Permit „ CITY OF TIGARD MECHANICAL PERMIT
1111 = COMMUNITY DEVELOPMENT Permit#: MEC2013-00477
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/19/2013
Parcel: 2S114BA07900
Jurisdiction: Tigard
Site address: 16280 SW WOODCREST AVE
Project: Ainsworth Subdivision: COPPER CREEK STAGE 2 Lot: 19
Project Description: Installation of furnace and A/C. Placement of A/C or heat pump units must comply with the manufacturer's
clearance requirements.
Contractor: OREGON HEATING&AIR CONDITIONING Owner: AINSWORTH, RUTH AFTON
19300 SW 118TH AVE 16280 SW WOODCREST AVE
TUALATIN, OR 97062 -. TIGARD, OR 97224
PHONE: 503-691-9699 PHONE: 503-620-5031
FAX: 503-691-8556
FEES
Specifics: Description Date Amount
Air Conditioning 08/19/2013 $46.75
Type of Use: SF Fumaces<100K BTU 08/19/2013 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 08/19/2013 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. -
Issued By: Permittee Signature: ON �/: /e*9-770/✓
Call 503.639.4175 by 7:00 a.m.for the next available Inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each Inspection.
,
Aug. 13. 2013 2: 02PM No. 0485 P. 1
Mechanical Permit A licati , ��T�� _ _ .. FOR OFFICE',USV ON1.1'
City of Tigard 1 V Date/By; -,9 43 47/" PermitNo.: C iiii'r 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
-1— Q�y�
=--M - Phone: 503.718.2439 Fax: 503.598.1960 AUG 3 o 013 Date/B y: Mee Permit:
TICARD Inspection Line: 503,639.4175 DataReadyBy: EI See Page 2 for
- - Internet: www.tigard-or.gov CITY OFTIGARD Not'fed/Metbod: M Supplemental Information
BUILDING DIVISION
TYPE Of WORK{ ':'COMMERCIAL FEE* SCHEDULE-USE CHECKLIST '
Mechanical permit fees+arc based on the value of the work
❑New construction (3 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit
Value:$
. CAT.GOAI O..CON.TRUCTION....
1i1 SmEN7 EQUIPMENT/SYSTEMS NT./.�x9TEMS PEES"
0 1-and 2-family dwelling ❑Commercial/industrial El Accessory building For special information use checklist
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea.J Total
• JOB'SITE INFORMATION:•AND LOCATION '.. Heating/cooling: U
Air conditioning f 46.75, W.
fob site address; /6.2 yo S(V Wo.. c p-,d ' t%e Furnace 100,000 BTU(duets/vents) I 46.75 c,/e. 7S-
Furnace 100,00N-BTU(ducts/vents) 54,91
Heat pump 61.06 '
Suitt/bldg./apt. " Project Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) - 2132
Unit heaters(fuel-type,not electric),
• in-wall,in-duct,suspended,etc. 4635 ,
Flue/vent for any of above 23.32
Other; 23.32
Subdivision: Lot no.:
Other fuel appliances: -
'fax map/pru-cel no.; Water heater 23.32
DESCRIPTION OF WORTS ' . Gas fireplacefnsert 33,39
Flue vent for water heater or gas
/7s1-A// re rngce and /'-t:,- Co ;o,i•• fireplace 23.32
Log lighter(gas) 23.32
- Wood/pelletstove - 33.39
Wood fireplacc/insert 23.32
Chimney/liner/flue/vent 23.32
t: PROPERTY OWNER ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: A h / r Range hood/other kitchen
equipment 33.39
Address: /r j i .y S W j/a a ere s#-Aire Clothes dryer exhaust 33.39
City/State/ZTP: Single-duct exhaust(bathrooms,
]4�a ra�� 0R 9 aY _toilet compartments,utility rooms) 23.32
Phone:(Svc) 6z a- S02 i Fax:( ) Attic/crawlspace fans 23.32
® APPLICANT ❑ CONTACT:.PI RSON Other: _23.32
ON, Fuel piping:
Business name: r✓1'- y�4 l _ $14.15 for first fowl$4.03 for each additional
Contact name:.c/( , ' III„p er Furnace,etc. I
,/, Gas heat pump
Address: 1?$o0 ,Sty f� 4ve Walllsuspended/unitheater
City/State/ZIP: 7 a/or" oR q 1 0C2 Water heater
Fireplace
Phone:(car )G9/.- 9"6 y9 Fax::( ) Range -
E-mail: Barbecue .
: ` CONTRACTOR' _ . ' ' ' . Clothes dryer(gas)
Other:
Business name: Q ,,,, ye lvECIIANICAL P1rRMIT FEES* •
Address: 19300 ,s4,, Il Ave _ Subtotal 9 T. s-O
City/State/ZIP: •� 0 Minimum permit fee($90.00)
/ G4�urrni n R �G� Plan review(25%of permit fee)
P one:(5.1)c9—96yc— Fax ( ) State surcharge(12%ofpetnrit
CCB lie.: / 7 /2 G TOTAL PERMIT FEE J o4
■
This permit application expires If a permit is not obtaieed ii r n 150
days after it has been accepted as complete.
•Authorized signature: C . rr • r Feo methodology set by Th-County lluilding Industry Service board
Print name: �, /r f-:: //.l..,, _ / e r. Date-
Agy.ey.Z or