Permit CITY OF TIGARD MECHANICAL PERMIT
I '1 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00155
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/12/2011
Parcel: 1 S134ACO5300
Jurisdiction: Tigard
Site address: 10954 SW GENEVA ST
Project: DUNNING Subdivision: HART'S LANDING Lot: 24
Project Description: Gas furnace replacement.
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: DUNNING, KRIS L
1005 INDUSTRIAL PARKWAY 10954 SW GENEVA ST
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 $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to • NC by calling 503.232.19: • :00.332.
Issued By: Permittee Signat
Call .639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application T i ;, , :, I , : I , I 1 ■
Addition/altcratib
Ci an Received
g �� Date/By ® ,�l illiiiliIll3�ltiII QIfIF 7
SI
13125 3W of N#11 Ti Blvd. , Tigard OR 9 `� Plan Review
Phone: 503,634.4171 Fax: 503 ' 1 Daso/By'
Other Permit. Inspection Line: 503. 639.4175 � eQ\ Dane Ready/By: Internet. Www.tigetdfit.$aY �j Nbti ffed/M od: i
PQ� F
. TYPE OF 4.., _, 4F . 5� foes` are based on the value of the work
Ma/ Sea 141- US* CRE KL T
ant Mechanical permit
❑ New construction ..1 tlY - . performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition ❑ er: 6`" mechanical materials, equipment, labor, overhead, and profit,
�''' value: S
l - and 2-family dwelling A Q a1 ❑ Accessory Indus � ry building (�iQ?rf l�J'
Y g For special information use checklist.
❑ Multi- family ❑Muster builder 0 Other: Description 1 Qty. 1 Ea. _ Total
• JOB S fl E.» '# .° HeatineJcooling
/-* _( Air conditioning
Job site address: !0 q � l n e V& s 1 _ . (requires site plea showine
City/ State/ZIP: 46.75 .
r i o Furnace 100,000 BTU (d„nt9/vents) . I 46.75 4/6'7
` � q a ,p. G I C� .�- Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: cJ I Project name: t , vt
9_, Heat pump 61,06
street/directions to job site: ' Duct work . 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fhel -type, not electric),
in-wall, in-duct, suspended, etc. 46.75
Flue/ventfor env of above 23.32
Subdivision: Lot no.: Other: . - - 23.32
V -
Tax map/parcel no.: Other fuel appliances
M - • 33.3
(3as fireplace 33.39
Q s r u, tr y �C r Flue vent for water heater or gas
-
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 2132
- Chimney/liner/flue/vent 23.32
-p'OWN'ER '`i ,, .•?NT Oh 23.32
)4ame: ANIM kA 0 y ` Environmental exhaust and ventilation
Address: 1 ' n e ve S e9R other kitchen 3339
City / State/ZIP: " • 4 a 0 b • L Clothes dryer exhaust 3339
Single -duct exhaust (bathrooms,
Phone: ( ) ) 3 , — 9 3 Fax: ( ) toilet compartments, utility rooms) 23.32
__� &_ r :' :3!E AI ; Anic/crawlspaoet3lrns 23.32
Other: 23.32
Business name:
9 tiaATING • _ _ .. `a Foci piping
Contact name: AND AIR C • I �
AND INDUSTRIA
Address: L 14 first four: $4.03 for each additional
Furnac 5 etc. .!5 for
- NEWBERG. OR 97132 cat, heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: cm ) 1 4 5e. Fax:: (d 5 - 3 R"�Q i Co S waterheatar -
S3Q p -- Flrepiace
E -mail: Range
Cfi t• Barbecue
Business name: Clothes dryer (gas)
■ . _ _ •„ I ft , .. . i Other:
Address: 1005 INDUSTRIAL PKWY . AN1CAL PER71411T pus.
t rr ; - r •" • •v - -
City /State/ZIP: Subtotal t/ 4, s-
Phone: ( ) I Fax. ( ) ql)
Minimum permit fee (590.00) , o 0
Plan review (25% of permit the)
CCB lie.: '7 5 . . State surcharge (12% of permit fee)
TOTAL PERMIT FEE /p 0 • 80
Authorized signature: This penult application expires if a permit is not obtained within 180
days alter It has been accepted as complete.
Print name: lb I God .1r\,, v
Date: ILI ( • Fee methodology se. by Th-County Building Industry Service Board
mawmwariamirt>aiEC>arsidira-
doc 10101819 440 -i6ITr (1 UD7/COMIWVna)
CO0 /E00EI 99108E9E09 XVJ OZ :ZI 1.1.03 /Zl /b0