Permit CITY OF TIGARD MECHANICAL PERMIT
`E'1 MECHANICAL
CO MMUNITY DEVELOPMENT Pe rmit #: MEC2011 00152
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/12/2011
Parcel: 1 S134BD10400
Jurisdiction: Tigard
Site address: 10868 SW 118TH CT
Project: FOSTER Subdivision: PENN LAWN ESTATES NO. 2 Lot: 32
Project Description: Gas furnace replacement.
Contractor: FOUR SEASONS HEATING & NC INC. Owner: FOSTER, JAMES D /GALE A
1005 INDUSTRIAL PARKWAY 10868 SW 118TH CT
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 - 538 -1950 PHONE:
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
•
Furnaces < 100K BTU 04/12/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 04/12/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/12/2011 $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 1 2.2344.
Issued By: / Permittee Signature: 9_ �
Call 503. 39�y 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.
Mechanical Permit Anplicati CEIVED
City of Tigard Received y, 4 h " _ ..
N...
13125
Phone: 03639 Blvd..
171 Fax: 503 9 PR 12 2011 p Review Other Permit:
Inspection Line: 503.639.4175 Dam RtadyBy
Internet: www-tigard -a.gov CITY OF TIGARD Nouaea a:
BUILDING DIVISION
TYPE .OP r _ - CO i,> I, PEE '.;� - � �T
▪ New
Mechanical Pe rmit foes' are based on the value .. work
construction gAddition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical matenalg, equipment, labor, overhead, and profit
CATEGORY.;( . "
Value
. -,
1-
and /SYMMS Min
and 2- filthily dwelling ❑ Comrnercial/industrist ❑ Accessory building For spacial information um checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. ! Total
i � :.'9�� 4 ,1. �'"?M .- Heatfgt/c4aliu Air conditioning
Job site address: (� t t / (requires situ pun 9howu,a olacomnnr) 46.75
i ► s � Furnace 100.000 BTU (ducts/veers) f -. 46.75 �4 "7 .Ir
City /State/Z1P: I • / s
Furnace 100`00+ BTU (ducts/vents) 54.91
Suite/bldgJapt- n0,: Project name: (9 Z Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
1 r 11ydronie hot water system 23.32 I
Residential boiler (radiator or
i 6
h iron 23-32
Unit heaters (fuel -type, not electric),
in-wall. ir-0u�, suspended, etc. 46,75
• Flue/vent for an/Alt ve 23-32
// 141. no. :
Subdivision: Other: 23 -32
Tax map/parcel no -: a anees 3 32
,. -
Other fuel apph
M, y,7 • Nw � Y, .... 5 +;" Water beater
/ ` ,�;,. .. • W .. " M ... Gas - .lace 33.39
(-;(• s F LA- v- fA Q c fl 1br water heater or gas 23.32
� • : i _.. •- (.as - 23.32
Wood/pellet stove MI 33 -39 NM
Wood fi _.1aceJinsert 23.32
Chi /liner /flue/vent MOM
.. `M ,!a ;;, Other: 23.32
Name: j t y CC �,-% Environmental exhaust and vendladon -
�.J r . I v llnnge hood/other kitchen
Address: C) ; 6 W r S t equipment 3139
Clothes . .
exhaust ME 33)9 ME
• s • i Singte uet exhaust (bathrooms.
csimi toilet • • attments. utili moms MI 23.32 1M
Phone: S e • 0 : 0 raw .. a fans
Attie/craw 23.32 NOM ICAIVT..;, Other. 23.32 ME
Business name: Fuel plP*UE
- . - _ • s-- . • '1: - - 4 • 1 f $14.15 for first four: 54.03 for each addldooal
Contact name: t • _ " is , • a . = , : , _Furnace, ate.
Address: 1005 INDUSTRIAL P A eras heat • •,,,
, , : - • " ,' Wel l/suspendedlueithcater MI
City /State/ZI1': _ _
Phone: ( s r1. Fax:: (5a$ , � 1 `Q (6, W heater
Fireplace
&mail: Rangce . -
Barbecue
• l ,[.
14 - "1' i Clothes dryer (gas)
Business name: - M a Wm r • I Other
Address: r t � l,: 0 OVAL ' .'re'
N 1 : . ., i _ .. Subtotal
City /State/ZIP: Minimum permit fee (590.00) q 0
Phone: , N Sp g — - '5 Fes ( ) Ptah review (259b of permit foe)
State surcharge (12% of permit fee) / 0 r I
CCB tic.: "-] TOTAL PERMIT FEE / p0 , . ■
This permit appttatioe expires is permit is net obtained within 180
Authorized Signature: `- • � v, . ^ • days after It has Wee accepted as complete.
Date. ` Fee methodology tat by 'Fri-County Bondi** Induy Service Board
i Print name: I* - r. 4 .Q '' -,,�1 u
• tadlaitl a t "Fades 10 /01189 44O.4dl rr (11l COSZJW6a)
600 /600ZI 93108E9E09 XVJ 60:51 110Z /11 /b0