Permit CITY OF TIGARD MECHANICAL PERMIT
114 = • COMMUNITY DEVELOPMENT Permit#: MEC2015-00420
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 06/29/2015
Parcel: 1 S134DC07400
Jurisdiction: Tigard
Site address: 11735 SW GALLO AVE
Project: Swanson Subdivision: GALLO'S VINEYARD Lot: 5
Project Description: Installation of gas furnace and a/c. Placement of a/c unit must comply with manufacturer's clearance requirements.
Investigative fees due per BCC2015-00030.
Contractor: ROTH HEATING&COOLING Owner: SWANSON, HAROLD
PO BOX 1265 11735 SW GALLO AVE
CANBY, OR 97013 TIGARD, OR 97223
PHONE: 503-266-1249 PHONE:
FAX: 503-266-3478
FEES
Specifics: Description Date Amount
Air Conditioning 06/29/2015 $46.75
Type of Use: SF Furnaces< 100K BTU 06/29/2015 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 06/29/2015 $11.22
Occupancy Grp: Investigation Fee 06/29/2015 $90.00
Stories: Investigation 12%State Surcharge 06/29/2015 $10.80
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $205.52
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: drift— Permittee Signature: j
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
1
015032663478 11:15:06 06-29-2015 1 !1
Mechanical Permit A II EIVED FOR OFFICE USE ONLY
EriCity of Tigard Received zip) �/
g Datdey: a 9 i5 zip) Permit No.:HE C o.O,S co a0
, 13125 SW Hall Blvd.,Tigard,OR 972 i 0 9 2015 Plan Review �J_
Phone: 503.718.2439 Fax: 503.598.1 Date/13y: Other Perm&gide,10/5--em 36
TIGARD Inspection Line: 503.639.4175 Date Ready/By hats Ed See(rage 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method' Supplemental information
BUILDING DIVISION -
- - -- - -- --- - -. 1 ca I. I l;- s c Pm — - - Mechanical permit tees'are based on the value of the work
❑New construction ®Addition/alteration/replacement ; performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: i mechanical materials,equipment,lama.overhead,and profit.
-- - - ---- - -----,..'_— . . Value:$� Clf O v Laf3 `U7YbL D
p_)
nRlL9. . .
Z I-and 2-family dwelling ❑Cotrmtercial/industrial U Accessory building Fur special inJirrmatior use c/eA/rsr.
❑ Multi-family ❑Master builder ❑Other: Description [Qty. I 8a. [Total
l o MR ITn` 7��i,�t1 (t c.... . ... Heating/cooling:
- _ --_-- --- -- -.__ --- . Air conditioning I _46.75
Job site address: 1 1735 SW Calla Ave. Furnace 100,000 BTU(duets/veins) I 46.73
City/State/ZIP:Tigard,OR 97223 Furnace 100,000+BTU(duas/ventsl 54.91
Heal pump 61.06 1
Suite/bldg./apt.no.: Project name:
Duel work 23.32 1
Cross street/directions to job site: Hydronic but water system _23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric), •
_in-wall,in-duet,suspended,etc. 46.75
Flue/vent fur any of above 23.32
Other: 23.32
Subdivision: Lot no.: -
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
(6X3) cIR I(oXjt'*bi .: Gas fireplat.e/insert . 3339
-_.-_- -- Flue vent fur water healer or gas
Installation of gas furnace and air conditioner. fireplace 23.32
Lug lighter(gas) _ 23.32
• - - - - -- Wood/pellet stove 33.39
- Wood lireplace/insert 23.32
Chimney/l Merin ue/vent 23.32
Urvirunntctuul exhaust turd vculilati 23.32
. tiuu:
I Name:Harold Swanson Range hood/other kitchen
Address: 11735 SW Gallo Ave. equipment - 33.39 II
Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,OR 97223 Single-duct exhaust(bathrooms,
toilet companments,utility rooms) 23.32
Phone:( ) Fax.( ) Altie/crawlspaee fans _23.32
tf . 00. , ;�i i 112 o' * I Other: 23.32
Business name:Ruth Healing and Cooling
`"'�� Fuel piping: i
514.15 for first roar;$4.03 for each additional
Contact name:Jesse Mountie Fumaee,rte. _ I
Address:PO Box 1265 Gas heat pump
Wall/suspended/unit heater
City/State/1P:Canby,OR 97013 Water heater
Phone:(503)266-1249 Fax::(503)266-3478 Fireplace
r -- Range
f-mail jcsscm a,roth-luttl.cow Barbecue
B I V o - Clothes dryer(gas)
Business name:Roth Heating and Cooling Other
Address:PO Box 1265 Subtotal 0 5. -a
City/State/ZIP:Canby,OR 97013 Minimum permit lee($90.00) - --
I'Iut review(25%of permit Ice) "----Phone:(503)266-1249 I Fax:(503)266-3478 - State surcharge(12%ol'lxnnit lee) //•a.�:
CCB lic.:14008 — TOTAL PERMIT FEE 1py,'72j
This permit upplicnaiun expires 11 a permit is not ubutiurd within fret
days after it has been accepted as cuaptele.
Authorized signature: • Fero otethudulogy set by'Fri-County ttuddulg hWustry Servie Board
Print name:Jesse Mansclle ate:6129/15 /N✓E hr/ 10.9 n LI rL. le .- 11/00•YG
I\auildingWermits1MEC YttautApp_040I13.doc 441M017r(II/02/CUM/WEt) 4c9_0 Lam,.. ,-Z
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Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11735 SW GALLO AVE, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00420
David Young
Violation Summary:
Inspector Contractor