Permit i
CITY OF TIGARD MECHANICAL PERMIT
IN 2 COMMUNITY DEVELOPMENT Permit#: MEC2013 00526
-T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/18/2013
Parcel: 1 S 134BD05400
Jurisdiction: Tigard
Site address: 11560 SW GLENWOOD CT
Project: BELLEVILLE Subdivision: ENGLEWOOD NO.2 Lot: 142
Project Description: Furnace and A/C replacement. A/C unit must comply with manufacturer's clearance requirements.
Contractor: CLACKAMAS HEATING&COOLING LLC Owner: BELLEVILLE, LEO D
15115 SE PENNY LEE CT. BELLEVILLE, CAMILLA M
CLACKAMAS,OR 97015 LONG, LINDA S ET AL
11560 SW GLENWOOD CT
TIGARD,OR 97223
PHONE: 503-658-4808 PHONE:
FAX: 888-500-2912
FEES
Specifics: Description Date Amount
Air Conditioning 09/18/2013 $46.75
Type of Use: SF Furnaces<100K BTU 09/18/2013 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 09/18/2013 $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:
/i
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.
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•
Mechanical Permit Applica i o
City of Tagard Received if ,411r14115, '
o 13125 SW Hall Blvd I,Tigard,OR 97 r ECEVED Plan Review
IS Phone: 503.718.2439 Fax: 503.598.1960 Date/By atherPe1°"t
I I C, ‘1,l0 Inspection Late: 503:639.4175 S E P 16 2013 Date Ready/By: lurri: .5 See Page 2 far
Internet: www.tigard-or.gov Notified/Method: 7,1/4, SapplemeatalInformadon
I . i • , '.,.1.', -"
aif- _ :� _�;;A ^ ?.:`c .4� _}- t, ` , Mechanical;_. it fees ate based on the value of,the work' j
permit e
New construction Addition/alteratio rep acement V PefM Indicate the value(rounded w the nearest dollar)of all
mednanical materials,equipment,labor,overhead,and profit
Demolition Other: Value S
.1 'Y t jA.r . F r- .?z:•hti^"s+-r&:-+t, T4, t," '�.urr�'.-lr.`'4�r L` _¢ a ^-r- r v^ -- ^vv ,r�•m
v i sa =..r__ u Far spe�l6ifasme itta duellist
1-and 2-family dwelling 0 ∎L' al/ Accessory building Description I Qty. I Fa 1 Total
Multi-family Master builder Other: gam:
fl.-e .' fl, .... -,:i.-.I_ ;rim " r,,, i . . _`.J i ;. Airconditioning J 46.75 446,-75-
Job site //560 Sc'C/ •►! e rwRoto C Furnace 100,000 BIT (ducts/vent 46.75 y6,7 S'
Furnace 100,000+BTU(ducts/vents) 54.97
City/State'ZIP: -77`p,� D f / ,1 9.7 2Z 3 Heat pump 61.06
Suite/bldg./apt.no.: 0" I Project name: rl�y_��,/c i� Duct work 23.32
v° V Hydronic hot water system 23.32
Cross street/directions to job site: Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,induct,suspended.etc. 46.75
Flue/vent for any of above 23.32
Other 23.32
Subdivision: I Lot no.: Other fuel ut7uP8aoees:
Water heater 23.32
Tax map/parcel no.: Gas fireplace/insert 33.39
));<%.2i K, -;" ac ".� ' f T'. , r '-:'77: 5 '�" .,, 2 ,, °7 ? Flue vent for water heater or gas
V,. . _� .
a.�_,, S.'...,.sf�.msc z...[....� .� ., .. _ --{._F: ,,r�h.��..`; �..f_�:+s�.�,ar�..Xw..,.. _� fireplace 23.32
Ft4 -P2 x ce_ g /g c ve,p/o_c.e_lvL2h '. Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplacefunsen 23.32
Chimney/liner/flue/vent 23.32
Other, 23.32
.. v ,Y Snvnaomeand exhaust and a�tdation:
.,,'� .�.��,:4 ..,, *. ,�.. „?'�:a..�'"l 'lit c r�z -4„r''',,:;`,:'..A.!;.4- ,,t:',:z1.,' ,; � � Ra►�ehood/other tritehen
c equipment 33.39
Name: Ise e/l�/! /(e /lei eo / Clothes dryer exhaust 33.39
Address: I/560 SGr CT/eh Gr/ ' °�0 Singledua exhaust(bathrooms,
CityIState1ZJP �,/ toilet compartments,utility rooms) _ 23.32
�i�f7C �a t'
Atticiccawlspacefons 23.32
Phone:0 5O2f, 0.6 y X 9 Fax:0 Other 23.32
'0t�a.�, i-i y eN� 1 �:L 1 .$�i:C., 'r { , c J VNr -1 F. ..t '6',',.10.4`:": :
•3 .,st Y{ =' .2c&.C':�"\--... ...:I.._;.a_ � -fi�3 .. -iS�4J{i: Y^'-e2.=_L� -4,1.2:_1n1!_. 4i for f rstf�4o•W each additional
Business name:l`��L /yp�jl-$ '4.k4 f - '//,� Furnace,etc.
Contact name: ihtige'/i,7 ze g 42J v hp� L'f . Gas heat pump
Address:/S`I i r SE �eii N i /lP-P Water he ended/unit heater
y,�j water heater
City/State/ZIP: ti/,�G/ / t, s ow 9/ e /-r1 Fireplace
Range
Phone:0 503 6 .5 y to I lax':()f 9 a s Z91 2 Barbecue
E-mail: Clothes dryer(gas)
`;-4-. '•.c•`=.7.0".7. .14g,„!:- ) ' 2g `ft M• " Other
v'4 a" err, 2 „_-„ -.... 1 ,- ..: a
6 T+L,: 4.`,4i>'`�? six. -- -;" �• -S �[
Business name: �°./0}G`i..ogyyj fy S . • n�� 60,1,� Subtotal °� .SO
Address: J 01 S ✓ epA ei iQ� Minimum permit fee:($90.00)
Plan review(25%of permit fee)
City/State/ZIP:G/40--G ,yLA.$ 0 goes. 9 7 p lS State surcharge(12%of permit fee) l//. 2 2 /
Phone:0 5-Q d y�0,rf Fax:0 /!/ie,S't�D Z9/2 tfldspamit a imet�rm tfa Fobs othin 102 �/
CCB lie.: /6,5-63 0 7 t s/r days after Mambas accepted as mmpleee.
• Fee methodology set by TriCountyBuilding Industry Service Board
Authorized signature:
Print name: //IA. 3 r/14 f . A€4,14 i, I Date: '1l6 /3
I:IBullding'.Pamits\MEC Pe,muupp 040113.eoc 14046617T(1UO2/OMIWEB)