Permit � n CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit0: MEC2010 -00496
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/12/2010
Parcel: 1S133DA01800
Jurisdiction: Tigard
Site address: 11065 SW SUMMER LAKE DR
Subdivision: Lot: 0
Project: Kaiser
Project Description: Install gas furnace.
Owner. • FEES
KAISER, USA & RICH Description Date Amount
11065 SW SUMMER LAKE DR Furnaces < 100K BTU 10/12/2010 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 10/12/2010 $10.80
PHONE: 503 - 366 -0787 Minimum Fee Adjustment - Mechanical 10/12/2010 $43.25
Contractor:
COMFORT AIR HEATING & COOLING INC
PO BOX 821484
VANCOUVER, WA 98682
PHONE: 360 -891 -2665
FAX: 360 - 891 -2666
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: "C(2fr134 Permittee Signature: e/✓ ,9-1
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.
10/10/2010 20:45 3608912666 COMFORT AIR HEATING PAGE 01/02
Mechanical Permit Application > ; ,,, FOR ohhlc:rc use <),I.v
Ci of Ti alyd Received
11 - 131 Hell Blvd., Tigard, OR 97223 OCT d 2 20;0 Daro'By. to /L /Q Petsnit Ne -�'
E•ZQ /O - 00 9
III • Phone: 503.639.4171 Fax: 503.598.1960 Flan Review
' • -' .. • Data By: Other Permit:
T I GA K D Inspection Line: 503.639.4175 I -al! ;, pate ReadyB
Intcmct: www.tigard or.gov (t7 :� `; -� y: See Pagt 2 for
�.: ,,,�. r j 't l ,S 'Notified/Method: Supplemental Information
. ' TYPE OF: WORK : •
• , CONNk ?1tCIAG')h')8E';; =,USt C1EiEC1([,1S .
❑ 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 0 Other:
mechanical materials, equipment, labor, overhead, and profit.
CATEGORY 'OF CONSTRUCTION .. • ... Value: $ -
® 1- and 2- family dwelling El Commercial /industrial ❑ Accessory building R S>dp NT1A I�Q 0 1.01 1 - 1 $XS ..... EES` .
For spec/al information use checklist.
❑ Multi- family ❑ Master builder 0 Other:
Description Qt 1 h Total
. .• .i. ..: .JOB, :.SITE 1NFORMAT'�ON :.A ND.LOCAT1LON -.:: Heating/cooling
n pti 1 T
HeaHn1{ /c
Job site address: 11065 Summer Lake Dr Air conditioning
(requires site plan showing Placement) 46.75
City/State /ZIP: 97224 Furnace 100,000 BTU (ducts✓ vents) _ I_ 46.75 46.75
Suite/bldg./apt. no.: Project name: `- Furnace 100,000+ BTU (ducts/vents) 54.91
Heat pump 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
5ubdivl5lOn: Lot no.: Flue/vent for any of above 23.32
Other: 1 1 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF Vv,ORK : : : • • , .. ' • ` .:. Water heater
23.32
Install Gas Furnace Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace/insert 23.32
- ,
® PROPERTY OWNER:' Ot Chimney/liner/flue/vent 23.32
❑ TENANT . Other: 23.32
Name: Lisa & Rich Kaiser Environmental exhaust and ventilation
Address: 11065 Summer Lake Dr Range hood /other kitchen
equipment 33.39
City /State/ZIP: 97224 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)366 -0787 Fax: ( ) toilet compartments, utility rooms) 23.32 • $t: APPLICANT ; -: < :. . .....H'... :: ❑ CONT, CT `PERSO : •:: Attic/crawlspace fans 23.32
Business name: Comfort Air Heating & Cooling, Inc 23.32 -
Fuel piping
Contact name: victor Berezhnoy 514.15 for first four; 54.03 for each additional
Address: PO Box 821484 Furnace, eta
Gas heat pump
City / State/Z)P: Vancouver, WA 98682 Wall /suspended/unit heater
Phone: (360) 891 -2665 I Fax :: (360) 891 -2666 Water hratcr
Fireplace
E -mail: Tinab@comfortairnow.com Range
-
. ... .
CONTRACTOIR Barbecue
Business name: Comfort Mr Heating & Cooling, Inc Clothes d er as)
Other:
Address: 12209 NE Fourth Plain Rd suitc#Y
City /State /ZIP: Vancouver, WA 98682 Subtotal 46.75
11t6ne: (360) 891 -2665 Fax: (360) 891 -2666 Minimum permit fee ($90.00) 90.00
Plan review (25% of permit fee)
o t CCB lie.: 160705 State surcharge (12% of permit fee) 10.80
-
TOTAL AL PERMIT FEE 100.80 '.
Authorized signature: This permit application expires if a permit Is not obtained within 180
days after it has been accepted as complete
Print name: Tina Berezhnoy Date: 10/11/2010 • Fee methodology set by Tn- County Building Industry Service Board
I. 1BuitdinalPennits tMEC- PermitApp.doc I0 /01/09 4 40 - 4 617T (11 /02'COMAVEB) .