Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 00202
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05!10/2011
Parcel: 2S112BB12300
Jurisdiction: Tigard
Site address: 14100 SW FANNO CREEK PL
Project: SMITH Subdivision: COLONY CREEK ESTATES NO.4 Lot: 103
Project Description: Gas furnace replacement.
Contractor: ANCTIL HEATING & COOLING Owner: SMITH, EDITH
4320 N WILLIAMS AVE 14100 SW FANNO CR PL
PORTLAND, OR 97217 TIGARD, OR 97224
PHONE: 503 - 281 -0752 PHONE:
FAX: 503 - 282 -5722
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 05/10/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 05/10/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/10/2011 $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 1.800.3. •4.
Issued By: Permittee Signature:
Call 503.639.. 5 •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 Applica a FOR OFFICE r<. I? t I; >N► ;�
l City of Tigard +' �� R eCG1vGd P No,;
g Datc/By: ► (/ ..,61, AL t - • j/ Ai
-- 13125 SW Hall Blvd., Tigard, OR 97223 Plan Rcvieu
s Phone: 503.718.2439 Fax: 503.S98.I9 OtherPcrmit:
Inspection Line: 503.639.4175 BRAY 1 2011 0. vtc /By:
' T t U A R IB Uate Ready *: Itiedn Sec Page 2 for •
Internet: www- tigard- or.gUV CITY OF TIGARD Notified /Method; -r : Sopplementai Information
tiu'tl i - alp, �., , 1fD.IVISION ;: 1 , . , „Yra,v,r• j V` �:. �. t,
ya" ,�r 1i r % ^v 111'•4 i• N P9hRr� ,. t 1 t ..11 7 : i Yj Y IeW.: t , ` 4. �1 {v 1 h i i I �'(l2 V 71 . `'F n r '+ ,t A 4 t11�'; �t
o ,r, kii,2, " iwi' °' ci�dl9l' ° u+r Ml o i ^7 gw' 11,4�� .A!4ti,r, t •, iu6 l -i ®M•r�mi
j ,�: .,.� ;.� l ; � l lo: ,..AxA,.(711.,1 +,tA�arl.,.�I(ir I .,11.b.i! .�Ii..11�i� .,..�, �.r,tl,�.
1 "` ejd "i` (1, 113 a jrl4 " "PII`"wy "t�.�' .'t„ Mechanical permit fees* are based on the value of the work •
❑ Now construction ® A ddition /alteration /replacement performed, Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, tlquipment, labor overhead, and profit. • s�41 "' ; A; A ?i " E,4 " • I +A F 1 It 4 11 1 °l §' ol.''�i 'i I vS (. I Value; S
,Y� f A l ® 0 l 1 Pl.'F.� ! l .;. 1t {, U a I ' m 7 ? MIT 4717 7TH 19
.( >� : { Y:•A WI •i , yl.,, I. ,, j C � ,tV •.Yl�. �, A. �+IY 1,1 .11 .1 jtl•1 ( I" �1v II��1 •�t.� f .�SJF4Y /�j�a 1 j (�
' � - : ", x
• �Ir�� f� ^
® I- and 2- family dwelling ❑ Commercial /industrial (D Accessory building For special iriformation use checklist.
