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Permit s V CITY OF TIGAR ' MECHANICAL PERMIT Air COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00021 DATE ISSUED: 1/10/2007 TIAGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S 103AD - 04500 SITE ADDRESS: 12940 SW 107TH CT ZONING: R - 4.5 SUBDIVISION: PATHFINDER LOT: 035 JURISDICTION: TIG Project Description: Installation of gas furnace. CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: NAT 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Owner: FEES JOE GRISHAM Description Date Amount 12940 SW 107TH CT TIGARD, OR 97223 [MECH] Permit Fee 1/10/2007 $72.50 [TAX] 8% State Surcha 1/10/2007 $5.80 Total $78.30 Phone: 503- 620 -6179 Contractor: FOUR SEASONS HEATING & A/C INC. 1005 INDUSTRIAL PARKWAY NEWBERG, OR 97132 REQUIRED ITEMS AND REPORTS Contact #: PRI 503 -538 -1950 FAX 503 -538 -0165 Reg #: LIC 97152 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: /'�C., /Lc15 Permittee Signature: � � , Call 503.639.4175 by 7:00 a.m. for inspections 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. Jan 09 07 04:09p Malcolm Lamb 5035380165 p.3 • i' a F W. o i � O p t )+Vl tfr.Flrl91 t o ,roi. tv� ca 1A( � 1 ' - h d Mechanical Permit Application _ '10 ° � ilf„ f, , t ? r n R ` O r,,1. • IC L �ISE,OnL}ii, ;' :'. ``' ' , City of Tigard JR ( P. r1` A R eceived _ h ! f � �/'� y� y. t Date /By: / �© C 7 "")/...-"....1L Pennh Nn `" \6C,Z.'U ( f 13125 S W Hall Blvd., Tigard, OR 97 4 - = -° y t Plan Review Phone: 503.639.4171 Fax: 503.598.1960 nI ar.A. , ;� Date/By: Outer Permit: Inspection Line: 503.639.4175 JAN 2007 ;ll :. , 1.., Dale Ready /13y: Jam: ® See Pair? for Internet: www.ci.tigard.or.us C Notifred/Method: Supplemental Information �� kilo *ORItt6!Or. COMMERCIAL FEE* SCHEDULE - USE CHECKLI ❑ New construction If Addition /alteration /replacement Mechanical permit fees* arc based on the value of the work performed. Indicate the value (rounded to the nearest dollar) r ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead. and profit. CATEGORY OF CONSTRUCTION Value: $ I<:;.1 2 -tamil dwelling ❑ Accessory RESIDENTIAL EQUIPMENT / SYSTEMS FEES* y g ❑ Commercial /industrial buildin g For special information use checklist. ❑ Multi-family ❑ Master builder ❑ Other: Description 1 Qty. Ea. 1 Tit JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: `a Air conditioning or heat pump �x� 1. ID �. • ' � (requires site plan showing placement) 14.(10 City /Slate /ZIP: >�Q G� r- r� Furnace 100.000 I3T (elects %vents► 1 14.00 Suite bldg. /apt. no.: ` Project - name: Furnace I W,000+ BTU (ductclvents) 17.90 Gas heat pump 14.0(1 Cross street /directions to job site: Duct work 14.00 Hydronic hot water system 14.0(1 Residential boiler (radiator or hydmnic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended. etc. 1(1.00 Subdivision: Lot no.: Flue/vent for any of above 10.00 Other. 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 ` Gas fireplace 10.00 v^.\:', I1•..,/ �� -c t A 102_1E1 Qt `) Flue vent for water heater or gas fireplace 10.1)0 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.0(1 _ tirriROPERTY OWNER 1 0 TENANT Chimney/liner/flue/vent 10.00 Other: 10.00 Name: • G a //�� Environmental exhaust and ventilation Address: - A . 4 D S 1 ty, l''.-- . \ CA-- Range hood /other kitchen equipment 10.00 City /Slate /ZIP: .--\-- _ — 7 ?:P.--7' Clothts dryer xhaust exhaust 10.00 I Single duct exhaust (bathlncnns, Phone: �D'y� CPaQ 79 Fax: ( ) toilet compartments, utility rooms) 6.80 (,].APPLICANT • ❑ CONTACT PERSON Atticfcrawlspacc fans 111.00 tt� ,� Other: 111.00 Business nar �TD1.b� �Q�-.t5..." ` Th Fuel piping Contact name: C c .... .� 6 55.40 for first four: 5100 for each additional 1 C3 S =�� (� �� A A Furnace. ete. Address: �1+ la.k' Gas heat pump City /Stale/ZIP: Q. ArN Q e=1,1 J 3 Wall /suspended/ unit heater Phone: t cZ . r?,,c,K _ Ft � Fax: :47)3 . 3� _ S Water hcttcr J Fireplace E -mail: Range CONTRACTOR Barbecue ' • Business name: S � Clothes dryer (gas) Lky Address: 1IZir) —. NIC1V•-- N MECHANICAL PERMIT FEES* City /Stale /ZIP : ���.4 �„�p 1 ^� Subtotal �' tFi- 9 ` l r7 --- A ,.. ...., Minimum permit fee (572.50) Phone: 3 `� - I Fax' _J 3� �1 140.• � �/ Plan review (25% of permit tee) CCI3 lic.: c — 1 S State surehaege(8 %ofpennit fee) TOTAL PERMIT FEE o Authorized signature: C �1.Lj� This permst application expires if a permit k not obtained .ciltein 1 days after it has been accepted as complete. I Print name: �N��� • a ,� .A Date: \ Q ./ y 7 ' fee methodology set by Tri C'nunly Building Industry Scr •ice Roan I:...,0E•Penuits.MeY'...... tApp..e 12.01 ' -+ " —v 440 -06171 111•