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Permit IN CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2010 00629 T1+GARD' 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/07/2010 Parcel: 1S133DC07900 Jurisdiction: Tigard Site address: 11690 SW 134TH TER Project: Lang Subdivision: WINTER LAKE Lot: 10 Project Description: Install furnace and heat pump. Contractor: OREGON HEATING & AIR CONDITIONING Owner: LANG, RICHARD P & SHEILA ANN PO BOX 241 11690 SW 134TH TERRACE DUNDEE, OR 97115 TIGARD, OR 97223 PHONE: 503 - 691 -9699 PHONE: 503 - 810 -0968 FAX: 503 - 691 -8556 FEES Specifics: Description Date Amount Furnaces < 100K BTU 12/07/2010 $46.75 Type of Use: SF Heat Pump 12/07/2010 $61.06 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/07/2010 $12.94 Occupancy Grp: Stories: Fuel Fuel Types: . Gas Pressure: Total $120.75 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 dire :. -s ions • 5 NC by calling 503.232.1987 or 1.800.332.2344. _ Issued By: i _ L (' , J ` / Permittee '•ignature: IP / / LLir _ Call 503.639.4175 by 7:00 a.m. for the next available inspe on date. This permit card shall be kept in a conspicuous place on the job s' : • til completion of the project. Approved plans are required on the job site at the time of each inspection. . , 1 11' .. _ Mechanical Permit Applicationo - . , FOR 1 OFFICE USE ONLY CO i , City of Tigard *1 ,,,,,V i ri Rece 6' Permit No.. . ived , . n z , lii /./ . 63a• ,,Date/By: 1 ■ i 0 , 16 eo . ce 6 ' , ,,--...- - 13125 SW Hall Blvd., Tigard, OR 97223\ ' .. C , tb.g1/4.‘ Review _ .., Phone: 503.639.4171 Fax: 503.598.1960 V.' 'V'" P i° Othef Permit: T1GAR:PI n Line: 503.639 4175 ,, 6 ,\,,, ., R7,7d .---,76.,--,:- JuriE: El See Page 2 for Internet: www.tigard-or.gov gard-or.gov t.1 1 ( * CI' V Notitiod/Method: ---- Sapplemental Information ..N..No . , .. . . ' , • ,. .. ' ' TYPE OF WORK .; V" : .::: .: .:: . :: : 0 ..i- 2 4 1 , ;0-.E S C-PEEbtO . ' 2 ;P $E ' +0t idlii§T , . . . Mechanical permit fees* are based on the value of the work 0 New construction AdclitiOn/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all 0 bemOliriOn 0 tiler: mechanical materials, equipment, labor, overhead, and profit CATEGORY OF CQNSTRUCt[ON Value ,... i0OSIEIS71$1 - and 2-family dwelling 0 Commercial/industrial D Accessory building • For special infonnation use checklist. III Multi-family El Mater builder 0 Other: Description Qty, Ea. Total ::''''.'',,:., . '.: ' :':;•;,„:.'f' ,::::: JOB SITE iNFOIIMATTOiSt. totAttot■I ?, : .':' . , ! ,, "..: :, .::. Ileacooliti Job site address: a L 03 i eq0 S. t i-1).--Texy- . (_4 Air conditionin,g (requires site plan ihowing ps.cement) 46.75 City/State/ZIP: - 1 - lakAr't,L ., - 1 aa IS F Fu u m m a %ce 1 100 00:0 0 0 00 0+ 13 8 TU ru (d t u2/ wv verit en s u ) ) 1 5 4 4 6 :9 75 1 Suitc/bldg./apt, no,: Project name: 1-lein Ealinp _____ 1 61.06 . Cross street/directions to job site: Duct work 23.32 - Hydronic hot water system 73,32 Residential boiler (radigtor or hydronic) 23.32 Unit heaters (fuel-type, not electric), in-wall, in-duct, suspended, etc. 46.75 nue/vent for any of above 23.32 Subdivision: • Lot no,; Other: 23.32 Tax map/parcel no.: Other fuel appliances , 23.32 DtscRipTioN.IA wolut H .:,;.....:. ,*,:.:,y ... „,.;t:' .: ; .„,,,i,,!,. Water heater - Gas fireplace 33.39 f liki,Le...Q-;1 . nue vent for water heater or gas • fireplace 23.32 us . AP Al fu Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 - 23,32 Pg9Pra3:17t QWNER , Y. ,,. . , ; - ;. , :i . ., , , , ,''::, , . ,;:‘:•':,..,.,,' , 114.41Y.T: , . , : , :c!.'.:' . 1:.; , : , : ,::•:.. 23.32 Name: . ., 0 4- \0 . 4 ,- E ,L 1 Environmental e"ithaust and ventilation Range hood/other Idtchen Address: \ R o p t 6 u , A, 41 7 equipment • 3339 City/State/ZIP: c c , G ,.... c D_g_,,, Clothes dryer exhaust 33.39 Single-duct exhaut (bathrooms, Plior S i (a? Fax: ( ) toilet compartments, utility rooms) 1 23.32 . .:...'...; :', ..,, : : , i,4kAppocANt .. ::1 . . :.....' . . . . LI CONTACT pEttspN , ,:,: . Attic/crawlspace fans 23.32 1 4,__, W - 7" ---- " -- Other: 23.32 1 Business name: Fuel .i • ing Contact name: (. 1 $14.15 for first four; S4.03 for each additional - - - Pomace, etc, _ Acidre , ss: 0 , G6(..___ ( 9.4 i heat City/Stare./Za A g • ) 0 4 " i Wall/suspendecl/unit heater Water hearer Phone: 516) laRt CI A • 0 Pax:: Ai,. • anillf . Fireplace ,___ E-mail: Range ' .'.. '., .,;',:,:'.'si ':: • ;'' ; • :' : ': .' .:: .':'; : '.:.(-.* ..L-ipp '77 1: :; :.. : .2 :.. : ::,. . H Barbecue Business name: • a, a A& • :A■t011 Oliimr-I■r■ . 'FA Clothes dryer (gas) Other; r e Addr b eSS! - 2, , abig K L ( :. ; ,, , : ,: .: , M 40..WFf..4*. :). , • : . : , .. . - City/State/ZIP; i IMAlic 04 1 ,..!-; Subtotal i (71 I Vt " - Minimum permit fee ($90.00) Phone; azi ct (0Q' i F ax ( gSA-- Plan review (25% of permit fee) CCB lic,: .. t D-tk State surcharge (12% of permit fee) jug te ' - TOTAL PERMIT 'TEE ....13, '7. 1 # 1 i i This permit application expires If a permit is not obtaine within 180 Authorized s e: j A A 1//%4•Mill■i. days after it has been accepted as complete- , . I • hint name: A L. g. 1 Fee methodology set by Tri-County Building Industry Service lloard Mil /4 1 : -. i i ZZ CO/TO 3Ed ONLIV3H No93ao 95S8-169-EO9 IZ :Si CITOZ/E0/Zi 0 44 0 3 7 4 First Floor • Main Floor 10' + • 5' + Brittany Drive Garage 10' + Jurisdiction - City of Tigard SW 134th Terrace Job #: Scale: 1/8" = 1'0" Performed by Craig Roggers for: Page 1 Richard & Sheila Lang Right - Suttees Universal 11690 SW 134th Terrace 7.1.25 RSU12736 Tgard, OR 97223 2010- Nov -26 07:33:16 Phone: 503 - 810 -0968 .., Files\Lanp Richard & Sheila.rup CO/CO 30 d EiNI203H NOJ3d0 9998- I69 -E09 TZ :ST OT2Z /E0 /ZT