Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 00381
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/11/2013
Parcel: 1 S125DD05301
Jurisdiction: Tigard
Site address: 9810 SW VENTURA CT
Project: Allen Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 61
Project Description: Install a/c unit. Placement of a/c unit must comply with manufacturers clearance requirements.
Contractor: ANCTIL HEATING & COOLING Owner: ALLEN, JAMES & KATHLEEN
4320 N WILLIAMS AVE 9810 SW VENTURA CT
PORTLAND, OR 97217 TIGARD, OR 97223
PHONE: 503 - 281 -0752 PHONE: 503 - 209 -4700
FAX: 503 - 282 -5722
FEES
Specifics: Description Date Amount
Air Conditioning 07/11/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/11/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 07/11/2013 $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 qu- . . OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B : / I C-COti Permittee Signatu ` I„
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.
07/09/2013 13:28 FAX 5032825722 � Anctil Heating & Cooling 010001/0002 t/
Mechanical Permit Ap ,1 f ED FOR OFFICE USE ONLY
City of Tigard ail- 2013
Date/By: ( /e -�O 0 ?p/3 3g/
N = ° 131 Hall lvd., Tigard, OR ail- atelBy: 7 !( / 3 y. Perm Ain.: ,y
Plan Review • Phone: 503.718.2439 Fax; 503.598.1960 Other Date/By:
Ckher Permlt.
TIGARD Inspection Lin 503 1u11
C1 �_ •��,^� Date Tuns: See Page 2 for
Internet: www.tigard or.gov BUILDING V N NotibedlMethoecVMeto Supplemental upptemental tnformatiort
•- " TYPE.: OP "WOliK ; `. PEE S
- T -
G'HE1tIIt:E`. I3SE'CHECKLiS
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alterat ion /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGy.ORY :OF .
• '' ' , . R MF".NTA1I,.;PO -
.ME.i• L-,7 SYS FE _
® I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For
spedallr(jormarroa use checklist.
❑ Multi - family 0 Master builder
❑ Other: Description Qty. Ea. Total
. JOB S1TE LNEtoRMAt1oN Nll, LOCAT ION . :::: ' < '`,: :::_ :::,ii:;,-: HeatinWcoolittg:
Air conditioning 1 46.75 46 . 7 5
Job site address: 9 810 SW VENTURA COURT Furnace 100,000 BTU ( ducts/vents) 46.75
City /State/ZIP: TIGARD OR 97223 Furnace 100,000+ BTU (ducts/vents) 54.91
Duct pump 61.06
Suite/bldg. /apt. no.: Project name: il-$$85-212— Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler (radiator or
_ hydronic) 23.32
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. 23'32
Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
DESCRIPTIONI.OF . WORK '..:
fireplace/insert 33.39
" Flue vent for water heater or gas
INSTALL AC fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner /flue/vent 23.32
OWNER " Other; 23.32
6 PROPERTY
Environmental exhaust and ventilation:
Name: JIM AND KATHLEEN ALLEN Range hood /other kitchen
equipment 33.39
Address:
9 810 SW VENTURA COURT Clothes dryer exhaust 33.39
City / State/ZIP: T IGARD OR 9 72 2 3 Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 2332
Phone: ( ) 5 0 3- 2 0 9 — 4 7 0 0 Fax: ( ) _Anic/crawlspace fans 23.32
fa APPLICANT .:. , ..: `::. "0 `CONTACT ` PERSON :, ...<; ::: Other: 23.32
Fuel piping:
Business name: ANCTIL HEATING AND COOLING
514.15 for first four; 54,03 for each additional
Contact name: CHRI STINE BARTON Furnace, etc.
Address: 4320 N WILLIAMS AVENUE Gas heat pump
WalUsuspended/unit heater
City/State/ZIP: PORTLAND OR 97217 _ Water heater
Phone:( ) 503 - 281 - 0752 Fax: :( ) 503 - 282 -5722 Fireplace
Range
E -mail: INSTALL @ANCTILHVAC . COM ` Bce
'' CONTRACTOR' :. dryer .:;:..•. Clothes lothesd e7' (gas)
Business name; ANCTIL HEATING & COOLING Other:
" +' ImECHAIqCAI?4,.Ei21KIT;FEES °. - ..
Address: SAME AS ABOVE _ Subtotal
City / State/ZIP: Minimum permit fee ($90.00) »' et'
Plan review (25% of permit fee)
Phone: ( ) Fax: ( ) State surcharge (12% of permit fee) /d -'Sr'
CCB tic.: 8897 TOTAL PERMIT FEE //,, . $O
n This permit application expires if a permit is not obtained within ISO
AI SN�y\
days after it has been
un y Building as complete.
Authorized signature: l' ' 11l i Fee methodology set by Tri -Cowry Building Industry Service Board
name: CHRISTINE BARTON I D ate: 7/9/13
t :\Buildire.Permirs \AMC PenrutApp_0401 13.doc 440-46177' (I I /02/COM/WEB)