� s ;....,-. ,_ �� Value: $ •
E,a Lr (sORY OF CON&F�(LfCJ•ION`'. :s;1` : Y :. E yy;;�� I $ 1 q • BE 9!s'
� - -� l;::s.rr.� ItSSID _l � �•�;- !
0 and 2- family dwelling 0 Comtnercial/ivadustrial ❑ Accessory building For spedal ratfo►mation use Checklist
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
•;
1 Y.' 'y, • •'.y ! .:,: i• •, -' aeatiniet:ooling:
JOS; "S1 E;l c Q�',` 1 ;} �i`Yt� 'r` :' y � 6: ,,, :.' . '; Air conditioning 1 _ 46.75 • t/6.
, A
v. site address: j' L s - i f 94 , tae Furnace 100,000 BTU(ducti/veuta) 46.75
City /State/ZIP: r rd oR q 7 2-Z 7 Furnace 100,000+ BTU (ducts/veb) 54.91
�� Heat plump 61.06
Suite/bldg./apt- no.: I Project name: Duct 23.32
Cross street/directions to job site: Hydronic hot ivater system 23.32
Residential boiler (radiator or
• hydranic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. _ 46.75 _
Flue/vent for any of above _ 23.32
Other: 2332
Subdivision ` Lot no.: w
- Other fuel appliances: - _
Tax map /parcel no.: Water heater 23.32
,. ..: *auk . - 3339
• D E 9 CtiS[TQN OF WORI{ - —
Gas fireplaeofuu
' { " r - " Flue vent for water heater or gas
fireplace 23.32
el - 14A /I Air• Gli&-,,,rKr Log lighter (gas) 23.32
— Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner /fiue/vent 2332
• Other: 23.32
• pRopERW piiiSTER , .' . 1. ; C'. T ' Environmental exhaust and ventilation:
Name: .'4 le, 1, f; «i_g k/ 4 % : Range hood/other kitchen
4t 33.39
Address: g ...s 9 C t6 Clothes dryer exhaust 3339
Single -duct exhaust (bathrooms,
City /State/ZIP:
4 4 4 ci q.2.27 toilet compartments, utility rooms) 73.32
Phone: (5 ) 8.8' /t/1$ Fax: ( ) Attie%rawlspace fans 2332
1. APPLICA .. . .: .Q CONFA( ;PBR O Other: 2332
N
' Fuel .1.: .
Business name: O eq n Hsa4 _ 314.15 for brat foot, $4.03 for each addttioaal
Contact name: / Furnace, eta _
e . Ave s heatjurmp
Address: 111 .5 / , A /'f ,. :' walvauspended/unit heater
City /State/ZIP: T 4 t h ,„ OR i 70c - Water heater
i
Phone: (Sod) GI/— 9699 Fax: : ( ) Fireplace
tle
E -mail: Barbecue •
. /" • . COr crf)ir�' ... . Clothes drycJRas
. Other:
Business name: ap Ye ` . :....., t l l v l CAJ(� .... . RS' •
Address: /f3 d _FA/ // ,4 — Subtotal. 1/C. ZS
Minimum permit fee (590.00) To-
City /StacefLlP: T 4 ( o 9 lz _. .� Plan review (25 %of permit fee) Phone: (So3 ) 'f/— 76 fq ax: ( ) State surcharge (12% of permit fee) y j D • $o •
CCB lic.: j� TOTAL PERMIT FEE 10 0 _ 7cQ
! - { S Mir permit application expires if a permit is not obtained within 180
•
days after it has been accepted as complete.
Authorized sigotature: i • Fee methodology set by Td-Cotmty Building Industry Service Board
—r -.