Permit CITY OF TIGARD MECHANICAL PERMIT
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2 - COMMUNITY DEVELOPMENT Permit #: MEC2010 00029
T[• LT A1x. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01/20/2010
Parcel: 2S111AA04300
Jurisdiction: Tigard
Site address: 14450 SW 86TH AVE
Subdivision: GREENSWARD PARK Lot: 31
Project: Bitney
Project Description: Replace heat pump and gas furnace.
Owner: FEES
BITNEY, ROBERT C & KATHRYN M Description Date Amount
14450 SW 86TH AVE
TIGARD, OR 97224 Furnaces < 100K BTU 01/20/2010 $46.75
Heat Pump 01/20/2010 $61.06
PHONE: • 12% State Surcharge - Mechanical 01/20/2010 $12,94
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 $120.75
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law: All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 - 0100. You may obtain a copy of the rules
or direct questi. to OUNC by calling 503.246.6699 or 1.800.332.2344.
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Issued B / 1 tO .� I Permittee Signature: Qe , g t 4 r s 4......
• Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until., completion of the project.
Approved plans are required on the job site at the, time of each inspection.
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Mechanical. Permit Application
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�i City of Tigard • ED
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_� 13125 SW Hall Blvd., Tigard, OR 97223 - Plan Review
► . - „Inspection JFA1 1 Phone: 503.639.4171 Fax: 503.$A�096p 9 2010 x . Other Nrmn: aceZOtC.0d0,11 .
lnternet: www.tif,ard-or.gov Netifiedimethod: ...t Supplemental laformadon
CITY OF TIGARD -
TYJ a } \g` 1'
❑ Ncw construction iIAAt PEE °..
tl Addition /alteration /replacercttt
Mechanical performed. Indicate at e the value alu based on
e (rounded to the nearest of
re work
patfOrmcd. ndicat the luo rest dollar) of all
{] Demolition ❑ Other: meehanical:matcrials; cquiprnenn labor, overhead, and profit.
Value. S
Y dwelling ❑ Commercial/industrial 1 . and dwell tCommercial/industrial � Acc - ^ , � I :
c�►3�iGA1�X OF canlst!�.v .., ° . -
essory building S IETA1%EQW PM 4$4, MS lS" ..
. d 2f For special Offorinadon use checklist.
0 Multi- family • ❑ Masterbuilder III Other:
Description 1 Qty, 1 Ea. 1 Total
. ' JOS SITE.INf O tTI09t:'ANR . .t e . ,, . Heating/cooling
,Lift ? l Air'conditk ring
Job Site address: • • �. rep uues site , tan showin.. , laaement 46.75
City/State/ZIP: t • S `' 6 C Fumuoe 100,00013TU (ductaivcnts) 46.75 ..-ibt 15
Furnace 100,000+ BTU (duets/vental 54.91
SuiteJbldg. /apt. no.: Proje t name: . / : 1 w, 14eat pump f 61.06 Co) . b lr
Cross street/directions to job site: Duct work 23.32
Hydtunic' hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters,.(fucl -type, not electric).
in -wall, in-duct, suspended, etc. 46.75
Subdivision: Lot no.:
Flue/vent for any of above 23.32
Other:. 23.3
Tax map /parcel no.: Other fuel appliances
• ( ��!
ES 11R1!1;OE WQR1 ,
- Water heater 2332
Gras fireplace 33.39
I •M I _ 1 _.I� / Flue water heater or gas
fi rtip� . 23.32
1�-7 - -1 .11u:'� Log lighter (gas) 2332
Wond/pcllct stovc 33.39
O Wood fireplace /insert 23.32
Chimney/liner/Am/vent 23.32
'! Atlieht :U:11 NE ,, v, % "Fr' ... . Other'
?3.32
Jl , Environmental exhauetand vcudtation ■ 1 Rangeliood/otherkitchen
Address: N. • • Jy ry .g ( 1, equipnte 33.39
Cl othes dryer exhausi 33:39
City /slate /ZIP: A el 7. a j ...
J-'� 1 ! Single -duet exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility. rooms) 23.32
.4PPI:IC4N'>< . .. : { 3 .. Acv ,mitig,s ,. ' Attic/crawispace fans 23.32
Business name: FOU o' N .- H T1 ' • Other: 2312
Faelpipiag
Contact na 1:1. ► p M ' .� i:lt $14.15 for first four; 54.03 for each additional
Address: NEWBERG, OR 9713 Furnace, etc.
Gas heat pump
City /State/ZIP: Wail /suspended/unit heater
II
Phone: ( ) Fax:: ( ) Water: heater
Fi =. lace
E -mail: Range
TRAC„r47Tia " Barbecue
Bus N , INC Business name:
AND AIR ONDITIONI 0• ;q ` , ii , o ^_: ?c Clothes dryer (gas)
G Othm
Address: 1005 INDUSTRIAL PKWY ... . cHAnn t,, p r.1: •
City /State /ZTP: t . _ s ,_
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subtotal /D t, �'
- Minimum permit fa ($90.00) -
'1 one: ( ) 5 9s� I Fax: (56-5 ) - / Plan review (25% of permit fee)
CCB'lic.: State surcharge (12% of permit fee) _ / A- ■ 41
r i TOTAL PERMIT FEE ' L. t
This p ermit appllcatlon cakes if a Wm* obtained within igo
a t Authorized signature: 1 days attar lt baa been accepted as complete.
Print n a m e : te r , A Date: -•- a t a t - - I .. Fee methodology s o t Iti Building industry Service Board
1: 1 Build4Pwaiiullifl3GpermitApp.doo 10O1/09 440-1617r (1IPo2/COM/WF.$)
17 00 /17O02 'AV O9 Zl OIOZ /61./l0
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FOUR SEASONS HEAtitio • c4
N AND AIR CONDITIONING, iNC.
10U5 INDUSTRIAL PKWY <=
NEWBERG, OR 97132 0
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