Permit II - II CITY OF TIGARD C PE
' COMMUNITY DEVELOPMENT Permit ME #: MEC2011 - HANICAL 00212 RMIT
TIGAR.D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/17/2011
Parcel: 2S110AB04400
Jurisdiction: Tigard
Site address: 11370 SW GAARDE ST
Project: PAULUS Subdivision: 1994 -042 PARTITION PLAT Lot: 1
Project Description: Gas furnace replacement.
Contractor: EFFICIENCY HEATING & COOLING'LLC Owner: PAULUS, JOHN G & KIMBERLY F
10117 SE SUNNYSIDE RD STE F #19 11370 SW GAARDE ST
CLACKAMAS, OR 97015 TIGARD, OR 97224
PHONE: 503 - 698 -5588 PHONE:
FAX: 503 -698 -9378
FEES
' Specifics: Description Date Amount
Furnaces < 100K BTU 05/17/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 05/17/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/17/2011 $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:
C. 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.
IV '111- 11:,:eived- .
, •
Mechanical Permit Application F1ECE 17'.0R OFFICE USE °NIA'
• - - - City of Tigard MAY 1 6 2011 Date/BY:5 MMU
m Pcrmit Nn., 1 7,
, -.I 13125 SW Hall 1-3Ivd., Tigard, OR 97223
1 111
IllanI6vle
: . Il ;: ' Phone: 503.7182439 Fa e: 503.598.1960 : CIllicr Pprmi
TI.C.lAR,T) t;
. ,,, rac/By
lrwpcction 1 .inc: 501.639..117S CITY OF TIGA - i;p Jiirla; 1 73 SCC Pagc 2 fur
Internet: WWW,tig,FIITI-Or,g, 'Yid
PLANNING/ENGINE: !INN temcilind; t----CP supplemental information
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Mechanical permit fees* arc hased on I he value of the work
E] New construction 10 A dd tion/a 1 terati on/repl acemerst performed, 'indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other; mechanical materials, equipment, labor- overhead, and profit,
• Value: $
: ':'•:•'. .': H •• •• • • ;.;
;.,;•.•,•:4,•,..;••( •• •,,•••: _.,,,:.,•••••;••‘• •;•;,••,•...„.,•,..,,•••;••••;•;.•J;;•:::•.••:;i,::••:!..;;;;•;•;.: lookittAt:41
IEI 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special iujormation use clteekli.51.
12 Multi-Family [7 Master builder 0 Other: Description . Qty. Ea. Total
H. ,:: ::;'.:HJ.O :•.,: 2 :,:'•!:;... : ;'',;H ilea(in
,,... , '.. .„ ,. ,. ••••• ,..0 ,.,t.,,. . ... • • ' ' '' • ''''''•"":'••• '' '' ' Air conditioning
Job site address: 11370 SW Caarde t Iittioiro !die plim .0.110whig pineoin mil) 49,75
Furnace)00,000,13:1‘1.1(kets 1 46.75 46.75
City/State/ZIP: Tigard OR 97224
Furnace 100.000+ BTU (duets/vents) 54,91
Suite/bldg./apt. no.: 1 Pr )ject name: Paulus Heat pump
(requires site plan aljowiuylaceinent) _ 61.06
Crcwi struclidiredions lo job site: Duct work 23,32
1-lydronic hot water system — 23.32
--
.--. Residential hoilcr (rarlialor or
jydronic) 23.32
— Unit heaters (fuel-type, not electric),
in-wall, in-duet, 511.51:1CIlded, etc, 46.75
Hue/vent fotnyof above 23.32
Subdivision: Lot no.:
-- Other 23,32
'Tax map/parcel no.;
Other fuel appliances:
;:....;';.i .•;.;:H....;:';: .,;••,H Hijjtk*kt tjet)iei4W8i,ibt.i.k.!;":,: '.,..'; . ::•• :..':.':.:: Water heater 23.32
Gas Fireplace 33,39
Iteplace gas furnace
. Flue vent for water heater or gas
Fireplace 23,32
Log lighter _Was) ___ , 23.32
Wood/pellet stove 33,39
— _
Wood fireplace/ins --_---
ert. 23.32
..
.iiii6k,Itliii`,;tiW'$;Itfe;::!:'!::. ., : .,.,.,:: .: :.:..; ,,,,,:n.litirs, • t.:..,,, .. ' ...,... I.: ..,. Chimney/liner/flue/vent 23,32
, ;1': . '' . 1 ..1; • ...,.‘: •::,,••.- ,.':.,..I.4.4...:,1." ''',:!, H•;' ''', .. ''. ';: , '.•1‘, , -;1. , ,,,.,:Lli•.•LL:,::.:1.14.1„,„:, oth 23.32
....---,----„-- --
Name: Environmental exhaust and ventilation:
--„, -
Range hood/oi her kitchen
Address:
. . ---, equipment 33.39
City/State/ZIP: Clothes dryer exhaust 3139_
Single-duel exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23,32
' : l':', : .•.: S1W,'..t;Ii.tMOt,e':..' •:' . AitiC/CrOWISpaCc thliS 23.32
Other 23.32
Business name:
Fuel piping:
Contact name; $14.1n for liret four. $4-03 for oath additional
Address: • Furnace, etc,
Gas heat pump
City/State/ZIP:
Wail/suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
— —. Fireplace
P-mail:
Range
,• ..H , ..1: , ;::1 , :',:;',!''.';•••::'' H::: ,'!,!,; :'!H! 1" ',.: i "i• :.':'. " :'''' :.': ' •.'' '.'‘.:.' - :: ' ''''''' Barhcuji
1 ---
Business name: Efficiency tlentiog 4: Cooling LLC Clothes dryer (gas)
----- --- Other: . ....I
Address: 10117 SE Sunnyside Rd Suite F19 ',.....':,....:i:,,:,.g40.‹.1o5.57e.37T7517wiTTTTi.,::!:-H:...„-::.::,
City/State/ZIP: Clackamas OR 9701:l Subtotal
—........„......—....,.-----_, - - .. - . - .—
-
Mirlin1131111)Crrnil fee (590.0)1) ef 0, dc)
Phone: (503 ) 698.5.188 Fax: (503) 698.9378
Plan review (25% of permit lee)
-- ----------____
COB tic,: 187834 .
Slate surcharge (12% of permit le) /
,
_ '
TOTAL PERMIT FEE Ida ,
Authorized signattlye..,,....--- ...--.K.A? T„,5 permit application expires if a permit h; not ohtaincd within ISO
--. day* after it lins bcen nccCritCd n'S COmplciv.
Print name: Mau Reitman Date: 5.15.2011 ' Fee ineihodology SCI by TH-Coilitty Building IiiiiiiSit'y Service Boa
1:115,iiIc4ins\rarrnlis \ NI lit:-Pcrinll App.cloc CM/WIC/ 440-4617T ( I 1 /02/COMAVE (3)