Loading...
Permit ,, CITY OF TIGARD MECHANICAL PERMIT 11 11 ' COMMUNITY DEVELOPMENT Permit #: MEC2010 -00639 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/08/2010 Parcel: 2S114BB15600 Jurisdiction: Tigard Site address: 16052 SW 103RD AVE Project: JEFFREYS Subdivision: RIVERVIEW ESTATES Lot: 2 Project Description: Gas furnace replacement. Contractor: EFFICIENCY HEATING & COOLING LLC Owner: JEFFREYS, WILLIAM W & 10117 SE SUNNYSIDE RD STE F #19 WOLFE, KRISTINA L CLACKAMAS, OR 97015 16052 SW 103RD AVE TIGARD, OR 97224 PHONE: 503 - 698 -5588 PHONE: FAX: 503 - 698 -9378 FEES Specifics: Description Date Amount Furnaces < 100K BTU 12/08/2010 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 12/08/2010 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/08/2010 $43.25 Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas Gas Pressure: 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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.80a • Issued By: Permittee Signature: 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. It N eeIu i c�l ..P eranii A li ,, City of Tigard � I (1.12i)� l If I .141? (rw(. �' Recoho - A � '" 1317,5 SW Hail Blvd -, Tigard, Oft 97223 Q `�Q�Q DatolTiy; r � 0 --- Permit No.; ' Piionc: 503,639.4171 Fax: 503.598 -1960 DEC Phm Review l i n T (:. A R,ID .4175 f AGAR" U Other Permit; T i p nti �/ I , it Rena y: l� r Internet: www.tigard-or.gov or g c l t o i� 0 See Page 2 (or "I4 DI „ 1 f± - r ;IVIS ficd/Mctlt c Supplemental lnformntian + ° r � 1i, � a �� U L d U I — • :,•.,:.:;::,:,.!.:':. ..: . ;. '. t t' b Wits. ', n v •wr,.l lvA.'1YJLK 1� „. �;` 1411, f?°I+;��,�' +I�tl��f>,E -� 0t.#*Mo"t' <. 0 Ncw construction 0 Addition /alteration /replacement McchA+tical permit fees* arc ha5cd on the vahic of the work 0 Demolition Other: Indicate the value (rounded to the nearest dollar) of all mechanical atcri u' 1 '' „ a labor, overhead. and rofit m Is c. i rircnt o r r Ei ;-. y dwelling "] ern ". """ "sll /i " "F�11'` llC lii Value: $ nd 2 famil dwellin. ndustrial 1 Accessory building ( y � 5 ' $' © Multi - family ❑ Master builder 0 Other: For special tyormarinr, use checklist. t 1:i i'Y?lgy9fl�ft'�f11 1111d tiCOS',.' v>l l ,l0''t0, Description n Q ' fi eatitt - Conlin . ob site address: I6052 SW 103 Ave Air conditioning U rcwiroe site inn ahowin Inetocnt 4( City /State /ZiP: Tigard OR 97224 Furnace 100,000 13113 ducts /vents 46.75 Suite/bldg. /apt. no,: Project name: ",a.. e /ll 6 Furnace 100,000 BTU (ducts/vents 54.91 �rt�� 61,06 Cross street/directions to job site: Duct work 23.32 _ 1 'dronic hot water s . tem EINEM Residential boiler (radiator or — hydronic 23.32 Unit heaters (fuel - type, not electric), - in -wall in -duct, sus . ended, etc. Subdivision: Lot no.: Fluc/vent for an of above 23.32 NNE - Other: 23.32 fax map /parcel no.: Other fuel a ..liancry ir Y ; 1r 11lEJl.1K.lYT1Olt i O.0 W tJR(114: 1 i Wate heater 23 -32 Replace gas furnace Oas C, laoc 33.39 Flue vent for water heater or gas III fire dace 23.32 — — — Lop l;htcr • as 23.32 — Wood/ p ellet stove 3339 Rill Wood PROlt `"(( i) ;' it •t1!� jib' CI]itnne /lluo /vtnt 2332 insert Name: _ „� , , Other; F,m lronmental exhaust and ventilation Address; Range hood/other kitchen r c ui.mcnt 33.39 IIII City /Stale/ZTP: Cloths d er exhaust IIIII 33,39 Singic - duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet cam artmcnts, unlit rooms 23.32 IIM d4 ' ilek4t , creolV t„kt 't 1,it lt, iv Attic /crawls.ace fans 23.32 MO OM Business name; Other: 23,32 Fuel .i ing Contact. name: $14,1 for first four: $4.03 for each additional Address: Furnace, etc. 11111111111111= - Gas heat urrt • City /State /ZTP: Wa11 /sus ended /unit hea phone..(- ) _ Pax:: ( ) Water heater L' -mail: Fireplace _ IIIII1== Cooling ..`C�1'V�!ttei lei' 1k Ran Barbecue � � Business naive: Efficiency 1lcating & Clnthcs d er ac T�� — Other IIIIIIIII Address: 10117 ST Snnnyslde Rd Suite F19 i *t"t''1EPOV . 'ftt. 1C 1j"f Sad 1 City /StateIZTP: Clackamas, OR 97015 Phntte: (503) 698.5588 Fax; (503) 698.937 ]vlinimutn permit fen ($90.00) t/0 G Plan review (25% of permit fee) � CC13 lie.: 187834 8 - l a„), State Surcharge (12% of permit f�) d , TOTAL .PERMIT FEE ` Authorized signatt Al This permit npplicntion expires if a pcnett la not obtained tisitbia 1 days nferr it has been accepted ns complete. Print name: Matt Robninn Datc: 12.7.2010 " fee methodology set, by Tri- County Building industry Scrvicc Board 1 : 1 fluflding \hamits \MHC- Parrm4A00,d0c 10/01/00 440- 4017T /02/COMhyt;l3)