Permit CITY OF TIGARD MECHANICAL PERMIT
.74
s COMMUNITY DEVELOPMENT Permit #: MEC201000450
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/10/2010
Parcel: 2S114BB01300
Jurisdiction: Tigard
Site address: 10245 SW SERENA WAY
Subdivision: PICKS LANDING NO. 1 Lot: 27
Project: Stenberg
Project Description: Gas furnace replacement.
Owner: FEES
STENBERG, KRISTINE H Description Date Amount
10245 SW SERENA WAY
TIGARD, OR 97224 Furnaces < 100K BTU 09/10/2010 $46.75
12% State Surcharge - Mechanical 09/10/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 09/10/2010 $43.25
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 $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 503.246.6699 or 1.800.332.2344.
Issued By: �� 5 Perrnittee Signature: • • ,,, / ___
Ca 3.639.4175 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.
09/09/2010 09:23 FAX 5035380165 a002/003
Mech l_Permtt A lien (� : r :•: i i; r l
City of Tigard p 9 tip1p y� � Permit No.: Er.....)-0 ki _ • 7
N ...... 13125 SW Hall Blvd., Tigard, OR 97223 (_ • to . Vie
• tr. . 503.639.4175 Fax:503,598.1960 0 �ec,) s*0 • y am -, ; Other Permit:
' ' : Inspection Line' Internet: www.tigard -or.go 0" ACS V Noticed/ d: ta nf bemadea
TYPE .. : COMMERCIAL•.PEE• SCHEDULE — perancsaisr
O New construction laAddition/altcration/replacemcni
Mechanical sit ' an bases value of the work
perthrmed. Indicate the value (rounded to the nearest dollar) of all
Q Demolition ❑ Other mechanical matcdats, equipment, labor, overhead. and profit
CATEGORY OF : :.. . •
• Ligt 1- and 2- faimlly dwelling El Commercial industrial 13 Accessory building
)asksio T AI. EQuestifr / 9Y57`EMS Y
For special information use checklist.
❑ Multi - family - ❑ Master builder Q other: Description E Qty. era. ( Total
•
Jos sus imiim uwit AND• Eti itlie Reatina/cootine _ •
Job site address: (0 a HS `31 5 Y e)\Ck �}.�C�1 Air conditioning
t
showing y�acome:tt) 46.75
City/State/ZIP: — t1 (� trd 01 'I' qi 22 l �_ (inquires aiuplsn Furnace 100,000 BTU (ducts/vents) I i . 46.75 the - 71
Suite/bldg./apt. no.: Project name: tnkel, Furnace 100,000+ BTU (duas/vems) 54.91
Heat Fume 61.06
Cross sircet/dircdions to job site: Duct work 23.32
Hydronic hot water system 2332 1
Residential boiler (radiator or
hyamnic) 2332 •
• Unit heaters (fuel -type, not electric).
•
• in•wali, in -duex, suspended. etc. 46.75 •
Subdivision: Lot no.:
Flue/vent for any of above 23.32 •
Other 2.3.32 •
Tax map/parcel no.: Omer fuel appliances
i OF WOR .. !:. .. Watu heater 23.32
Er ■ ■ _ PeC,d2-fir Gas fireplace g 33.3
Flue vent fbr water hearer or as
fi
• •
replace 23.32 •
•
. Lag lighter (gm) 23.32
W
•
ood/pellet stove 33 -39 •
Wood fireplace/insert 2132
Chimneyltirur/8ue/vent 23.32
MEW PROPERTY OWNER • • :] "TENANT • • Other - 23.32
Name: V\S SAP - eY Envitonmentatexhaustandventilation
it to Ran equipment hood/other kitchen r •
•
Address: r)1 .t� ► _ _ _ _ equipment 33.39
City /State/ZIP: -- D, (1 } di_ T1 D D,1--� Il Clothes dryer exhaust 3339
Single-duct exhaust (bah-owns.
phone 5(3) t - 7 ( / W Fax ( ) toilet compatnncnts, utility rooms) , 23.32 J" [] APPLICANT ; . ::... f ] 004ACT PERSON Auia/crawlspacc fans 23.32 •
•
Other 23.32 •
Business name: Fuel piping •
�A/ vR � ID� J.V-- 'ttt'L • -• •-;(
Contact name: (ry - _ S141S for first four: 54.03 for each additional •
- , • - • Furnace. etc. - -
Address: i nns INDUSTRIAL PKWY
City/Statc/ZIP: . NEWBERG, OR 97`132 Gas heat pump
p WalUsttspendedh,nit heater
PM= a5) C✓? g / (�) Fax:: ( ) Water hearer
Fireplace
E-mail: Range
• . . Barbecue •
Business name; FOUR SEASON$ .HEAT Clot dryer (gas)
S -
,, i - sow • a • 1 1: , - •
• Addles: e t ■ - ■ t. .4 ■ . MECHANICAL PERMIT MVP_
City/State/ZIP: NEWBERG, OR 97132 subtotal F)
Minimum pertnit fee ($90.00) `Td 1 0 `o
Phone: ( ) 53s7— / / FAX Fill: ( ) Plan review (25% of permit fee)
cat lie.: IV I t:"J' State surcharge (12% of permit fee) /0 t
TOTAL PERMIT FEE
Authorized : , Si,' after Permit *Wades expires if a aott a mat rwiv,u 4 u
fter tt has been a piato.
Print =he :. weggroir, Date: 'la/ i • Fee methodology set by Tri.County Building industry Service Hoard i.
L :.;....,. tarotrov • ITT (I lt021COM/WES)
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