Permit CITY OF TIGARD MECHANICAL PERMIT
111 COMMUNITY DEVELOPMENT Permit#: MEC2019-00900
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/31/2019
T I G A It.I_) 9 Parcel: 2S 110AD09900
Jurisdiction: Tigard
Site address: 10901 SW ANNAND HILL CT
Project: Annand Heights, Lot 1 Subdivision: ANNAND HEIGHTS Lot: 1
Project Description: Installing A/C Unit. Placement of unit must comply with manufacturers requirements.
Contractor: TRI COUNTY TEMP CONTROL INC Owner: ANNAND HILL LLC
13150 S CLACKAMAS RIVER DR BY RICHARDS, M DALE
OREGON CITY, OR 97045 12655 SW NORTH DAKOTA ST
TIGARD, OR 97223
PHONE: (503)557-2220 PHONE: 503-780-4375
FAX: 503-557-0919
FEES
Specifics: Description Date Amount
Air Conditioning 12/31/2019 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 12/31/2019 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 12/31/2019 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC y calling 503.23 987 or 1.800.332.2344. �/c
Issued By: Permittee Signature: S / jl/ .t9jy 7) t
Call 503.639.4175 by 7:00 a.m.for the next available inspection date. J" b G[�� �f `�
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the Job site at the time of each inspection.
Mechanical Permit Application IOR t,f►►( t ra 0\1.1
City of Tigard �t/u j 3 /� �4 ees/ Uc
' .Ill13125 SW Hall Blvd.,Tigard,OR 97223 es.
Phone: 503.718.2439 Fax: 503.598.1960 ( uate/By: `7UeO' '
i c:1, Inspection Line: 503.639.4175 Jate Ready/By ruris. ® See Page 2 for
Internet: www.tigard-or.gov 1 Notified/Method: Supplemental Information
Mechanical permit fees'are based on the value of the work
G 'ew construction 0 Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
j r-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family ❑Master builder 0 Other: Description I Qty. 1 Ea. 1 Total
Heating/cooling:
Air conditioning _(/ 46.75
Job site address: (����)t - ter / A , / ✓Cr f,ale Furnace 100,000 BTU(ducts/vents) . 46.75
City/State/ZIP: :T.?,
air" OZ 97223 Furnace 100,000+BTU(ducts/veats) 54.91
` Heat pump 61.06
Suite/bldgJapt.no.: I Project name:/514/4,46/914,/Fb Duct work 23.32
Cross street/directions to job site: la ip th Hydronic hot water system 23.32
Jr 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
Subdivision: (nna /�e'/y/j 76 I Lot no.:/ der: 23.32
i (/ Other fuel appliances:
Tax map/parce no.: Water heater 23.32
. Gas fireplace/insert 33.39
/` .'/i!7` Flue for water heater or gas
fireplaceace 23.32
ci ' Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
_. Other: 23.32
Environmental exhaust and ventilation:
Name: j A,1 af.4 s `It Si j c- Range hood/other kitchen
equipment 33.39
Address: V yJ ,(f r Clothes dryer exhaust 33.39
City/State/ZIP: 7• G� ,-t i .2 y3 Single-duct exhaust(bathrooms,
' toilet compartments,utility rooms) 23.32
Phone:( (51 . . d — j,7' Fax:ip 3) j • ) 77r ai Attic/crawlspace fans 23.32
Other 23.32
Fuel piping:
Business name: rSC[itie. $14.15 for first four;S4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
WalVsuspended/unit heater
City/State/ZIP: Water heater
Phone:( ) I Fax::( ) Fireplace
Range
E-mail: r 0 ar L.,•p►tS Jj/4.3 !J _ ( A _ Barbecue
'.. ` Clothes dryer(gas)
Other
Business name: •Flr5Ir (4 I z_
n r n v F • r
Address: /3/5V /Il/PeAutS iv—tc-'/` 1) • Subtotal
City/State/ZIP: OfriQit CIS tJ Qn d Minimum permit tee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: -7.2.6.23 TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: pill ' Fee methodology set by Tri-County Building Industry Service Board
Print name: lira
d ftridiu.) Date: 49/!�./`(`
LtBuildingtPermils C_PermitApp_-0400 1133 doc 440-4617r(I I/02/COM/WF,B)