Permit (11) CITY OF TIGARD MECHANICAL PERMIT
'1: COMMUNITY DEVELOPMENT Permit#: MEC2016-00427
Date Issued: 06/14/2016
Ti G A RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S109AB10100
Jurisdiction: Tigard
Site address: 14197 SW 132ND TER
Project: COKER Subdivision: RAVEN RIDGE Lot: 31
Project Description: Replacing gas furnace and heat pump.
Contractor: WESTERN HEATING&COOLING INC Owner: COKER, EDWARD W III
50618 COLUMBIA RIVER HWY 14197 SW 132ND TER
SCAPPOOSE, OR 97056 TIGARD, OR 97224
PHONE: 503-543-5599 PHONE:
FAX: 503-543-3693
FEES
Specifics: Description Date Amount
Air Conditioning 06/14/2016 $46.75
Type of Use: SF Heat Pump 06/14/2016 $61.06
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 06/14/2016 $12.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $120.75
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ` ' -:Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONL\'
Received ,
City of Tigard �,` /C� DateBAMIll Permit No.. _
114 v 13125 SW Hall Blvd.,Tigard,OR 97A3 V G y ' - A
Phone: 503.718.2439 Fax: 503.5981ji Plan Review
Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 rl O�6 Date ReadyBy: ® See Page 2 for
Internet: www.tigard-or.gov t11 L Notified/Method: MISupplemental Information
Jl1 -
p - Mechanical permit fees*are based on the value of the work
❑New construction UAddition/alte� *,r eplacement performed.Indicate the value(rounded to the nearest dollar)of all
E]Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
.;'v. f e 't ,3 Value:$
CEI 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
Heating/cooling:
_,,..: __ ...' r �.. Air conditioning 46.75
Job site address: ` ti( q'7 Srs) I Qlir-race- Furnace 100,000 BTU(ducts/vents) 1 46.75 Y if,.'7
Furnace 100,000+BTU(ducts/vents) 54.91City/State/ZIP: 'rSatd O _-7c.1.29
( Heat pump 1 61.06
j I
,v(pSuite bldg./apt.no.: Project name: Co ke
Duct work 23.32
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), 1
in-wall,in-duct,suspended,etc. 46.75 I
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
�' - rt, a ; a Gas fireplace/Insert 33.39
� Flue vent for water heater or gas
We-1oyr t' ��a.C_, CaQ _ Qe , 64 R ,. fireplace 23.32
Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32
.- - ... s Environmental exhaust and ventilation:
Name: Cd Co IKe r Range hood/other kitchen
1 02^ 1 equipment 33.39
Address: (
1q 1 5� (3 d ler rac,L. Clothes dryer exhaust 33.39
City/State/ZIP: �� Single-duct exhaust(bathrooms,
g 02_ ctl H
I toilet compartments,utility rooms) 23.32
Phone:(so'') $Ito - d(o t7 2 Fax:( ) Attic/crawlspace fans 23.32
Other: 23.32
Business name: Fuel piping:
�Q, �,^ �2 �J Co t/�Q, �tn $14.15 for first four;$4.03 for each additional
Contact name: C J Furnace,etc.
Ul!
Gas heat pump
Address: 5 0(9 1% C o mob,F - ...t,- Hwy Wall/suspended/unit heater
City/State/ZIP: "- c�Dsc o R q Z 0S b Water heater
S4
Phone:( Fax::( ) Fireplace
Soy St-13- S 1 S '� 54 —310(21...S Range
E-mail: A
he ✓,/ . lin r Barbecue
Clothes dryer(gas)
Business name: wea4r,r, Lle C1,4` o,,J co. 1.-- --1. ,In C.
t
Other:
Address: (o( g c,i V",,k)`G R t�S ySubtotal I o-t iS
City/State/ZIP: S00' e q'10 5(O Minimum permit fee($90.00)
C a
PQ Plan review(25%of permit fee)
Phone:(c o s LA-5 _ 5 5(1 ot Fax:(t0 ) 543-3C43 State surcharge(12%of permit fee) 12,q L
CCB lic.: '1(o7 t TOTAL PERMIT FEE )2O.75
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: fir.._../7"---"' * Fee methodology set by Tri-County Building Industry Service Board
Print name: J,,,,,k;c, o33$ Date: S A/1 (v
I:\Building\Permits'MEC_PermitApp_040113.doc 440-4617T(11/02/COM/WEB)