Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00252
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/03/2010
T[ G AR D Parcel: 1 S 134 B D07004
Jurisdiction: Tigard
Site address: 11344 SW COTTONWOOD LN
Subdivision: ENGLEWOOD NO. 3 Lot: 229
Project: Lorenyen
Project Description: Installing furnace and A/C.
Owner: FEES
LORENYEN, GARY Description Date Amount
11344 SW COTTONWOOD LN
TIGARD, OR 97223 Air Conditioning 06/03/2010 $46.75
Furnaces < 100K BTU 06/03/2010 $46.75
PHONE: 503 - 684 -3199 12% State Surcharge - Mechanical 06/03/2010 $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: COM
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: Permittee Signature:
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.
Mechanical Permit A Ili ' i i c rl I is , ; i ? it , i „, , ,., ,
City of Tigard Received
13125 SW Hall Blvd., Tigard, OR 972 Plan Review d £ r ��
' Phone: 503.639.4171 pax: 2 0 1 0 Dato/By: Other Permit:
Inspection Line: 503.639.4175 Date Ready/By: IN See Page 2 for
Internet: www.tigardor.govCITY OF TIGARD Notified/Method: Suppleraeatt'iafornation
1 �S
, . ., ' ., r. -. iii .','.:� .. � (�1 � ?u*PS�.•�,
❑ New construction Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition " tiler: mechanical materials. equipment. labor, overhead, and profit
alue. 5
-1- and 2- fhmily dwelling ID Commercialindustrial Accessory building '' � '
For special information use checldist.
❑ Multi - family ❑ Master builder Cl Other: " Description 1 Qty. I Fa. I Total
?, ' -+. : :: iOB SPX IF4 Olt #AT40Si :! ,.. :YMCA' O (. Heat
Job sits address: Air conditioning 1 /�
• (requires site pun showing etaoem eno ( 46.75 7te 7S,
City /State/ZIP: ` / Furnace 100,000 BTU (ducts/vents) 1 46.75 44, 7
�'CCt name: Furnace 1 00,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. 110.:
Hcat pump 61.06
Cross sired/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
_ _ Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fliel -type, not electric),
in -wall. in -duct, suspended, etc. _ 46.75 -
Lot Flue/vent for any of above 23.32
Subdivision: Other: 23.32
Tax map/parcel no.: Other fad appliances .
Water heater 23 32
A- -- Ce � Gas fireplace _ _ 33,39
� � Pluc vent nt fo fOr Water heater Or gas
Log og fireplace 23.32
L.ligh igftter (pas) 23.32 T '
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
. .. . .)
r .. : 4. o1: : :4 . .4i . . I. 1y+1� T". tncr/f1 cnt
Chimncy/l' ue/v 23 32
Other: 23.32
Name; L. L. , Environmental exhaust and ventilation
l Range hood/other kitchen
Address: AG . .. f .�l/ equipment 33.39
•
City/State/ZIP: "7 i t i Clothes dryer exhaust 33.39
1 ----- Single -duct exhaust (bathrooms,
Phone: ( 511.) �y Fax ( ) Toilet compartments, utility rooms) 23.32
Attic/cnrwla fans 23 .3a
' Other: 2332
Business name' Fuel piping
name: FOUR SE S14.15 for first fbur; S4.03 for each additional
AND AI SEASONS HEATING Furnace. .
Addres CONDI TtONIN Gas heat pump
T City/State/Z 1P NE�IBgpG OR 871 > W all/suspended/unithe a ter .
Phone: ( 53$1 .51, i Fax:: (� -"O 1 to b Water hearer
Fireplace
c� / Range
E-mail: /
M
BAi WIMG
Clothes dryer as)
Business name:
FOUR SEASONS Other: _
SaN$ H �.rATlNti C pc,' ' Subtotal q5iu
City/State/ZIP: 1005 INDJJSTRI I PION
Minimum ',emit fee ($90.00)
—Plone: ( ) NEUVBERG, • #171(32 ) Plan review (25%of pumit fee)
t7 r a 3 ii State surcharge (12% of permit fee) 1 t TA
CCB lip.: - 1 F ...• State
TOTAL PERMIT FEE J� E
This permit appiiendon expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: 1k E y i wi e i Date: ' et • Fee methodology sot by Tn-County Building industry Service Board
I'.aildi itslb{CC+>'ermiapp'dOe 10/01/09 440- 4617T(I1/027cOMMw®)
b00 /E002 991.08E9E09 XVJ 9b :91. OLOZ /Z0/90
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; • A/o-HEAT P - SITE PLAN ,
FEET TO BACK OF PROPERTY LINE t - TP E
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FEET TO SIDE PROPERTY LINE
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R SEASONS HEATING
AND AIR CONDmONING, INC.
- 3 I 1005 INDUSTRIAL PKWY -
NEWBERG, OR 97132
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FEET TO FRONT PROPERTY LINE
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up PLEASE . FAX APPLICATI N WITH SITE P
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