Permit CITY OF TIGARD MECHANICAL PERMIT
311 . COMMUNITY DEVELOPMENT Permit #: MEC2010 -00613
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/24/2010
Parcel: 2S111CA03800
Jurisdiction: Tigard
Site address: 9725 SW LAKESIDE DR
Project: Allen Subdivision: Lot: 0
Project Description: Gas furnace installation.
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: ALLEN, CLAIRE N
1005 INDUSTRIAL PARKWAY 9725 LAKESIDE DR
NEWBERG, OR 97132 TIGARD, OR 97224
PHONE: 503 - 538 -1950 PHONE:
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Type of Use: SF Furnaces < 100K BTU 11/24/2010 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 11/24/2010 $10.80
Occupancy Grp: Occupancy Load: Minimum Fee Adjustment - Mechanical 11/24/2010 $43.25
Stories:
Project Valuation: $0.00
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $100.80
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
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 503.232.1987 or 1.800.332.2344.
Issued By: ' Permittee Signature:
j■
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.
11/22/2010 11:42 FAX 5035380165 2002/003
1Vtechanical Permit Aoplication, Id ?l2 t. )I I l 1. t wl. (1\1.1
.
� Received �j r
City off Tigard �1 10 DrieBy. `, PennitNo,; f _ , ii — dap(
IN ..... a 13125 5W Hall Blvd., Tigard, OR 1% Plan Review
M Phone: 503.639A171 Fax: 503.598.1960 V Date/By;
Permit.
i ,, Inspection Line: 503.639.4175 N O C Date Ready,BY t8 See Page 2 for
Internet: www.tigard-or.gov Q ,V . ' 1$1 Notified/tvtetbod: Supplementrtt Information
. { t - - f `+' �'"r •a ludLt, r,•n �t,s. , AV4,*.M1 eta. A. t, `
!'c'- ^"'Y�4,7�, 1 'Ps'.. , i` ) , ✓ ,6 hV !r . . . �',,. \..$),' �'l ': i YY }.! !73. N ti's
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Mechanical permit fees' arc based on the value of the work
0 New construction I•` Addition/alteration/replacement performed" Indicate the value (rounded to the nearest dollar) of all
❑ Demolition • • er: mechanical materials, equipment, labor, overhead, an profit.
MIIIMENISE. �r l=umv/nv�rtxyttve w g " s` "t Value: $
4 c t., 1 (� k4,r °;� �`� j>; r1 s �-+� . n o nn t
r!1 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
• ulti- family 0 Master builder 0 Other: Description j Qty. [ Ea. ] Total
,
I o , z y.,.
',�,>• ' � q Heating/cooling
Job Air conditioning
Site address: J _ (requires Site plan showing placement) 46.75 N.'
.
City /StateZtP: I Tom'
LW+ p" ' Z Furnace 100,000 F1TU (ducts/vents) 1 46.75 : l '7
sims Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: I� d r . _ Heat 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronicJ 23.32
Unit heaters (feel -type, not electric),
in - wall, in - duct_ suspended, ctc. 46.75
y Flue/vent for any of above 23.32
Subdivision: Lot no.: Otter: 2.3.32
Otb fuel a
map/parcel no.: er ue
Tax . .
.. "' 'R ti d1.i .,h �. u1a: htti,r dr, ^y1 nr Water heater 33
� ,
GiS fireplace 33.39
r . Flue vent for water heater or gas
fi lace 23.32
9 Log lighter (ga 23.32
Wood/ e�llet stove 33.39
Wood fireplace/insert 23.32 _
, %µ Chimney/line[ /fludvent 23.32
' "(
0 Yi QP
� q Other 2332
I .+r
Environmental exhaust and ventilation
■ r - a. Range hood/other kitchen
Address: 5 / ., . ,L l'a equipment 33.39
City/State/ZIP w a ` Eaa Clothes dryer exhaust 33,39
i i-,..
Single -duct exhaust (bathrooms,
Phone: , ) Q Fax: ( )
toilet compartments, utility rooms) 23.32
0 .4.FF rYCiI111')l p .q t .r ` r�° r r Altic/crawlspacc fans 2332
Other: 23.32
Business name: Fuel piping
Contact name: eA
TING 514,15 for first four; S4.03 for each additional Address:
•` 1 . -• 1 DVTIONING I ' Furnace. etc.
Gas heat pump ,
City/State/ZIP: • a e INDUS g; _ - ' 4 ;, A. Wall /suspended/unit heater
Water heater
Phone: ( ) NEW: ' a � Fireplace
E -mail: Ran
i 7 � ,, � :4 vuag7 t vien � i � ' . n I Barbecue
t
-
Clothes dryer ( l i
other:
Address: - M 4m , , , ; �4r! f , ".i,S
City/StateJZTP:
• ■•* ' • i • ~� - t Subtotal
, Minimum permit fen ($90.00) t : : 7?) .
Phone: ( ) ' Plan review (25% of permit free)
�►� State surcharge (12% of permit See) 10 (SO
TOTAL PERMIT FEE IIDO e TiOI
' This permit applicator' expires if a permit is not obtained within Igo
Authorized sign', t • days after it has been accepted as complete.
Print name: EI : f rs1>r r Date: 02/10A M Fee methodology set by Tri -County Building Industry Service Board
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