Permit CITY OF TIGARD MECHANICAL PERMIT
11 11- n - COMMUNITY DEVELOPMEN Permit #: MEC2013 -00394
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/16/2013
Parcel: 25111 CC20701
Jurisdiction: Tigard
Site address: 15660 SW GREENLEAF CT
Project: Gamelgaard Subdivision: SUMMERFIELD NO.5 Lot: 265
Project Description: Replace existing NC. Placement of A/C or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: A TEMP HEATING & COOLING INC Owner. GAMELGAARD, MARILYN J
16000 SE EVELYN ST 15660 SW GREENLEAF CT
CLACKAMAS, OR 97015 -9519 TIGARD, OR 97224
PHONE: 503 - 650 -5014 PHONE: 503 -670 -1486
FAX: 503 - 557 -2990
FEES
Specifics: Description Date Amount
Air Conditioning 07/16/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/16/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 07/16/2013 $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 bbyycalling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: fj(f ,—Io�J L,' e � O
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.
•
07/11/2013 14:09 5035572990 A TEMP HEATING PAGE 01
Mechanical Permit A.pplicad Fop, OF1'l( I: pm; ()NI.)
City of Tigard ECEI ' n 7 / la Pm"" No./MEC, i /3 40399
�- ° 13125 SW Hall Blvd., Tigard, OR 9722 y
Plan Rcvicw
' • • Phone: 503.718.2439 Fax: 503.598.1960 Datc/By: Other Permit:
inspection Line; 503.639.4175 JUL 1 1 2013 mate kead aiu : gf See Page 2 for
Internet: www.tigard- or.gov Notified/Method: 77( SupplementalInfarmatton
CITY OFTIGARD
mfr sro
• TY1pE d 19 . 7 �...... Mechanical permit to e l � �.
• feesR are based oaths value of the work
❑ New construction 13 Addition /alteration/replacement performed, indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
Value: $
CATEG(O0Y''AF C010Tit crO1n ' - kith . �2.YJ1 1P!1ft�1V Or.O 1 ;FEES"
IZ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist
❑ Multi- family ❑ Master builder. 0 Other: Description 1 Qty. L Ea. [
• ' ;Site) f1I ilia. A61 D .L61CAl TION'
Heating/cooling:
. , „, can ceo!
--�' Air conditioning 1 46.75 f(. 7
J site address: I 6 5141 r - r+ l eq •1" Cf r Furnace 100,000 BTU (duets/vents) 46.75
City /$tatc/7,iP: -r o q ? 22- 4/ Furnace 10S000+ I3TU (ducts/vents) 54.91
Heat pump 61.06
Suite/bldgJapt. no.; Project name: Duct work 23.32
Cross street/directions to job site: Hy dronic-hotwater- system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fucl -type, not electric),
in -wall, induct 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
I OESCll' Wlrft N OF WORK - Gas fireplace/insert e/insert 33.39
/4 �J - ,U S f ,14// Flue for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood Greplacetmscrt 23.32
Chimney/liner/flue/vent 23.32
ta p`ROP1 kite ta> R, I .E) TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Met rt H e Range hood /other kitchen -
equipment 33.39
Address: (
6ts � tf/ & ej h i 94 C Clothes dryerochaust 33.39
City /State/ZIP: " ; ,, a ,( 0R . 6) '� 22 [.r Single -duct cxhauat (hathroems,
J toilet compartments, utility rooms) 23.32
Phone: (S-U5) j z -1 if k 6' Fax: ( ) Attic /crawlspacc fans 23.32
. 014I cAN'I'' : . , . , 0:. CONTACT. PET*1N Other: 23.32
Fuel piping:
Business name: $14,15 for that fear, 34.03 for each additional
Contact name: a O Coo1.3NO,INC
iflanCl ]p.St. Furoaw, etc.
Address: Clackamas, OR 97015 Gas heat pump
If "'PI i , i - Wall /suspended/unit heater .
City /State/ZIP! Water heater
Phone: ( ) Fax:: (563) SS? - 2 y 90 Fireplace
I �e
E -mail: S IC. ci ✓ f @ a 4 w,•Ite YI Q.a 'I',h1,� • r_ dtA Barbecue
at 1tt1*'Ei r} i Clothes dryer (Ras)
Business name: I�T811dP HEATING AND COOLING, INC Other;
c?"1.1 Address: lttlxlu /elpnSt.
Subtotal y6r
_ 10 11 O 1
City /State/ZIP: 503-650.5014 Minimum permit fcc ($90.00) 13 _ 7
Plan review (25% of permit fee)
Phone:
( ) Fax; (s-18),S-S-7 - 2‘M9 State surcharge (12% of permit fee) 10 VV
CCB lie.: t g• ■ TOTAL PERMIT FEE r
This permit application expirem if a permit is not obtained within 180
day* after it hem been accepted am complete.
Authorized signature: / • Fcc methodology set by 7ti- Coenty Building ind Service Board
Print name: , j 4t st 1- gorT?.� .e.r Date: 7- // -,
1 :\Building\PermitAMIX PermitApp olat13.doc 440.4t17r(I1/n2/C.OMAYEII)