Permit CITY OF TIGARD MECHANICAL PERMIT
Permit#: MEC2013-00600
COMMUNITY DEVELOPMENT Date Issued: 10/09/2013
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S 09/201 7000
Jurisdiction: Tigard
Site address: 15790 SW SERENA CT
Project: Goddard Subdivision: KERWOOD ESTATES Lot: 17
Project Description: Replace existing gas furnace.
Contractor: ABLE HEATING&COOLING LLC Owner: GODDARD,JAMES A&JANET B
16285 SW 85TH AVE#105 15790 SW SERENA CT
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503-579-2250 PHONE: 503-620-3095
FAX: 503-620-3980
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 10/09/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 10/09/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 10/09/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: � Permittee Signature: OAT /JG'C1--77/"./
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application
g\e\CCS) F(>R OI ICa: l:til.O\1:1'.� Received � �
City of Tigard ® Da,�B PermitNo,y�Etc27i3 4060 s
13125 SW Hall Blvd.,Tigard,OR •S:,r,? Y• % �3 ./i.
01' Plan Review
' 0 Phone: 503.718.2439 Fax: 503.598.i6 i !ter' 1 DatelBY. Other Permit:
'TIGARD Inspection Line: 503.639.4175 Daze Rea B Jaris
Internet: www.cigard-nr.gov OO -rkcp.,. I, `on fied/Method: ��� Supplemental Information
TYPE OF WORK �`�,� COMMERCIAL FEE" SCHEDULE - USE CHECKLIST
® gg `� Mechanical permit fees*are based on the value of the work
❑New construction Addition/alterationlyd acement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For spedal information use checklitL
❑Multi-family ❑Master builder ❑Other: Description Qty. 1 Ea Total
JOB SITE IN FORMATION AND LOCATION Heating/cooing:
Air conditioning i 46.75 ■
Job site address:15790 SW SERENA COURT Furnace 100,000 BTU(ducts/vents) / 46.75
City/State/ZIP:TIGARD,OR. 97224 Furnace 100,000+BTU was/vents) 54.91
Heat pump 61.06
Suite/bldg./apt-no.: I Project name:GODDARD Duct work 23.32
Cross street/directions to job site: jydronic hot water system _ 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,is-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other. 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater . 23.32
DESCRIPTION OF WORK Gas fireplawfinsert 33.39
Flue vent for water heater or gas
REPLACE EXISTING GAS FURNACE fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner!lluelvent 23.32
•
® PROPERTY OWNER ❑ TENANT Other: 23.32
---- Environmental exhaust and ventilation:
Name:JIM GODDARD Range hood/other kitchen
equipment 3339
Address:15790 SW SERENA COURT Clothes dner exhaust 3339
City/State/ZIP:TIGARD,OR. 97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)620-3095 Fax:( ) Atticicrawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON .. Other. 23,32
Business name Fuel piping:
_ S14.15 for first four,$4.03 for each additional
Contact name: Furnace,etc. I
Address: Gas heat pump
Wallrsuspended/unit heater i
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail: Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:ABLE HEATING 8 COOLING LLC Other:
. MECHANICAL PERMIT FEES'
Address:16285 SW 85TH AVE. SUITE 105 Subtotal
City/StatelZIP:TIGARD,OR. 97224 Minimum permit fee($90.00)
Plan review(25%of permit fee)
hone:(503)579-2250 Fax:(503)620-3980 State surcharge(12%of permit fee) p
CCB tic.: , T�� TOTAL PERMIT FEE ,/eer ,I (�
This permit application expires if a permit is not obtained within 1ao
days after it has been accepted as cemplete.
Authorized si tore: • Fee methodology set by Tri-County Building Industry Service Board
Print name: E)l t 1..k , ( t_ ,1 E Date:
1:1Building\Perrnit, EC_Permit 040113.doc sl 446-4617T(I 1/02/CO61/WEB)
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