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Permit CITY OF TIGARD MECHANICAL PERMIT 2 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00420 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Date Issued: 09/21/2011 Parcel: 25111 CC18200 Jurisdiction: Tigard Site address: 10480 SW HIGHLAND DR Project: HILLER Subdivision: SUMMERFIELD NO 4 Lot: 233 Project Description: Gas furnace replacement and A/C installation Contractor: FOUR SEASONS HEATING & NC INC Owner: HILLER FAMILY REVOCABLE LIVING T 1005 INDUSTRIAL PARKWAY 10480 SW HIGHLAND DR NEWBERG, OR 97132 TIGARD, OR 97224 PHONE 503 - 538 -1950 PHONE: 503 - 598 -7471 FAX. 503 - 538 -0165 FEES Specifics: Description Date Amount Air Conditioning 09/21/2011 $46 75 Type of Use: SF Furnaces < 100K BTU 09/21/2011 $46.75 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 09/21/2011 $11.22 Occupancy Grp: Stories: Fuel Fuel Types 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: — �J Call 503.6 9. , 75 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. 09/20/2011 12'26 FAX 5035380165 Z002/003 • Mechanical Permit Anvil ation 1 t ll; l )1-1. I( i. (. LA. (OA \ IS City of Tigard �E1��� fts� I 'enn i f No.: �� ,� I 1 — L� 13125 SW Hall Blvd., Tigard, OR 972.2.3 Phone: 503.639.4171 Fax: 503.598.19b0 r • Inspection Line: 503.639.4175 S E P 2 0 2011 Internet: www.tigerd- or.gov � Btw Pa Z for CITY OF TIGARD Soppim tororwstiw - ❑ New construction ddition/a1tcration/rcplacement Mechanical permit fees'" are based on the value of the work ❑ Demolition pm : performed. Indicate the value (rounded to the nearest dollar) of all mechanical materials, equipment, labor, overhead, and profit w •: , r ter +r �y Value: $ wr'. I - and 2 - family dwelling © Commercial/industrial [I Accessory building it)t±SID NT11p a l information u Ir T checklist. ,' ' Far s information arse checklist. • Multi- family [] Master builder ❑ Other D 1 Qty. L Ea 1 Total R y r ear '> � i<leatiaa/eoollug 10 v d Dv- , Air a Job site address: 0n ' j I ` (requires site plan showing pl� I l) f 46.75 '1 (0.'1 y' fri city/state/Zlr: r,�� - o' 1 Furnace 100,000 ETU (ducts/vents) I 46.75 4 (r,, - )S Suite/bl dg ap / t. no.: ` -. `" / P /] 1! t/' Furnace 100,000+ BTU (ducts/vents) 54.91 ro�ect name: � r Heat pump 61.46 Cross street/directions to job site: Duct work 23.32 Rvdronic hot water system 2332 - . Residential boiler (radiator or - hydronic 23.32 Unit heaters (fucl - type, not electric), — . _ - in - wall, in duct,,suspended, etc. 46.75 Subdivision: Lot no.: Alue/vent for any of above 23.32 - Other: 23,32 Tax map/paMei no -; Other fuel audiences • ' `-r _ ' - Water heater ' 2332 i / � 8 ,(` �.(� � G as firt place 33.39 • AM L. /A 1 r x` � ! � j/LC�1, Flu vent for water heater or gas fireplace 2332 Log lighter (gas) 23.32 wood/. list stove 33,39 Wood fireplace/insert 23.32 ;; '::'2-'. n. ; y° i ^ ',, ) t ,r ,;I i7o ,, , . y ,,. Chimney/liner/flue/vent 2332 ' � `� w„ Other: 23.32 Name: � ` [ I Lek— Environmental exhaust and ventilation /� Range hood/otber kitchen Address: �� ar7 , �. L-f_ It d . Ch _. v'e--- equipment . 3339 , City /StatealPr - ti " N � C ? , 2 _ Li Clothes dryer exhaust 33.39 Single-duct exhaust (bathrooms. Phone: Ca 1 L-/ i Fax: ( ) toilet compartments, utility rooms) 23.32 rte F ._ 4 "4 'f..' Y ...: . 'c : 7' , / ,1P - N" 'ia;,OS 'i , ° r �; .. ;�;' - Attic/crawlspace fans 23.32 Busine35 mune: 1 Other i 2332 Fuel piping Contact name: t� t �FOLJI SEASON' additional $14.15 for first four; $4.03 for each additional ANO AIR CONDITIONING, INC. Furnace, etc. . Gas heat pump City /State/ZIP: a l, ; k * ! 111 ■• A A Wall/suspended/unit heater Phone: ( Water heater t , f' w W i • ) .` _ Fireplace E-mail: Ramp Y , P \.7 i Y . t A , .. Barbecue 'I Business AND AIR CONDMONING, INC. Clothes dryer cFas) Other: Address: 1005 INDUSTRIAL PKWY niEc PlE RD4 is `.'' ' Cityistate/ZiP: Subtotal N ■ ) E G - Minimum permit fee ($90.00) p ow 4 - c o Phone: .' J 9 s OR 911 o Fax: ( ) Plan review (2596 of permit fee) CCB lie.: t'7 J ?_ _ State surcharge (12% of permit fee) Fre . A /1. A TOTAL PERMIT F'EE • yi ,7a Authorized Signs r This permit application aspires if a permit is not o within IFS d� i k days after it has been accepted as complex. ' Er`+ , , Date: US/ • Feo methodology sot by Td- County Building Indoetry Service Board r: nhnitanop arasuulibc- Permiu►pp.aoc torol/ov 440.4617T (1 2ro2/coM/WEB) • 09/21/2011 08:00 FAX 5035380165 0 002/002 pr(r it SEP 2 1 2011 • CITY OF TIGARD BJi+_DING DIVISION bi . 4. tti coo .9 cs. a , tri E tri • tti