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Permit CITY OF TIGARD MECHANICAL PERMIT Permit #: MEC2011 00030 11 1 2 - COMMUNITY DEVELOPMEN Date Issued: 01/19/2011 IIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S110BD07700 Jurisdiction: Tigard Site address: 11770 SW ASPEN RIDGE DR Project: Langenhuysen Subdivision: ASPEN RIDGE Lot: 49 Project Description: Replace gas furnace. Contractor: A TEMP HEATING & COOLING INC Owner: LANGENHUYSEN, JOHN 16000 SE EVELYN ST 11770 SW ASPEN RIDGE DR CLACKAMAS, OR 97015 -9519 TIGARD, OR 97224 PHONE: 503 - 650 -5014 PHONE: 503 - 624 -1392 FAX: 503 - 557 -2990 • FEES Specifics: Description Date Amount Furnaces < 100K BTU 01/19/2011 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 01/19/2011 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/19/2011 $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 1.800.332.2344. Issued By: Permittee Signature: e)/`/ /7/ 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. 01/18/2011 10:26 5035572990 A TEMP HEATING PAGE 02 Mechanical Permit Application, caic'ke) ; s FOR 0FEllt•F USE ' On1,4- City of Ti and Received , g Plan R - . i�T Pettmt /YE420/ — 6 J0 * 13125 SW I -itil Blvd., Tigard. CSR, 97223 " 011 v ' 1 ' . Fhrnto' 503,639.4.171 Fax; 503,598.1960 ,\ ? Eton Rwm t� t\ iDatc /Dy: Other Permit: r I GA R u Inspection Line: 503,639.4175 s�, ' n ;1D pate Rend y ,T y: n :. 6./ .• See Page 2 lni u lntcmct: www,t,i nrd- or.gov � NOtilieSIVIcthod: upplementalInformrnn CAI tr c;,`9�S��c� S TYPE OF WORK1t \\ t�� COMMERCIAL FEE* SCHEDULE - USE C'YiEC1CI,IST 0 New construction Additf on /alters replac t Mechanical permit fecal' arc based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition 0 Other: mechanical matcria_ts, equipment, labor, overhead profit, CATEGORY OF CONSTRUCTION Value: $ Ir 1- and 2- family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES* g © Commercial/industrial [] Accesso building — - - ❑ Mai-family For .special information use checklist. Y ❑ M aster builder 0 Other: Description — P L Qty. Ea. Total ,IOB SITE INFORMAT.iON AND LOCATION _Heatit - Job site addr ess: f r Air conditioning ` � � ►� C rcq tares sitepinn 46.75 City /State /LIP: ---T rw • 9 ry .- Furnace 100.000 duets/vents 46,75 1 Suite, old /s 1. nn.: ff Furnace 100,000 a - DTU (duc�z/ventt 54.91 R P Prnjcct mm�e: � VSO44., wan p 61.06 Cross street/directions to job site: Duct work 23. 32 I hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fucl -type, not, electric), n -wall, in -dut, suspended ctc. 46.75 Subdivision: Flue /vent for an�of .tltovc 2332 i,pt na : Other 23.32 Tax map /Estee! no.: Other heel appliance, DES RIPTION Or WORK Watencoatcr 23.32 C li , i , f 4rts fireplace 33.39 ` ; ,1 , t... I L1 , Flue vent for water heater or gas fir _ lace X3,32 1_,0 li bier 9_ 23,3 Wood /pellet stove 33.39 Wood fireplace /insert 23.32 I Chimney /liner /flue /vent 23.32 III /RO TY OWNER ❑ TENANT Other: i 23.32 ■ T Name. f! / ,,♦ Environmental exhaust. and ventilation Ta Address: / Range hood /other kitchen AP- ! ! i , equipment 33.39 City /Slate /7,1P; 1111 �� r1 Clothes dryer exhaust 33,39 - ) ( 1 — Single -duet exhaust (bathrooms, Phone: ( 7,„) l l F ax. ( ) _ toile cam ar tntcnta, utili roo 3,32 74 PPLICANT ❑ CONTACT PERSON Attic/crawl pace fans 23,32 Business name: Other: 23.32 Comma name: ' Fuel Miring h $14.15 for first four, 54.[13 for each additional Address: Clackamas, OR 97015 Furnace, etc, City / Sta[e /7_,IP: SU; WO - 5U,f 4 - Om; heat pump Wall/suspended/unit heater Phone; ( Fax: (_� 1" (� water heater W T m E-mail: .!/ �:� ' Pt laee j t , Rtlnf c ,_ CONTRA OR Barbecue Business ratite: m - Clothes dryer (a ) _ w —� M Or mr _ . other. _— Address: 16000 SE Evelyn St D' ECITANi.CAL PERMIT FEES* CitV'Statc 7,[F; tt • I - SCi 14 _ _ subtotal Phone: ( ) F ax: ( , ,,� (��� iv;n+tnum permit tee ( 590.00 ) 1, t r — - - - v � ' •n Pian review (25% of permit fee) C$ tic.; �J Q - l , � . t 2 �� State surcharge (12% p{ permit fee) TOTAL PFR'1M M I R 1.,....- Authorized, mature, - Thus permi nppltcatinn expires It a pet4nit in noobtain . (Ely. after It hat been ueeepted a, complete. Print name: (- j/' ? Date: " Fee meth ndnlo set by 70-County Building Them* Scrvtec 13oar l f: 1 81111( ling\ Perm ienimEC- PecmitAnn/Ink% to /at/0V 440- 4617T 1.'D2rtOMUWEB)