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Permit
11111 CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2011 -00170 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/20/2011 Parcel: 2S 111 DC07800 Jurisdiction: Tigard Site address: 15665 SW OAKHILL LN Project: Brewer Subdivision: SUMMERFIELD NO.10 Lot: 579 Project Description: Install gas furnace and NC. Unit must meet 3' minimum front and side yard setbacks. Contractor: FOUR SEASONS HEATING & A/C INC. Owner: BREWER, JOHN A III & SANDRA J 1005 INDUSTRIAL PARKWAY 15665 SW OAKHILL LN. NEWBERG, OR 97132 TIGARD, OR 97224 PHONE: 503 - 538 -1950 PHONE: 503 - 968 -6440 FAX: 503 - 538 -0165 FEES Specifics: Description Date Amount Air Conditioning 04/20/2011 $46.75 Type of Use: SF Furnaces < 100K BTU 04/20/2011 $46.75 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 04/20/2011 $11.22 Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas Gas Pressure: Total $104.72 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: C),17 /�,e /c7,12-/ r� 7 „ ` / Call 503.639.4175 by 7:00 a.m. for the next available inspection date. v 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. 04/18/2011 13:07 FAX 5035380165 Ej002 /004 Mechanical Permit Application E� 1 ilk 1 > I i ii l t , , O\ I 1 City of Tigard CEIV ��'' Permit xo.:� y�C� ,// d D/ Review ■ 13125 SW Hall Blvd., Tigard, OR 97223 Plan a Phone: 503.639.4171 Fax: 503.598.19CpPR 19 2011 DatNP,y: Other Permit: Inspection Line: 503.639.4175 i p� R y/gy; B see Pate 2 for EEir Internet: www.tigard- or.gov Tiotitied/Method: Supplemental Information CITY OF TIGARD yq swy r','';'1''' :,'.' . V � . � 1 , , r :,5: : ,fi . a kn6 x'12 1�c a �x ur � 9° u' �r+, iY.'� � ' !0 t � � w x , )r f � ''.10. "� �-�' ". x Mechanical permit Ices' art based on the value of the work © New construction ddition /alteration/replacement performed, indicate the value (rounded to the nearest dollar) of all ❑ Demolition Other: mechanical materials, equipment, labor. overhead, and profit , v et r .; . a. l u4 : �v a c Value; $ . r 1- and 2 -famil y dwelling Commeretallindustrial ❑ Accessory building For special Inform mion use checklist. IN Multi - family ❑ Master builder ❑ Other: Description Qty. En. Total Job site address \ Air conditioning - �� & � ,� 1 r L� -, wires site • tan showin_ .lacement III 46.75 MIE City /Statc/ZIP: 0-11 Z ( 2, Furnace 100,000 BTU (ducts/vents) f. 46.75 X J Q� c5 / r Furnace 100,000+ BTU dacts/venta 54.91 Suitc/bldg. /apt no.: Project name: ��� �/, Heat pump 61.06 Cross street /dlrections to job site: Duct work 23. 32 HYdronic hot water system 23.32 Residential boiler (radiator or hydronic) 23 - 32 Unit heaters (fuel -type, not electric), in -wall, in- duct, suspended, etc- 46.75 Subdivision: (Lot no.: Flue/vent for any of above 23.32 Other: 23 -32 Tax map /parcel no.: Other fuel appliances ,,'T., 1 ... ' 66ee ,.. w tR., ^ 7',,,, t ' a "r W YN v, h;i 'qt W 4 r '..:60.0 Water heater 23.32 - Gas fireplace 33.39 IF Imo. • 1/ / m I, t, 1 Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 0 : , R , .. yad ,. , r n„ 4 y F , r ,,, u; Chimncy/tincr /flue/vent 23.32 _ t_ :•;.' " " Other: 23.32 Name: J a n r E r r) � Rk ...t.. �V Environmental exhaust and ventilation Address:I 6(0 (p 4 3 ' c LAJ Y54 ii Lei hood/other kitchen +--- � equipment 33 -39 City/State/ZIP: "\ • 4 , • q -7JZ.- y Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: ) di i , i + , £ alt Fax: ( ) toilet compartments, utility rooms) 23.32 - H u , "" Attic/crawlspace this 23.32 e Other: 23.32 Business name: Fuel piping contact name � AR DmONlNGr INC.. $14,15 for first four; $4.03 for each additiona Address: I� �p'� PKWY �Y Furnace, etc. ,NDUS I n -- Gas heat pump City/State/ZIP: , �� ��. Wall/suspended/unit heater Nivill Phone: ( ) Fax:: ( ) Water heater Fireplace E-mail: _ Rye - • , ' y.' ''t1' ai 4 ,,, i t I C, Ja. Barbecue _ Clothes dryer (gas) Business name: �D AIR C ONIall 1QN 1 Other - Address: 1 005 INDU$'rRI I �:r, . ,'N . rl City /State/ZIP: NkrAS O p - Subtotal C OR� Minimum permit fee ($90.00) Phone. ( ) ) Plan review (25% of permit fee) , .2. r \ J �CCB lie.: q7/� State surcharge (12% of permit fee) 1 l eh t V V TOTAL PERMIT FEE .IP7� ) Authorized signature: ----•-j days permit a yp u it h.a been aaoepbod u9 oomplec. mil' 1 Print name: , ' methodology set by Tn - County Building Indust:Y Service Board �� .+ �la. r w,/ 1:18uttd .doe 10/01/09 440 - 4 61 rr (11 /or/COM /weB) / /� / . 7t? 04/19/2011 13:08 FAX 5035380165 12004/004 4V/14164VO Va-Lt PAA ;V 063 3V1tl bAIr Vt run - inAue rcn$H ..iv.+ r r , g. - , 64 c, . *1 b o 4 ,„, ' g M 0 to " ...71 i n. ., ._.„g r:- ° vi . ' st - c '-c_ . 0 ,,,,,, -1'.• 4 %--, . 1 . • _ 0;\ ,t, 8 ' - . - . Iv , - - 1 ., -r R _ . M ,, 0 ii, . ., -- , . .. . .4 ,,, .1 _ i - 0 ..._ ., . .. r ria ' . Aim.iiikH ' g . . . . E. .. •-cf 0 pvi . t , . .. t.n '..• E 04 . , g fli . . , . . . . . ... , .