Permit CITY OF TIGARD MECHANICAL PERMIT
III l: ,- COMMUNITY DEVELOPMEN
Permit #: MEC2013 -00430
Date Issued: 2013
07/30/
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 7/ 3 /2013 01
Jurisdiction: Tigard
Site address: 12476 SW EDGEWATER CT
Project: Donivan Subdivision: MILL VIEW Lot: 2
Project Description: Replace existing A/C. Placement of A/C or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: ABLE HEATING & COOLING LLC Owner: DONIVAN, ETTA A
16285 SW 85TH AVE #105 12476 SW EDGEWATER CT
TIGARD, OR 97224 TIGARD, OR 97223
•
PHONE: 503 - 579 -2250 PHONE: 503 - 590 -3278
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Air Conditioning 07/30/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/30/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 07/30/2013 $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:
ait4t-7‘7P2 Pemiittee Signature: ,a/17 �-�P G /e e9
��' ���CCC 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.
Mechanical Permit A
�° licatio 13 V = - . r ORZOITICl. Lary— _
City of Tigard Received �� Permil xo ytoaoi3 -oo
13125 SW Hall Blvd., Tigard, OR 97223 JUL 2.9 Date/B Y 7 Id 1 74P y lo
Phone: 503.718.2439 Fax: 503.598.1960 2�i3 Plan Review
DatelBy: Other Permit:
T LG A F .D Inspection Line: 503.639.41 C
— — Internet: www,tigard or -gov 0F�G'�D Date RcadylBy Avis 0 See Paget for
BUILD"'GDNISION Notifed/Ividhod. � [ Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction Mechanical permit fees' are based on the value of the work
® Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: S
RPSIDEN•IIAL EQUIPMENT /SYSTEMS FELS*
0 I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For. special information use checklist.
0 Multi- family ❑ Master builder
❑ Other: Description I Qty. I Ea { Total
r -
JOB SITE INFORMATION AND LOCATION Heating/coalirtg:
Job site address: 12476 SW EDGEWATER COURT Air conditioning 1 46.75 46.75
Furnace 100,000 BTU (deem/vents) 46.75
City /State/ZIP: TIGARD, OR. 97223 Furnace 100,000+ BTU (ducts /cents) 54.91
Suite/bldg./apt. no.: Project name: DONIVAN Heat p 61.06
Duct work ; 23 32
Cross street/directions to job site: Hydronic hot water system 23.32
R boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wail, in -duct, suspended, etc. 46.75
Flue/vent for any of above 23.32
i
Subdivision: Lot no.: Other. 23.32 _
Other fuel appliances:
Tax map/parcel no.: Wafer heater 23.32 `
DESCRIPTION OF WORK Gas fireplace/insert 33.39
REPLACE EXISTING A/C UNIT Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
•
El PROPERTY OWNER l ❑ TENANT Other: 23.32
Name: ETTA DONIVAN Environmental exhaust and ventilation:
Range hood /other kitchen
equipment 33.39
Address: 12476 SW EDGEWATER COURT Clothes dryer exhaust 33.39
City/State/ZIP: TIGARD, OR. 97223 Single -duct exhaust (bathrooms,
• toilet compartments, utility rooms) 23.32
Phone: (503)590 -3278 Fax: ( ) Attic/ctawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON air 23.32
' Business name:
- -- Fuel piping:
$14.15 for first four, S4.03 for each additional
Contact name: Furnace, etc.
Address: Gas heat pump
Wall /suspended/unit heater
City /State/Z IP: Water heater
Phone: ( ) Fireplace
Fax:: ( )
E -mail: Range Barbecue
— _... — CONTRACTOR Clothes dryer (gas)
Business name: ABLE HEATING St COOLING LLC Other:
MECHANICAL PERMIT FEES'
Address: 16285 SW 85 AYE. SUITE 105 Subtotal ' 46.75
City/State/ZIP: TIGARD , OR. 97224 Minimum permit fee (590.00) 90,00
one: 503 579 -2250 Plan review (25 %ofpermit fee)
( ) J Fax: (503) 620-3980 _ ___ State surcharge (12% of permit fee) 10.80
1 ,,,,,,,
CCB lie.: 184392 TOTAL PERMIT FEE 100,80
This permit application expires if o permit is not obtained within 180
days after it has bee ac as complete
Authorized signature: ' Fee methodology set by Tri- Cowily Building Industry Service Board
w;":"..
Print name: KELLY 14 .1 l Date: 7 -25-13
tatuitdinglPennitsumc PermuApp_o4oI 44 0- 4617r(I1 /02/COM/WE )
1 • d 086£OZ9£09 6u!Ioo0 is) 6ui ;eeH env d££ :170 £l, 9Z Inf