Permit MECHANICAL PERMIT
CITY OF TIGARD
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00283
Date Issued: 06/22/2010
T1GA.RD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S114AD01100
Jurisdiction: Tigard
Site address: 8905 SW WAVERLY DR
Subdivision: WAVERLY ESTATES Lot: 10
Project: Jaimes
Project Description: A/C installation.
Owner: FEES
JAIMES, DAVID Description Date Amount
8905 SW WAVERLY
TIGARD, OR 97224 Air Conditioning 06/22/2010 $46.75
Minimum Fee Adjustment - Mechanical 06/22/2010 $43.25
PHONE: 503 - 928 -6734 12% State Surcharge - Mechanical 06/22/2010 $10.80
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:
Gas Pressue:
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503 . • ` ` 1.800.332.2344.
Issued By: ci► 4/.4.Ar 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.
MechanicaH Permit A licatioiil r»' 't 'J ^R1KP"#tl�lst '"""'m,x^(-'+A " F a^ t t', " r +
Q "m'� w „,j l!, 1 Mi � t1� i !1AE'1 P i. , , il
" °� U e.144 4 4 4 `o4,1.4ette!. 1 7"41 "!` -... 5 ;iAr � a .4 9 yaa¢.he iteFd1 Received i
1 u . CI ® 't`lga>l'd i ? ! ......y. 0 r /a aor*n,t No.. m12. ..
"i �- 13125 SW 1{ell Blvd., T OR 97 Plan Review
�., , . y Phone: 503,639.4171 Fax: 503.598.1960 Date/By: Other Permit:
, , �+i xt t'�� '; Inspection Line: 503.639,4175 JUN 21 2 010 Date Ready/By: ;ens ' SI See Page for
r tL t'i.V.Q Internet www.tigard- ot.gov Notified/Method: 7) Surptemea ed tptonnetioa
C OF TrARD
TYPE QF wgl D i t.C, D i v I S I Q N COMMERCIAL FEE SCHEDULE - USE CHECIQJST
❑ 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
O Demolition they mechanical materials, equipment, labor, overhead, and profit. • CATEGORY OF CO<NS'CRU`cI'ION Value: $ ..
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
7 .- k ------ - 2_�,,,ily dwelling 0 Commercial/industrial ❑ Accessory building For special rrlformatlon use checkltrl.
❑ multi-family . ❑ Master builder 0 Other: Description 1 Qty. L Ea. L Total
JOB SITE INFORMATION AND- LOCATION Heating/cooling
9. - -- Air conditioning
Job site address: • D I ' �� . ` (requires site plan showing placement) 1 46.75 4•75
--- . ' / (/'� a ! - � , Ci ry JStatc/Z1P: y / i Furnace 100,000 BTU (ducts/vents) 46,75
Pomace 100.000+ BTU onus/veinal 54.91
Suite/bldg./apt. no.: Project name: r _ .. ' ricer Bump 61,06
Cross street/directions to job site: Duct work 23.32 _
Hydronic hot water system _ _ 23.32 _
_ Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46 -75
Flue/vent - kr goy of above 23.32
Subdivision: Lot no.: Outer: _ 23.32
Tax map/parcel no Other fuel appliances
Water heater 23.32
DESCRIPTION OF 'WORK ' ,. ' -
Gas Ample= , 33,39
Flue vent for water heater or gas
fimplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace/insert 23.32
V
Chimney/iiner /flue/vont 23.32
it ' ; OPERTY OWNER . , a TENANT Other: 23.32
Name: 1 _� -4 `.I " -.i ! . F- nvironmental exhaust and ventilation 1 Range hood/other kitchen d f. : (� ! 4y,r k cauil7ntcrtt 1 33.39
City /State/ZIP: / t � D ' ' 72 i- he dryer exhaust 33.39
� - - T Single-duet exhaust (bathrooms,
Phone: (S3) ei „ - 3 ' ( ) toilet compartments, utility rooms) 23.32 .
XAPPLICAr T ( . • . CI CO1rrA,Cr PERSON Attic /crawlspa a fhas 23.32
!POUR P6 H AT Other: _ 2332
Business name: Feel p[p[fltt
` ` S14.15 fir first four; S4.03 for each additional
Cone: 1005 INDUSTRIAL POW Gas heat
Address: , - NEWBERG, OR 97132 Fos heat p»mp
Ci LIP Wallsuspended/unit hearer
• --- Pux:: • + Water heater
Phone: • 3 a ' • , Fireplace
&mail= G , ,!Ak r ' Po . • / _ 0 . E ■_4.. r GO Range
CONTRACTOR
Barbecue
Clothes dryer (gas)
Business name: Other:
Address: AND AIR CONDITIONING, INC. MECHANICAL PERMrr FEES*
City /Scate iTe.. 0 p 1 " ' - ■ 1 t • Subtotal
Minimum permit fee (590.00) 1 q f7 , o 0
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB tic.: q 7 1 `c State surcharge (12% of permit fee) 1 ( ) .. R'0
! ,, TOTAL PERMIT FEE
/Q Ch a
This permit appileadon expire t if a permit is not obtained within t
Authorized signature: ttrt r - days after it has been accepted ascomplete.
li Print name: ( f • 42_ Date: - 21 /0 ` Foe methodology set by Tri- County Building industry Service Boaad
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