Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00306
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/30/2011
Parcel: 2S102AB00203
Jurisdiction: Tigard
Site address: 9425 SW CENTER ST
Project: Gillaspie Subdivision: MARIELL Lot: 3
Project Description: Install gas furnace.
Contractor: FOUR SEASONS HEATING & NC INC. Owner: GILLASPIE, DAVID A & ELAINE
1005 INDUSTRIAL PARKWAY 13621 SW MOUNTAIN RIDGE CT
NEWBERG, OR 97132 TIGARD, OR 97224
PHONE: 503 - 538 -1950 PHONE: 971- 506 -6704
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 06/29/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 06/29/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 06/29/2011 $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 No _ - ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or dirt questions to OU b, a g 50 32.1987 or 1.800.332.2344.
Iss -d By: ` Permittee
Call 503.639.4175 by 7:00 a.m. for the next available in + • tion 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.
08/29/2011 10:28 FAX 5035380185 Z002/003
i Mechanical Permit App t,,
i t i 011.1(T. [ SE t
City of Tigard � � n (o d' illriffelEMIEMRS
13126 SW Hall Blvd., Tigard, o :_, '
Phone: 503.6394171 F ? ', ' .,. ' 1 ,. Platt ltsvia w Other Pars
Inspection Lino: 503.639.41 � \\ Date R e
Internet www.tigard -or_ VO ' Notified/Method: liMEHESEEll
LI New construction„„ALddition/a1 ' it4la certierrt Mechanical permit fees are based an the value of the work
Q Demolition ❑ Other; 9 me c er chanica ma al equipment, labor overhead, and profit. all
Value $
r. ' REMO:kV/IAL EQCf1�1ili; 7` / .
-4 •
1- and 2 -famil dwellin Commercial/industrial ❑ Accessory building
Multi-family 0 Master builder For special information rag Checklist.
Other: Description Ea
i f J Total
JOB SYI`E r mr.A .L(1 A i' Fleeting/cooling -
�-* Air conditioning
Job site address:
r 1 (r 4 4n s she plan showing placement) 46.7
• City /State/ZIP: — 0 r G Ourd / d5 �� ,a Furnace 100,000 BTU (duate/vcnta) 46.75
Suite/bldg./apt no.: Project. name: i +
S Fu l 00,000+ BTT1 (duote/venta) 54.91
e l f t 1 Heat pump 61.06
Cross street/directions to job site: Duct work - 2332 _
Flxdronic 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
Flue/vent for any of above 23.32
Subdivision: Lot no.; W Other. 23.32 •
Tax map/parcel no.: Other fuel appliances : Water Dater 33.39
_ A Gas place 33.
+ �rl GL.I". . fire Flue vent for water heater or gas _ . ,
fireplace 23.32
I _ Lo)c 1iO rtes (gas) 23.32
Wood/pellet stove 33.39
' Wood fireplace/insert 23.32
tr i•..' " .. ;,'. 4'` 400 '.. l+i91 `... ''' . -.t ;. Chimney/liner/flue/vent 23.32
C Other: 23.32
Y Name . - e ^ •. e.+ Environmental exhaust and ventilation
Range hood/other kitchen
Addross: 5 ,..} re 2. equipment 33.39 _
? City /State/ZIP: cur-4 ! 2 ,1/ - Clothes dryer exhaust 33.39
single -duct exhaust (bathrooms.
en 40 "T J ( Fax ( ) toilet compartments. utility rooms) 23.32
w�!, W';:ir, :,7t 'h .
,. a ,,,, ;`•,:�; i 7', a,';; > r; - " i; ✓" Attic/esawlspacefans 23,32
Business no: OUR SEASONS HEATING Other 1 23.32
Fuel piping ..
? Con�t CONDITIONING, INC. _ $14.15 for first four; $4.03 for each additional
Adthrs: Furnace, etc.
1006 INDusTRIAL Piet I Gas heat pwap
City/State/ZIP: ,� Wall/suspended/unit heater 'AWNING) VR Phone: ( F ax ( ) Wafer heater ,
Fireplace
E -mail: �1 Range – .. .
:-. v;.'", '1`:LJ .b Barbecue .
i Business AIR OONDI • INC 1 INC. Clothes dryer (gas) _
Other:
A
ss- 1005 INDUSTRIAL PKWY KWY To : k. ::'.
'ice` , . ,
Git m: subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($90,00) 'Ti) ■Q U
Plan review (25% ofpennit fee) ','++��
CCB lie.: x`711 State surcharge (12 % ® D
of fee) to Q
C�[� TOTAL PERMIT FEE f /A , A
Airtho Lgna nuS �� �_ ' 4 � Yh7a permit application expires if permit is not obedn t p�
l iZ ed s days sailor it has bee* accepted as complete.
Print name: Kod:. k 1, u^n [' Q p f'-
/p 7 ,„/ • Fee malhodology set by Tn- County Building industry �
I :\Ba ctosTe oniMME .PPer 10/01(09 J , 440- 4617T(I, )