Permit - CITY OF TIGARD MECHANICAL PERMIT
II C COMMUNITY DEVELOPMENT Permit#: MEC2010 -00350
TIGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/21/2010
Parcel: 1 S 133CD03400
Jurisdiction: Tigard
Site address: 13579 SW ASHBURY LN
Subdivision: COTSWALD MEADOWS Lot: 32
Project: Pattison
Project Description: Replace gas furnace and A/C. Unit must meet 3' minimum rear and side yard setbacks.
Owner: FEES
PATTISON, LYNDIE M Description Date Amount
13579 SW ASHBURY LN Air Conditioning 07/21/2010 $46.75
TIGARD, OR 97223 Furnaces < 100K BTU 07/21/2010 $46.75
PHONE: 503 - 590 -7184 Fuel Piping 07/21/2010 $14.15
12% State Surcharge - Mechanical 07/21/2010 $12.92
Contractor:
WOLFERS, INC
290 YOUNG ST
WOODBURN, OR 97071
PHONE: 503 -981 -4511
FAX: 503 - 981 -0801
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
Total $120.57
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: 6rA/ ,0 L4..../ CC�N /
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.
Jul 16 10 11:37a WOLFERS HEATING AND AIR C (503) 9810801 p.2
��1 V �� ,`
Mechanical Permit Applica t oa of r1ck use a`cy
City Of Tigard Received
° 13125 SW Hall Bhd., Tigard, OR 97223 (( ? Date lily: ��G'% % �I�! Permit No �C vO g ���
— 2 Phone: 503.639.4171 Fax: 503.598.1 L- 16 (' 0 ' Plan Review Other Permit:
Inspection Line: 503.639.4175 Date B}.
_
T I GA R D Internet: www.tiganl CITE' OF T Date Ready /By: J� ® See Page 2 for
Notified/Method: Supplemental Information
BUILDING DIVISION
- TYPE OF WORK - COMMERCIAL FEE* SCHEDULE :_ USE CHECKLIST
❑ 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 ❑ Other: mechanical materials. equipment, q pment, labor, overhead, and profit.
CATEGORY. :OF CONSTRUCTION Value: $
® 1 - and 2- family dwelling ❑ Commercial/industrial RESIDENTIALEQUIPMENTI SYSTEMS FEES*
❑ Accessory building
El Multi-family El Master builder ❑ Other: For special information use checklist.
Description 1 Qty. 1 Ea. 1 Total
JOB :SITE INFORMATION. AND LOCATION Heating/cooling
Air conditioning
lob site address: 13579 SW Ashbnry Lane
I (requites site plan showing placement) 46.75 ' 0.
City/State /ZIP: Tigard OR 97223 Furnace 100.000 BTU (ducts/vents) I 46.75 Qty,, L
Furnace 100.000+ BTU (ducts'vents) 54.91
Suite/bldg. /apt. no.: Project name: 50128
Heat pump p 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
Subdivision: Lot no.:
Flue/vent for any of above 23.32
Other: 1 23.32 .
Tax map /parcel no.: Other fuel appliances
'DESCRIPTION 'CIF `WORK..: . . - Water heater 23.32
Gas fireplace 33.39
Replace gas furnace and air conditioning Flue vent for water heater or gas
fireplace 23.32
- Log lighter 23.32
Woedipellet stove 33.39
Wood fireplace/inser 23.32
® PROP.ERTY-.OWNER Chimney/linerfluelvent 23.32
0 TEN
Other: 23.32
Name: Lynn Pattison Environmental exhaust and ventilation
Address: 13579 SW Ashbury Lane
Range hood/other kitchen
equipment 33.34
City /State/ZIP: Tigard OR 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)590 - 7184 Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT f ,1 CONTACT` PERSON Attic /ctawlspace fans 23.32
Business name: Wolfer's Heating & Air Conditioning Other 2332
Fuel piping
Contact name: Jennifer Winningham 514.15 for first four; 54.03 for each additional
Address: 290 Young Street Furnace, etc. ! ILL C
Gras heat pump
City /State/ZIP: Woodburn OR 97071 Wall/suspended/unit heater
Phone: (503) 981 - 4511 Fax: : (503) 981 -0801 Water heater
Fireplace
E -mail: jennifer@wolfersheating.com Range
:CONTRACTOR i :: < Barbecue
Business name: Wolfer's Heating & Air Conditioning Clothes dryer (gas)
- Other. I ,
Address: 290 Young Street . = MECIIANfCAL PERMIT FEES*
City/State/ZIP: Woodburn OR 97071 Subtotal /07 45
Minimum permit fee ($90.00)
one: (503) 981 -4511 Fax: (503) 981 -0801 Plan review (25% of permit fee)
qi CCB lic.: 1911 State surcharge (12% of permit fee) i , 92
, TOTAL PERMIT FEE /,10 1- t/
Authorized signature- (5V ! 12 /7/ e i�G — - This permit application expires If a permit is not obtained within 180
days after it has been accepted as complete.
Print name: hif ate: 7 . Fee methodology set by Tri- County Building industry Service Board
Ifa uildinel'ermit\MEC- PermitAppdnc 11101/09 440- 4617T( l lro2/COM/WEn)
Jul 16 10 11:38a WOLFERS HEATING AND AIR C (503) 9810801 p.4
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