Permit CITY OF TIGARD MECHANICAL PERMIT
`
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00522
Date Issued: 10/22/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S103CB06800
Jurisdiction: Tigard
Site address: 12391 SW HOLLOW LN
Subdivision: Lot: 0
Project: Wagenhofer
Project Description: Replace furnace
Owner:
FEES
WAGENHOFER, KAY Description Date Amount
12391 SW HOLLOW LN Fumaces < 100K BTU 10/22/2010 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 10/22/2010 $10.80
PHONE: 503 - 590 -2674 Minimum Fee Adjustment - Mechanical 10/22/2010 $43.25
Contractor:
AIR PRIDE, INC.
18603 WILLAMETTE DR
WEST LINN, OR 97068
PHONE: 503 -655 -0556
FAX: 503 -655 -0534
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
By: �'��L�
Issued y � Permlttee Signature:
Q
' ` CaII 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application rORR OVIIC:E. USE c1N1.1
City of Tigard i �� '2• /Q Permit N s� Z cetea0 /0
``�O bateBy: DO I
' 13125 SW Hall Blvd., Tigard, OR 97223 V Plan Review 11 ' Phone: 503.639.4171 Fax: 503.598.I Date/By: Other Permit
T I i ,a I; f? Inspection Line: 503.639.4175 �� ik0 Date Ready/ay: fill See Page 2 for
Internet www.tigard- or.gov " L Tlodtud/Method: rin 3apotemenmt idtormadon
..... . ... ,.,..:, .13tilViv.'S. ^1N� , C 1 b.�l/ti'',ns�'
❑ New construction ® Addition/alter$tlonl n\w' `� Mechanical permit fees' are based on the value of the work
`` performed. hidicatc the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: '. mechanical materials, equipment, labor, overhead, and profit.
,
i i:
Value:
1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building `` `' °' "' � f r.. X17C1P1V1 ' Ssts '> MSt
For special information use checkl
❑ Multi- family ❑ Master builder ❑ Other: description Qty. 1 Ea. dotal
.
,.::.. , .. O %r iyi,Yl;[ *` 4. Heating/cooling
Job site address: 12391 SW Hollow Lane Air' conditioning or heat pump
_ (requires site plan sbavvin� placement) 14.00 —
City/State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts/vents) _ 1 14.00 14.00
Suite/61dgJapt no -: [Project dame: Furnace 100,000+ BTU (duets/yens) _ 17.90
Gas heat pump 14.00
Cross street/directions to job site: Duct work 10,00
Hydronic hot warer system 14.00
Residential boiler (radiator or
hydronic) 14.00 ,
Unit heaters (fuel -type, not electric).
in -wall, in -duct. suspended, etc. 14,00
Subdivision: Lot no.: Flue/vent for any of above 6.80
Other: - 10.00
Tax map /parcel no.: Other fuel appliances -
�¢ s:: � gar r Wate heate 10.00
�'•4 , . �f.�'�•, ,•�.._ !':{'r: '
v..
::. . ... '..! .. ::...... .............:.c.,.. ,�,:,,...,;:.� %,'.... ,.,,.,. r. ......,.....,......,•n•:!...,.. ,. .., •:�5i O water 10.00
r1aS fireplace Flue vent for or gas
Replace furnace. fireplace 10.00
P Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood flreplace/msert 10.00
/flue/vent
.....:..,.,,.... .:,� himncy/liner
0..P1�Ql'F,R' ;�11.�$ :.,., .,:;: aY ; . ,'' •',. ,.., ..' 10.00 _
Other:
Name: Kay Wagenhofer Environmental exhaust and ventilation _
Range hood/other kitchen
Address: 12391 SW Hollow Lane equipment 10.00
City /StateIZlP: Tigard, OR 97223 Clothes dryer exhaust 10.00
Singlc -duct exhaust (bathrooms,
.
.
.(503)590 -2674
Phone: ilk rooms) 6.80
...�..... ... ..... .......... :a - -'..: ;a /,,d :�� : ( ) toilet : ^ar.'� :: -i.. . Y:.i�:� Attic/crawlspace compartments,
7 t
ms
v ..
.... ,..,.. .,,. • .........,.. .,!. .,: 10,00
Business name: Fuel piping
Contact name: S5.40 for first four; 51.00 for each additional
Furnace, etc.
Address: SEE BELOW
...• Gas heat pump
City/State/Z1P: Wall/sus. dcdiunit
Water heater
Phone: ( ) Fit _ ( ) Fireplace
E -mail: csr@airpride.com Range .
/� °i• S:i� - = ?� ;: '�:: , : Barbecue
';.A?..}J ,•''i ; :: .!.. , ..,
Clothes dryer (gas)
Business name: Air Pride Inc.
Other - , ; , r- ,,,;,
Address: 18603 Willamette Dr. ., ........ ....: .......... , ,... .... .
penult ... (n 1
City/State/ZIP: West Linn, OR 97068
Minimum fee $72.50 ) 9Q,gi,
ne: (503) 635-0556 Fax: (503) 655-0534 Plan review (25% of permit fu) p
CCB lie.: 154359 . State surcharge (12% of permit fee) --8r/0
TOTAL PERMI1I E
� Thu p ermit application expires it a permit is nor (liaised within 180 metra Authorized signature: ! ^, days after it has beet accepted as complete.
Print name: Alicia Adkins Date: 10/21/2010 • Fee methodology set by Tri.County Building lndusery Service Board
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