Permit CITY OF TIGARD MECHANICAL PERMIT
r z1
`• COMMUNITY DEVELOPMENT Permit #: MEC2010 00590
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/17/2010
Parcel: 2S103CA03600
Jurisdiction: Tigard
Site address: 11575 SW TERRACE TRAILS DR
Project: Vaughn Subdivision: TERRACE TRAILS Lot: 8
Project Description: Gas furnace and AIC installation.
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: VAUGHN, DONALD & SHERRIE
1005 INDUSTRIAL PARKWAY 11575 SW TERRACE TRAILS DR
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 - 538 -1950 PHONE:
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Air Conditioning 11/17/2010 $46.75
Type of Use: SF Furnaces < 100K BTU 11/17/2010 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 11/17/2010 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503. . . .800.332.2344.
Issued By: Permittee Signature:
(..r L 1. v�
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
11/16/2010 10:41 FAX 5035380165 81002/004
. - .
Mechanical Permit APPli"6°n IZECEIVED ' 1 : -
1.01:Q1.1.1 1,. 1 .s1:.,
, City of Tigard Received
Datc/By: i a Liz to 6 Permit No.:
. 31
...-- 125 SW Hall Blvd., Tigsrd, OR 97223 plum Rovi
ii,,,,
NOV 1 6 2010 Other Permit:
Phone: 503.639.4171 Fax: 503.598.1960 Date/By:
Inspection Line: 503.639.4175
Date Ready/By:
intmet: www_tigard-at.gOV CITY OF TIGARD Notified/Method: , S P bi 2fr
i
en1 Information
.
.1 . t
'. - •' '' ''''' ' ' ''' ''' ' ' .: .. ' '. ''' '.'.. '' ' ' ' ' !' 1 ''' ;.,; , ".j5: ) ,..';'''.:;.: . .ii .. .,i'•.' , .■'4; ;'• ''',.:.: '. '':, .: , 'r . `' , .:,",'", 3, : '''',''',1' . ". ; „ !,')'' , l ',, i ; . 9 , 5:0 7'7,.:"* E - or ,,,-L.'-'="-'"„;p iig41. 1 '=. 2 em 3 ;4'''..T , " ,7 1 , 40.1 „ 0 ,..,!,7
Mechanical perrnit fees* are based on the value of the work
0 New construction Addition/alteration/replacement
perfbrmed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition Other: mechanical materials, equipment, labor, overhead, and profit
:
value: $
, 4ijiooiikiao:*e**CoiOO:! ' - .."''''',
1_ and 2-family m
ily dwelling 0 Comercial/industrial p Accessory building
1)1, ! , .R:r..$.!0 PCPEPWWMf"..„.
Doscription For specdal Information use checklist.
m
D ulti-family 0 Master builder 0 Other:
1 Qty, I Ea, I Total
1O ,•:., 1 er ' "'7",.:. ticatiojeowing
Air conditioning
Job site address: 1 i 915 ,..--=-, - ,--o ,, 'D Y (requires site plan showimi placement) 1 46.75 i liP 1 S .
City/State/ZIP: - 1 - \ cic .:
J C)a- °I-19-a- Furnace 100,000 BTU (ducts/vents) . 1 6 .75 1- 1 ( 1:
FllirlaCt 100,000+ BTU (ducts/vents) 54,91
Suite/bldg./apt. no.: ' Projcct narrw Vo...1/433 ix,„...Y1 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 (fucl-type, not electric),
in-wall, in-duct, suspended, etc. 46.75
Flue/vent for any of above 23.32
SubdiviSion: Lot no.: - -
Other: 23.32 _
Tax map/parcel no.: Other fuel appliances
. 4e1 , 1% 1 114. 1 1g 6 ,T;MaTtii0#0 4 ^) Water heater
;/;;,:i":0e44?!.1)01,W k.V : 4 \e.:„; ,1;4„ t: . ,. , ,.. — J 23.32
33.39 ,
_-.6a5_,....a,..„,,,,„ A r- ch nci., -Fr 0- 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
. -
. Chimney/liner/flue/vent 23.32 ..,
'OT : . T ;, . :'./. , :-.6 , ;:
$ "
.. 1 : . . -'.''' )`.' . other: 23.32
Name: 'T\/ ..rfAilj - 5 h eJberl - 4 1(,ucill yl Environmental exhaust and vendiadon
Range hood/other kitchen
Address: 1 1 573 ,f LAJ "TeArra CC Trar I Si D equipment 33.39
City/State/ZIP1 CI 6) Q.- '7 - - Clothes dryer exhaust 33.39
• Single-duct exhaust (bathrooms,
Phone: 7,1?1 . i 3._ t Fax ( ) tact cc,_ titiht)tutrn rooms 23.32
Attic/rawIspace fan 23.32
Business name: FOUR SEASONS j N Other. 23.32
Fuel piping
Contact nameA.D AIR coN DMONING, INC. $14.15 for fIrst four; $4.03 for each additional
.
Furnace, etc
Address: 1005 IND' JSTRIAI eisvvy Gas heat pump -
City/State/ZIP: ll/suspended/unit healer
.., . • 0 Wall/suspended/unit
- _ .. ,.,
' " Fax: : ( ) Water heater
Phone: ( ) .
Fireplace
E-mail: FOUR - .......; ; i . 1 ..s. Range - •
, . „„„.....,: , , ,..-.. ,,.:.:!..,,,.:;;., 7w ,,, ..: ,,,,,,.. ::;,,,!,.: ::: ,,, Barbecue
Clothes dryer (gas)
Business name:
Other:
TOOS INDUS i MAL 1 V?
Address: ;,...:: : :: .' E . .". " ,: : .'.?„:>. ; 14:Pr6.044*: : :■• : ,t';': . .. - ' . ,: ' :'' , ;' , ,,;,; " .r:::: , ;'
City/State/ZIP: 97132
s Subtotal
Minimum penrtit fee ($90.00)- i:;°
Phone: 66 ) $3z-1,5 I Fax: ( ) — Plan review (25% of permit fee) _
— ,
CCB lic.: Cf-71 .,77.„. - State surcharge (12% of permit fee) i 1 , Ili_
- TOTAL PERMIT FEE 1 a 72.
Authorized s ......3/4,11 This permit application expires if a permit 19 not obtain ..........v
ignattrA)(0 •e__ days after it bets been accepted as complete.
Print name: ' P . Date: 111 le - Fee methodology set by Tri-Ccunty Building Industry Service Boani
1:03411141ftg Termiti014E01 10101/09 4100-4617T (11/02/COM/WEB)
Ct
c
0
o .
A/C.-MAT PUMP---UNIT SITE PLAN -
FEET TO f BACK OF PR LINE tid .. . ,r
s 3a
•
FEET TO SIDE PROPERTY LINE
e
S —
°
I
In
FEET TO FRONT PROP 4 •.Ty LIB
CO 1
IC/ ADIMASS:. itiriT ,a57"tr 1...."e•Arete-e., 4
N � Y ggg p�j" �y}, p�'v�9�p''��1 y��+
V POSE • EF 3d i LT ✓d 7' �: I SITE PLAN '
1
O f f
N
I I
J
T