Permit 7 "` CITY OF TIGARD MECHANICAL PERMIT
1 ! t, ■ : COMMUNITY DEVELOPMENT Permit #: MEC2010 -00193
,a, ,,,04:',54. Date Issued: 04/30/2010
TIGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S111 0D06600
Jurisdiction: Tigard
Site address: 15780 SW STRATFORD LP
Subdivision: STRATFORD Lot: 63
Project: Crook
Project Description: Replace furnace and A/C
Owner: FEES
CROOK, MIKE Description Date Amount
15780 SW STRATFORD LP
TIGARD, OR 97224 Air Conditioning 04/30/2010 $46.75
Furnaces < 100K BTU 04/30/2010 $46.75
PHONE: 12% State Surcharge - Mechanical 04/30/2010 $11.22
Contractor:
FOUR SEASONS HEATING & A/C INC.
1005 INDUSTRIAL PARKWAY
NEWBERG, OR 97132
PHONE: 503- 538 -1950
FAX: 503 - 538 -0165
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
Total $104.72
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: /1) f ‘ Permittee Signature: 5 E L A Q p L J C. J T_ D
/ I Call 503.639.4175 by 7:00 a.m. for an inspection that business day. +
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.
i a
Mechanical Permit ApplicatioRECEIVED 1:01.4 oil Ic 1. 1 !;i:
City of Tigard Received
Dato/sy: 1=1:=IIMMIn
13125 SW Hall Blvd., Tigard, OR 97223 APR 2 8 2010 Plan Revicw
' • Phone: 503.639.4171 Fax: 503.598.1960 Date/By; Other Perrait:
Inspection Lne: i 503.639.4175
CITY OF TIGARD Dare RcadY/BY: 0 See Page 2 for
Internet; www.tigard BUILDING DIVISION Notified/Method; NIE Supplemental Information
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Mechanical permit fees* are based on the value of the work
fl New construction Cffiddition/alteration/replaccment performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 12 Other: mechanical marciirds, cquipmcnk labor, overhead,and profit.
Value
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., ,.,■04
PI
• and 2-family dwelling 0 Commercial/industrial U AceessOry building 4 OVW0*Fr4f0
For special information use checklist
El Multi-family El Master builder El Other: Description 1 Qty. 1 E& 1 Total
';‘.!;;;;...,.',',.;,'..'':.:.•.:; . : ', ' 4 - ' ....:**04*,r0:0 : 4 ',. :T.r ''';: 7:;:' ''': ':' Heating/cooling
Air amditioning
Job site address: )5 7c!O s W Sira , , r" i_.0, (r. sim plan showing placcm t) 1 46.75 46' 4 75
City/State/ZIP:
14pgro( 0 k. 43 7 .-.2- ii r Furnace 100,000 B'TU (aws/ ) ( 46.75 46.7c
1, Furnace 100,0001- BTU o is) 54.91
Suite/bldg./apt. no.: L./ I Project wane: crrlok Heat pump 61.06 J
Cross street/directions to job site: Duct work ....---- ---21.12... ------'.--
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 2332
Unit heaters (fuel-type, not electric).
in-wall, in-duct, suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision: I Lot no.:
Othe,r: 23.32
Tax map/parcel no.: Other fuel appliances
, .,;,,;:,•;:r.',.,,,:'.';:.'.ri,v07.,...!,.... -., ,b, Water heater 2332
— Gas fireplace 33.39
g • _ i 4_ •e_. 1. NA. . e. I. Flue vent for water heater or gas
fireplace 23,32
_At 1/4 a- , . ) t + i Ch Log lighter (gas) 23.32
_ wood/pellet stove 33.39
Wood fireplace/insert 23.32
chimney/liner/flue/vent 23.32
ti,"i,..: ri il::i•citS1140* :: ;'.:: ':,:11.,0r■n r ,..471111,MSNM oth 23.32
Name: i ' k• V Environmental exhaust and vendladon
Pfr Range hood/other kitchen
Address: •S t 0 "" 3 Er ALI: Al equipment 33.39
City/State/ZIP: 1-11 ok e?-7>.)-(1 Clothes dryer exhaust 33.39
1
Single-duet exhaust (bathrooms,
Phone: (601) ; ,a,..a Fax:( ) toilet compartments, utility rooms) 23.32
23.32
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Business nainc; POUlteeASOt419HV1ING Fuel Riping
Contact name: A.tliD AIR cONnrEIONING, for first four; $4.03 for each additional
r
Address: 1005 INDUSTRIAL PKWY Fumace,ctc.
NEWO'LlFte, OR 97132 Gas heat pump
City/Slate/ZIP: Wall/suspendedAmit heater
. water heater
Phone: (565 )$ ...,:±" --- c Fax: : (4 s -- 3 & -0 , & s---
Fireplace
f CiS• l."— !binge
Ill:r ...-..
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Clothes dryer (gas)
Addrss: AND AIR CONDITIONING, INC.
Business name: FOUR SEASONS 14 " 71 t4G , Other
e _
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luu5 INDUSTRIAL PKWY subtotal q•3. So
City/State/Z1P: NP Minimum permit fee ($90.00)
. one: ( ) 1 Fax: ( ) Flan review (25% of permit fce) •
CCB lic.: 9 -) ( __ ___ State surcharge (12% of pemiit fee) $( • )-)-
TOTAL PERMIT FEE irs)q. 12.
Authorized signature: ',"°;'" '6CCie(A-- Ibis permit appheadea expires if a permit is not obtained within 180
days after It has been accepted 83 complete.
k,
Print name: ." c ta, f .e .... 4-1-0 teN ik DatT. - .,..). E"7 0 ' Fee methodology set by Tri-County Building Industry Service Board
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23 8.
CITY OF TI RD
BUILDING DIVISION
FOUR SEASONS HEATING
AND AIR CONDITIONING, INC.
1005 INDUSTRIAL PKWY
NEWBERG, OR 97132
991080 Cog XVJ Zell OI0Z /8Z /170