❑ Multi - family ❑ Master builder ❑ Other; Description Qt Ea. Total '
' aw,1 ° uo 4 't ,y��, 1 1 y �� t 'r a ,?, l; Heating coolin
. ; , I I S +y7' 1 ,.1t g f,1** ,. 7f ° t0 ► h zh l 4:' ao dl Y 71 I ' , , 4 ?, !� �'t
E.�" �, aiddhl t Id ,.., YOk Air conditioni
Job site address: 14100 SW FANNO CREEK PLACE rcruires site Ian showin lacement 46.75
Furnace 100,000 BTU (ducL¢/vents) 1 46.75 46,75
City /State /ZIP: PORTLAND, OR 97224 -- Furnace 100,000+ BTU (dam/yenta) 54,91
Suite/bldg -/apt. no.: Project name: #29455 Heat pump
. ..._,...... (requires site plan show placement ) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23 32 •
- Residential boiler (radiator or •
h dronic 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:
va, za s1 �mr w J d: 23.32
v to A 7, ���Y�� 9 Ol " o m2� 0 to, 1" I F t B o a v p. : 1 Water heater
t'vP�au�l,4�'aSC+;rc�'� ni.,�. q�F�r a 7 F.�� j11N vr���(r"f�Ri' >b 11r�P�7:v�':7�Ft1)'t�'.r:•..,
PUSH/PULL GAS FURNACE Gas fireplace 33.39
Flue vent for water heater or gss
fire )lace 23.32
- Lo, lighter (gas) Mill 23.32 MO
Wood /. Duet stove T 33.39 NEM
Wood fireplace/inset% - 23.32
l ... Dr ";� i j 1 ,(4,.,' , 4 , o ril+� a - r ism r' w C,s, ,, 0 Chimney/liner/flue/vent 23.32
)7. r�Y��t , i _ hnE., b � :. "�r' istf atra'ttt A t . ,,; , �I „ ,rat h' X ,Iii ,, ?,P"U 1. ., ., A K 4 .' , _ ,,,L; , ,,1 Other. 23.32
•
Name: EDITH SMITH Environmental exhaust and ventilation:
Range hood/other kitchen
Address: 14100 SW FANNO CREEK PLACE ..ui.ment .
Clothes d er exhaust 33.39
City /State/ZIP: PORTLAND OR 97224 - Single duct exhaust (bathrooms, m p g =
Phone: (206)297-1637 Fax: ( ) toilet corn. . ents utility rooms_
■l w I r, Al' ANt r ' 7tP ° a / (I' a , . y . r z 1!' t'e , ' 9 a' e7,1y Attic /craw lace fans 23.32
, ; 1 � .•ic t9: „. ; y ' fi 94 . .„ -... • q l ' k'' ' "..' a ''' i, 1 a ''s '''' - ro I r i tr t ja N Pi'I,' 23.32 • O ther:
Business name: ANCTIL HEATING AND COOLING Fuel piping:
Contact name: CHRISTINE BARTON $14.15 for first four: $4.03 for each additional
Fmnac a etc. in =
Address; 4320 N WILLIAMS AVENUE IMIIIII�
City/State/ZIP: PORTLAND WalUsus.cndecUunit heater
Water heater
. 1111.111111
Phone: (503) 281 -0752 Fax: : (503) 282 -5722
Fireplace
E-mail; INSTALL@A I inr ° r l jrv{ pr, rF ,19, 1 tlP •IS'r{ Range . MIEN
.. d >r.�at t 0..! ll 'I g - ! 'l al ` (i' 0 . 0.1 VA a ,i 1 .l,,.A;bk; ,,p, ., ... ..d. ..01 { 1u "'� Barbccua �
!:.iC,r l �' i;, t ¢ r a „ m. Clothes er s
Business name: ANCTIL HEATING ANl) COO1 ING _ Other
1 1 1' J 1 A a at l�
Address: SAME AS ABOVE f'tY.,ry J' r'.-5 � ,.. 4t
Subtotal
City /State/ZIP: Minimum permit fee ($90.00) Y j
Phone: (- ) I FaX; ( ) Plan review ( of perm fe
_. �-, State surch.0 c (l 2 °0 25% o f pe rurit it fee) ,
- CC.i3 lie.: 8$97 - ..- ._- -.-- -- TOTAL PERMIT FEE � _
L.,.-... - -
__ _ -
Thit Permit apptatlon e?.hlYCa a m IS not Obtained within iii \ . 7 \I. dill's li after It hat been if uecPpted perit an vomplcte.
Authorized si ��, � !� �- - - _ • i`cc tnettlodology set by Tri4I 011nty fiWldntg Industry Ser'Ice Beard
/U /1 l
Print Hanle: C HRIS1INE BARTON . -.. 1 -_ D2t._ _r. S - --- -•
L -- -- -- . - 440-461 ?1' (u102VOlvlrwlnll
nn,r10.1t1
Id Wd170:170 IIIZ 60 'hpN ZZLSZBZ 20S : '0N dNOHd 6Ut IooO 2 6u TI-PH 1IlJNd : woad j