Permit CITY OF TIGARD MECHANICAL PERMIT
111111 COMMUNITY DEVELOPMENT Permit#: MEC2014-00413
Date Issued: 08/06/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 1S125DCO2200
Jurisdiction: Tigard
Site address: 7005 SW VENTURA DR
Project: Wilkerson Subdivision: WASHINGTON SQUARE ESTATES Lot: 12
Project Description: Replace gas furnace,insulate ductwork in unconditioned basement.
Contractor: RIGHT NOW HOME SERVICES INC Owner: WILKERSON
BOX#701 12042 SE SUNNYSIDE RD 7005 SW VENTURA
CLACKAMAS OR 97015 TIGARD, OR 97223
CLACKAMAS, OR 97015
PHONE: 503-662-1098 PHONE.
FAX: 503-775-6006
FEES
Specifics: Description Date Amount
Furnaces>=100K BTU 08/06/2014 554 91
Type of Use: SF 12%State Surcharge-Mechanical 08/06/2014 $10 80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/06/2014 535 09
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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 adopte�by the Oregon
Utility No n-Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain copy of the rules
or dir questions to OUNC calling 503.232.1987 or 1.800.332.2344.
Iss ed By: t� 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.
Mechanical Permit Application 1 ()11 (II I I( I I • I 1 l\I 1
City of Tigard Received y.
,� � (Q 411/1n11.1 Permit No.: M�i ��' .� l
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2439 Fax: 503.598.1960 Phtn Date/13y: Other Pmt:
Line: 503.639.4175
i I t; \I I) Date Ready/By: 1mu ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction pgi4Additionialterationireplacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:S L{vw
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
ligU-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For spedal information use checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
�� S-W`
Furnace conditioning 46.75
Job site address: Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: L r ci 4. d2 97 217 Furnace 100,000+BTU(ducts/vents) 54.91 N
Heat pump 61.
Suite/bldgJapt.no.: I Project name: YV 1,Kt 1(5work 0,3 Duct work
Cross street/directions to job site: Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above , 23.32
Other: _
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
_
epl t5T4 % Q � to, Flue for water heater or gas
fireplace
23.32
il2 Cr& &a t ter „ at e ..11-K jl!ti C n k4,tA,D / Log lighter(gas) 23.32
Wood/pellet stove 33.39
O 6P-6 eMe#- - 0/6-C040 t -ONet/t A/(
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ PROPERTY OWNER I ❑ TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
equipment 33.39
Address: Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility moms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
❑ APPLICANT ❑ CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address:
Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax::( ) Fireplace
Range
E-mail:
Barbecue
CONTRACTOR Clothes dryer(gas)
Business name: g--,11,t 1000 Pkl'1 a 6e(0I a 05 Other:
MECHANICAL PERMIT FEES*
Address:lae,41 5.C. Sve.h.NfIOe it4) 5v;}fie 70 I Q visteA wfr,'? f701 r Subtotal
City/State/ZIP: U l iA.5, oR /701 r Minimum permit fee($90.00) , %jer
/ Plan review(25%of permit fee) .. --
Phone:(96 )�` r'r� Fax:(j)3 ) 77$= (9 bD 10 State surcharge(12%of permit fee) fD.cro
CCB lie.: 1'1 tapas- TOTAL PERMIT FEE /ry'j `
This permit application expires if a permit is not obained within 180
days after it has bee.accepted as complete.
Authorized signature: • Fee methodology set by Tri.County Building Industry Service Board
0654 4)° ') 1;t.4'43
et-71+ -4--s.