Permit CITY OF TIGARD MECHANICAL PERMIT
11111 " �_ COMMUNITY DEVELOPMENT Permit#: MEC2013-00453
Date Issued: 08/06/2013
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S 06/201 8400
Jurisdiction: Tigard
Site address: 12467 SW ST ANDREWS LN
Project: Jameeli Subdivision: MOUNTAIN VIEW ESTATES Lot: 9
Project Description: Installation of NC. Placement of A/C or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: WOODWARD HEATING INC Owner: JAMEELI,AZHAR M
PO BOX 13610 WAQAR, SABEEN
SALEM, OR 97309 12467 SW ST ANDREWS LN
TIGARD, OR 97224
PHONE: 503-448-4328 PHONE: 503-551-4937
FAX: 503-448-0038
FEES
Specifics: Description Date Amount
Air Conditioning 08/06/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 08/06/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment-Mechanical 08/06/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /
Issued By: Permittee Signature: D^f #G/e64170/V
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the Job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
08/02/2013 08:54 5034380038 DOUG WOODWARD HEATNG PAGE 01/01
•
Mechanical Permit Application _ rOI:i)I I I( b: 1151'.ONl,1
1
City of Tigard Rayed
NI___ • 13125 SW Hall Blvd.,Tigard.�. {. r rh+tdRY: t7 l'i'' Permit Nrign20/2 // 53
' Phonc: 503.718.2439 Fix; 50'.5':4• ' a D2I Review Other Permit:
- Inspection Line: 503.639.4175 DatdBY:
I I<;;ti I:L7 Nate Ready/By:
d/Met o: ®9ec rent 2 Information Internet: www.tiRard or.gov AUG 5 2013 Notified/Method:
Sopplemcnat Informatian
[]New construction ail.Addition a 1. 1 01 1 ��I 1� Mechanical permit fcca+are based on the value lof the work
performed.Indicate the value(rounded to the ncarcst dollar)of all
❑Demolition ❑Other: _mechanical materials,equipment,labor,overhead-and profit.
Value:$
cii1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special lnfotMraiioa rctr.checklist
❑Multi-family ❑Master builder
--•.-..----__...., ❑Other: Description Qty. Ea I Total
.• HentirtR/cnnlinq:
Job site address: r Air conditioning / 46.75
/ �^ 5` ti Furnace 100,000 BTU(duelslventc) _ 46.75 •
City/Stale/ZIP: ! /,I_ _5'7 ,/ -Fumacc 100.000+R'11 f(duets/vents) 54,91
L �e 1� J '7
Suite/b Idg./apt.no.; Project name: Heat pump _ 61.06
- - Duct work —
23,32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential hoilcr(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: l,pt no.: Other 23.32 I
Other fuel appliances:
Tax map/parcel no.: Water heater
�. — --- — Gaa fireplace/insert 33.39
�` C'�dn .�1j,� •, filrcplocct for water heater or gas
23.32
Log lighter(gas) _ 23,32 —�
- Wood/pellet stove 33.39
Wood fireplace/insert 23,32 _
Chimney/liner/flue/vent . - 23.32
- — 1 Other: - .
23.32
Name: 4 Environmental exhaust and ventilation:
_ Range hood/other kitchen
Address: - c uipmcnt 33.39
5_0„01.&__ Clothes dryer exhaust 33,39
City/Siate/7.1P Single-duct exhaust(bathrooms,
Phone:(sue ) Fax; _toilet compartments,utility rooms) 23.32
( Attic/crawlspace fans 23.32
I = :T---� L ..;._C ` Other,
23,32 •
Business name; I t x-77 Fuel i In •
Contact name: ] $14.15 for first four;$4,03 for each addittnnnl
_ ,'.+ -)-ti r� 4/z•.er 4 Furnace.etc.
Acid s: o 1 Gas heat pump -
-City/State/7,1P; 5� �y ti`_ri Wall/suspended/unit heater
r 97 � Water heater
Phone:5'1 ) Fax::(S-1771 ) 40-- O liolace
E-mail; -Range `_�
-- -- Barbecue
` '.. - Clothes dryer(gas)
•Business name: _Clothes
.
Address:
City/State/VP;
- gunt»ntr
_ Minimum permit fee($90,00)
Phone;( ) Fax:( ) _ Plan review(25%of permit fee)
�-� State lurch 12"
CC'i1 lie.: ( �6 of permit fee)
TOTAL,PERMIT FEE ��04171) •
/J This permit Rppticttioa expires If a permit i„not obtained within 180
Authorized sigrtaturc; NJ7_/ days after It has been accepted at enmptote.
• Fee methmeiecy tel by Id-County Building lndutlry Service B,,rrt
Print name: ex.,, ,e4,r1 . • I Date: t
I\Ruoding\Pcrmi104eC PmnitApr_045113.dx
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