Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2013 00463
T WARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/08/2013
Parcel: 2S 111 C B00900
Jurisdiction: Tigard
Site address: 14940 SW 103RD AVE
Project: THOMAS Subdivision: DEL MONTE SUBDIVISION Lot: 8
Project Description: A/C replacement. Placement of A/C unit must comply with manufacturer's installation requirements.
Contractor: CARSON OIL COMPANY INC Owner: THOMAS, DON W BONNIE L
3125 NW 35TH 14940 SW 103RD AVE
PORTLAND,OR 97210 TIGARD,OR 97224
PHONE: 503-471-4365 PHONE:
FAX: 503-227-8521
FEES
Specifics: Description Date Amount
Air Conditioning 08/08/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 08/08/2013 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment-Mechanical 08/08/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503 ---A1 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Aug. 7. 2013 9: 24AM Carson Oil Dispatch-Sales No. 8672 P. 1/2
Mechanical Permit Applicati EcEivEr R Fo orlicr,uSE ONLY
City of Tigard v ' RDaeceteDivsdy: .6 A 1:11M1 Permit No.:
13125 SW Hall Blvd Tigard,OR 97223
IIIII u H .3 Plan ReVi8W
• 2.. • Phone; 503.718.2439 Fax 503.598.1960 AUG 7 2013 Date/By: Other Pemlit:
1'10 RD Inspection Line; 503.639.4175 Date Ready/By El See Page 2 for
A :
Internet: www.tigard-orgov CITY OF TI(imiL Notific&m.thod: MI Supplemental Information
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' Mechanical permit fees*are•based on the value of the work
•El New construction 5Add itionla Iteration/replacement performed.Indicate the value(rounded to.the nearest dollar)of all
0 Demolition El Other: mechanical materials,equipment,labor,overhead.and profit.
Value:$
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' •'' •-•'''' :;•:',11',iLlf!.',- fP. :!,::.-....:::::,
Id 1-and 2-family dwelling El Commercial/industrial P Accessory building ' For special information use checklist.
0 Multi-family P Master builder 0 Other: Description - • . ] Qty.. I Ea. Total
:!.:::',:• !';: ••'::'''''L-•'••:;'•;;;161i7;BittiiINFOR4VitWi'•Al■iii:.eettbG3tigi,115.11iirtrir7ljginri Ilea". e°61111/--- ----- --,-,77z, .....,
,.-.,..::::.;;;;::,••:.•,:;::::::;;;.;;;,;.,•,: . .„.„ ,.....,,,,,•...:.:,:,•• ,, •,•• '•••,,•••••-, •''''''''--•••••••'• - ''•-•••••'••• '(•l'454' Air conditioning • • /-• 46.75 ei eda-Li
Job site address;/4/1 g 1 O Ski /1...1 4.-1- Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: 7761410 DiR 9 77,2.# Furnace 100,000+BTU(ducts/vents). 54.91
Heat pump 61.06
'Suite/bldg./apt.no.: 1 Project name:1"EbrAdts _ Duct work 23.32
Cross streeldirecticins to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
__Su Des_ M o6srt. t)rt, hydronicl 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duet,suspended,etc. 46.75
• .
Flue/vent for any of above 23.32
Other: ---7 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23,32
•••••,..;. :,;„•':,,••::!, .:.:,.;--:''•:`::: :,].:,istiiiilioNg,c0WoRic .,:io4;;!;41.kyq-oiTly;t4i1''''''''' '''''' Gas fireplace/insert • 33.39
c-16.1 Flue vent for water heater or gas
Ai?... co,--le, z-rioulE.12. 1-7-- fireplace , . .23.32
Lo lighter(gas) _ . 23.32
•
- Wood/pellet stove 33.39.
Wood fireplace/insert . .„ ., 23.32
Chimney/liner/flue/vent . 23.32
::•:: ;f !P:;q:(j,±iiitietttokieh.,:::41,::c!.;:..,,ovi;i ::: :::;: :,vfn.:ilifiiiivr4-p .Eimilli Other: • 23.32
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71;700 4 -NO/11A s Range hood/other kitchen
equipment - . 33.39
Address: /4/15•40_11 AO c-•.0 .
Clothes dryer exhaust 33.39
City/State/ZIP: I/*6A g0, pg. q7224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)m2222 0/415 Fax:( ) Attic/crawlspace fans 23,32
.,-4 :,,:::::;. ; 23.32
;:i?::.!;::.: ;:4............................................................ld,,!;:',..kix..:076.37m:ot Other;
Business name. sat/ a/ L
Contact name: WA/k
i Fuel
P4341;11;4.15 for first four;S4.03 for each additional ,
Furnace,etc.
Gas heat pump
Address: .3/25 AIL/ .354 Avg, Wall/suspended/unit heater
City/State/ZIP: Po en4„..thif OR. driZ(0 Water heater
Phone:(5)3) 417/-L/36.5- 1 Fax:!(563)22 7436'v Fireplace
Range •
E-mail: 14/4u-is,,C, 0 A&1 )I40'I. e OM Barbecue
. • . . . .
,...::::, ,,,.:•;■:'•::',;:::!;::.,,,iil.",i:':::■:••. :!•::': ,.CCINtiiktOiC':•:;:':";f• :1 ;• , ;:7110FMp,fi,Viigiergi Clothes dryer(gas)
Other:
Business name:ags cuj 6,,( CA,....
, ,,,,4,/r
iliti 0,.j ., i,,:t..:EEv,J.,,i.,,..,,,,- .
. .Address! 3125 Ai 14 . 57-' Ave. subtotal
Minimum permit fee($90,00) gat()
City/State/ZIP: poxaa, ,,4 cvz_ 9-7 Jo
Plan review(25%of permit fee)
Phone:(503) 47/-4,:y Fax:(503)227-'52. 1 State surcharge(12%of permit fee) /0, go
-
CCB lie.:83136 _ TOTAL PERMIT FEE /60,810
-
This permit application expires if a permit is not obtained within 180
Authorized signature; ii za") • Fee meihoddoelyosgy*fleseirbyl Theriii-County Board
Print name: Ai M4/43
/
d
I Date: g) 7,1 3
1:113uildinOcrmilA11EC_PCriltitAP5..040113.dOt / 449-4617T(I 1/02/COMAVE11)