Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2013 00443
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/05/2013
Parcel: 2S111CC01000
Jurisdiction: Tigard
Site address: 10135 SW CENTURY OAK DR
Project: WHITE Subdivision: SUMMERFIELD Lot: 7
Project Description: NC Installation.Placement of NC unit must comply with manufacturer's clearance requirments.
Contractor: HYBRID HEATING&AIR CONDITIONING CO. Owner: WHITE,GARY&PAMELA
PO BOX 329 10135 SW CENTURY OAK DR
CORNELIUS, OR 97113 TIGARD,OR 97224
PHONE: 503-357-5663 PHONE:
FAX: 503-357-0668
FEES
Specifics: Description Date Amount
Air Conditioning 08/05/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 08/05/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment-Mechanical 08/05/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 03.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit ApplicatifilECEIV ED FOR OFFICI: I'SE()NIA
W 131 W Hall Blvd.,Tigard.OR 97223 UG 1 2013
•
IN City of Tigard
25 S
I Phone: 503.639.4171 Fax: 503.598.1960 A Received
Datealy:. , _
,
Plan Review
Date/By g _/ ipi,A7 i- 'IIEZINIMINIPM
Chbe Permit:
i.I GA R t) Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready/By. . MI El See Page 1 for
Internet: www.tigard-or .gov
BUILDING DIVISION NotifieeMethod: Supplemental,Information
• - • • • ,• •. •
' . ' '• •'.. rtpt 4
- .liapalc:,.-. . • • .. . ., . , — , . ...i.o If..-4:.0.4.4.10ti§f...4[2.40'4 ,:04
Mechanical permit fees*are based on the value of the work
D New construction cldition/alteration/replacement performed.indicate the value(rounded to the nearest dollar)of all
0 Demolition Other: mechanical=Aerials,equipment,labor,overhead,and profit
_ . Value:$ ,
CATEGORY:OF CONSTRUCTION . ..•. • ._ •• . ... .. . .. ......... ..,. ...
fl
__. ---..,---
-and 2-family dwelling 0 Commercial/industrial 0 Accessory building
Multi-family 0 Master builder 0 Other . . . .11,..,11010i ; : :%:-.° PTiSiff-niMS:011 .
.
For special I use checklist. '
Deser iOnty. Ea. Total
._:"
.10B SITE i1447ORMATION.AND tOcAtiON : . Heating/cooling
_I 11 Air conditioning
lob site address: fi7/J, 5 SfA"i 1/4...relt7 69,41C-. . 19....._,____ (requires site ohm showingsplacement) ( 46.75
__—
City StAtelZIP: n-li O a_I-.4 6 R. ci,7.,5z.z. Furnace)00,000 BTU(ductslveras)_ 46.75
— Furnace 100,000+BTU(duets)veres) 54.91
Suite/bldg./apt.no.: Project name: tj Wit, Heat. . . 61.06
Cross street/directions to job site: . tittct work 23.32
Hydronic hot waterystem 23.32
Residential boiler(radiator or ..
— dronic)
Unit heaters(fuel-type,not electric),
in-wall in-du s ded,etc. 46.75
_ Flevent for any of above 7332
Subdivision: I Lot no.: Other 23.32
Tax map/parcel no.: Other fuel appliances
DESCIMPTIONM.'WORK ; ,• . , ,;',.. .! Water heater 23.32
_ •
— Gas firs:dace 3339 • :
/
A r eZ_0 61-34.-4-- Flue vent for water heater or gas
lace 2332
Log lighter(gas) . 23.32
1 Wood/pellet stove 33.39
Wood fireilace/insert _ 23.32
. Chininex/liner/flurivent 23,32
VirItty owNra .L__. •.• .• •a.TET4ANr , •• other. 23.32
Name: 64:1 11 ED kt i-e.„ . Environmental exhaust and ventilation
• Range hood/other kitchen
Address: /005 abt) ezii-114,r3 I f,olk 1).,g equipment 33.39
•
City/State/ZIP: ..--1-1;ek 4.r.ct 6 k 57 2,.2, -. , Clothes dryer exhaust 3339
-r.
— Single-duct exhaust(bathrooms,
Phone:L5,0 3) Litd)_ 36 f5-- Fax ( ) ' toilet compartments,utility rooms) 23.32
r.—.
0 AFPLICANF • . •.. .ID.;Cckititr:19tesoN: .-: •: AttickrawisPece fans 23.32 •
23.32
Business name: .
Fuel piping
Contact name: $14.15 for first four;S4.03 for each additional
Furnace.etc.
Address: . Gas beat_ptunp _
City/State/ZIP: Wall/suspended/unit heater •
Phone:( ) Fax::( ) Water heater
Fir .lace
E-mail: Range _
cONr &CFOR Barbecue
. .
Business name: ./iiiv.c.i 41/el.7 e .e. C . -. Clothes dryer(gas)
Other
Address: ,e2 2c2-7 . • - .• / ....* :400.4011:471044#.17.0. :'.....:..:!.:-;. •:,':..
Gity/State/ZIP: r-pel-kc 4,e 91// 3 . . Subtotal
Minirmun permit Ice($90.00)
Phone:63)357._ 4-4 6 1.
Fax:(c5)3) 35'7--e‘‘d Plan review(25%of permit fee) .
,
CCB lie.; /IL...2 .0...ff • • State surcharge(12%of permit fee) /0.8 4,
. • TOTAL PERMIT FEE /0016
This permit applicado n expire,if a permit is not obtained within 180
Authorized signature: A ,/. . ..Z../.4 - . ..... days sifter it has been accepted 95 complete.
Print name: 7SAk4 id- el4411-0
r fe tc.... Date: 7—y(_13 • Fee methodology set by Tri•County Building Industry Service Board
rAnuidnouroasume.PertaitApp.doo tom 109 440.46177(ItiovcordN/13)