Permit CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: MEC2010 -00543
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/29/2010
Parcel: 2S111 DC12100
Jurisdiction: Tigard
Site address: 15900 SW OAK MEADOW LN
Subdivision: Lot: 0
Project: Stammer
Project Description: Gas furnace and A/C installation.
Owner: FEES
STAMMER, RICHARD Description Date Amount
15900 SW OAK MEADOW LN
TIGARD, OR 97224 Air Conditioning 10/29/2010 $46.75
Furnaces < 100K BTU 10/29/2010 $46.75
PHONE: 12% State Surcharge - Mechanical 10/29/2010 $11.22
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 $104.72
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 calling 503.246.6699 or 1.800.332.2344.
Issued By: �2� 4 ' Permittee Signature: /
— /-
a .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.
10/28/2010 13:10 FAX 5035380165 Ij003/003
Mechanical Permit Application , > R t 1 i l I r , . 1 ,, : r,.,
1 13 3 125 S Hall Blvd Tigard, OR 97223REC E IVE I ° r , ► ,.. .�.
Raeiv
Phone: 503.639.4171 Fax: 503.598.1960 Plan Yiew Other Permit
Inspection Line: 503.639.4175
OCT 2 8 2010 came aeady/ey Id See Wand: www.tiggrd-0r.gov Na flcd/Method Face ibr
� Sappkmeaallnfor>oatioa 1 • ^1:
Y ;y �~.r ',Z',,a.. :\A. .' °F: r ,;: .' .. N ; •t' - m i ' . V .r• P, ee ,N.,,� ^ :0 ', 1 .. ':� - f ly kr+ r+ae¢v. . :vr 7..ys... ..,
N.i•.:. y'.a':.
::r ., �.. ., - r o H? ( 1� ''; �... 7., .c\ v !, 6 �. • P •r rn`. M t `Q'.;
/ W C r- wy�Rw:riit. ter.7eC..tCIF'A.Fd��• .: -' _r
0 New construction Addition/alteration/replacement Mechanical permit fees" ate based on the value (tithe work
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
4 7C mechanical materials, equipmen , labor, overhead, and profit.
r ..., a: '"''; , :. i R , .Ile f7 Tlh![p� +lt'?,
1- and 2- family dwelling ❑ Commercial/industrial ' ❑ Accessory building ~ ` . -,!, a '> ., „ ,a :k _
For rectal Orformatton use cheddIsr
Multl- t8mily gsam� Master builder 0 r Description 1 Qtr. 1 Ea- 1 T� '
,
.'c . "T'viii•N ::∎; -;i k' . r;:;.Y' set:. s }: v: s 4vt.7 n??P.i31': ::p.s } :%:a . r „ ii ti t ,l.. . rc
= ''i : ' : ..: ...:.,: "° ' °. ;':, ts :; rt ,: ::....,.,, Headug/coennx
Irr.oN
Job site address: 1 ../ 7T �- -t cox , I , / n yt .Q Air conditioning / !_ C�
goo --�L� C .l ;'K� �+ �” �_+� J
(amiss site plan showing oleo:men° 46.75 1 110 r
City /State/ZIP: 1.1 � � � LI Furnace 100.000 BTU (duets/veats) 1 46.75 (Of 15
I / � Furnace 100,000+ BTU (ducts/v=0 54.91
Suite/b!
dg./apt. no.: Project rojcct name: m CJr
Heat pump 61.06
Cross sbset/ditections 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
Flue/vent for any of above 23.32
Subdivision: I Lot no.: Other 23.32
Tax map/parcel no.: Other fad appliances
i rr. w7.7 .•,r.: _ '. l' " *. tj' .: a`' : , fi t •^ ..,O' ;r�`!;.S0.).: .�.j?r5.4 Water heater 23.32
�-7 Al /� /�
_ rr. Cgs fireplace 33.39
Y Pets -FL J rrVI 2� ¶ Al s r a) n 0.4 C1he *-- 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
w ., y .. r •...: ie •� ; : , ; , ,,�' : 4t° , ; Yg;.••r.' ' ' • 1 Ch rnedflur/vent 23.32
'•tip: ;. s 1e%r:•l <y:)°F;�?`'s s imneyI1
,..
Nano: p .� �-1rA salon ltb 1 equipment Environmental exhaust and ventilation
Address: 1 C)C, a.5 �]CJ � Oc1 1..—n R hood/other kitchen 33 39
City /State ZTP: � ""1 1 r \ o� '�`'/ a�� Clothes dryer exhaust 33.39
Phone: / utility rooms)
v :
. :.• : ' `1 : v, ':; Fax. - :,t ,•�:� pace fatly
+�rr•,.'w• lair
w ( ) O COmp9ftm8IIi8 r00mS
. - ��'� Atdc%awls 23 32
Business name: Other. 2332
rOUR SEASONS HEATING Fuel piping
Contact name: 514.15 for first four; $4.03 for each additional
Address:
AND Alm uuNDITIONING, INC. Furnace, etc.
City /State/ZIP: 1005 INDUSTRIAL- PKWY Wi heater
Phone: ( ) NE R OPR 97'l32 water heater
N
Fireplace ,
E -mail: R ange
Business name: v 9 V Clothes dryer (gm)
Address: MID AIR 1 1 IrN:�:as. nar �wq �z.. ,•... y » ' ....
/'��� t. .r e - 'lute a.;n, r �!:; $�`
VMM k eW7ir9i iss)k: =•sn /.w ',, , t.•� '.!ul ' F
1
City /State/ZIP: INDUS PKWY
Phone :5 )55$ I95o NE11 R 97132
Minimum permit fee ($9o.00) ! 0
Plan review (25% of permit Lee)
CCB Tic.: f 7t State surcharge (12% of permit fete) J J Z
v. TOTAL PERMIT FEE
This perms application snares It a permit is not orrtoncd 80
Authorized signature: - / ✓1, days after it has been
accepted as complete.
Print Dunne: * V� ♦ � � • I Date: I / • , • Fee methodology see by Tri -Comfy Building Industry Service Board
BINAidlosTworns1MEGPermitApp .doc 10101/09 440- 4e17T(11 /02/coM/WEa)
N N
• •. `
' • • A/C -HAT PUMP -- -UNIT SITE PLAN . • - -
FEET T BACK OF PROPERTY LINE p
1 T
X
w
4 i� S 1 154
1 .3c)
' [ .. - - .
4 ' ; oil. F4A
7
...................,
• ' FEET TO SIDE PROPERTY LIME •
•
FEET TO FRONT PROPERTY LINE
PREPS: /SYoo w Z2
6 lets
•
PLEASE REFAX APPLICATIpN SITE PLAN
FOUR SEASONS HEATING
AND AIR CONDITIONING INC. • • • ' 1005 INDUSTRIAL. PKWY �,
• • - - NEWBERG; OR 97132 0
V N
11� O
N