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Permit ,, CITY OF TIGARD MECHANICAL PERMIT ' 111 ' '- COMMUNITY DEVELOPMENT Permit #: MEC2011 -00425 Date Issued: 09/23/2011 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Parcel: 2S104CA04500 Jurisdiction: Tigard Site address: 13521 SW MICHELLE CT Project: Rushlow Subdivision: HILLSHIRE Lot: 45 Project Description: Replace gas furnace and install a /c. NC unit must meet minimum 5' side and rear yard setbacks. Contractor: A TEMP HEATING & COOLING INC Owner: RUSHLOW, MAREE HOLLAND 16000 SE EVELYN ST 13521 MICHELLE CT CLACKAMAS, OR 97015 -9519 TIGARD, OR 97223 PHONE' 503 - 650 -5014 PHONE. FAX: 503 - 557 -2990 FEES Specifics: Description Date Amount Air Conditioning 09/23/2011 $46 75 Type of Use: SF Furnaces < 100K BTU 09/23/2011 $46 75 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 09/23/2011 $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 question OUNCby calling 503.232 1987 or 1.800 332.2344 Issued By: )\ .....____ _ . ,COP P ermittee Sig natur , � Call 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. Mechanical Permit A ?7?3 Pica n 1 Cy 0' Tigard t t t� 4 � 1 c -,t. r)1 rl( I; i til:l) . . • 5 SW 11n11 Blvd. a l�v 1SEP RCCC1VS � � I ! t w� f 13125 fi•'md, OR 97221S L....), Pe rms! No !! /� • • !'hone :;03 718 2439 Fax 503.598.1964 2 Plan Raley,. Ti (out I.) lnspcetlon Line' 503,639 4175 /� Dare/13), UtflerPenn,r lntemet' www ugard•or-oo‘ CITY OF T; ` ,® Dale Readylk3y tu , BULBUILD YY�i(r, ryi 1 {{ ryy ftft 33 NaliGrdimetlloa ®Srr I ugc 2 fur L ING Ql��iv'i(,S7�i - �,._ aupplemeo[ul TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST A ❑ New construction AddItIU3i/31( fftttOtj /rCPIaGS:171C!]t _ Mechanical permit fees* are based on the val fr.he tt'0rli 1 Ej llc nluli[i0tl performed, Indicate the value (rounded to the nearest dollar) ot all (,)lhei: uieehwiit.al materials, a u, mein labor, verhead. aid profit. __CATEGOR]' OF CONSTRUCTION _ Value. T - 1 -and 2-family (itv chin Commercial/industrial RESIDEN'T'IAL EQUIPMENT' / SYSTEMS 1 EES" [j ❑ Ac.essoiy building El hbr spedal information use &malls, _ Multi- ttin7ily ❑ Meister builder Other, U Description 1 Qt I Ea. 1 vial JOB SITE INFORMATION AND LOCATION llratia,/troulin?: I Job site address. / � I 1 Air conditioning —,.. 1 __ , _____ , 6 ___ t � l (rclu.res silk pl,n st,ow pluccu,entl i 46 -f :If C'Iry /SLatc /'LIP; �; �� �7 G { � _ Furnace 10(1,000 EtTIJ (ducts /v ' 1 16,75 ( ] Sui /bid /apt. ri ` „ C• g P no,: furnace 100,000+ BTU (ductx'vanrs) 54,91 `' ^ I tufeet name: Cruse street/directions to j uh site: J I Heat pump �^ ` t uire> sire Ian sl,uwru �_1 la�cmenl) (� I "� - Duct wgl'k 23 32 J hot watei system 23 32 .- - ---- Residential boiler (radiator or " ~"" `T hydrunic) 2132 — --- Unit hearers (1'41-type, nut electric), —_- In -wall, in -duct, sus ended, etc 4ti 75 _ Subdivision: Lot no : Flue /vent for any of above 23,32 Tax ma / �"'~ Other, map /parcel [[u . �� �_ 23 32 Ut foe! appli DESCRIPTION OF WORK ^ _ n Water heater 2332 v /edit _ q J .+J (' . a, 4 f C A r 4. 1. n Sr i Ga fireplace 33.34 f."2-- i - ^ , 1 Flue veil( for water heater or gas 11 ctY t+7Gr! 1 ( (vi t' , fire tu, e_ 23,32 Leg li bier «us 23.32 " Wood /pellet stove 33 39 Wood fireplace /insert 23.32 PROPER I'Y OWNER ❑ TENANT' O ther e� /liter /fiue/vcnt ~W 23 32 Name: Jilt �( }p 1 Other 23 32 h�7 ��1 f1�� £nvirun[neUtal exhaust and ventilation: Address: ` 3 � ' T I I y Range hood /other latchcn / t' equipment 33 39 fits /Swte /LIP. �C i , 1" 2 - cloth. dryer exhaust ^ a; 39 Phone: ( ) F AIL: Single-duet exhaust (bathrooms, _ - _ i0iiet compartments, utility rooms) 23.32 tg APPLICANT © CONTACT PERSON Attic/crawlspace fans 23 32 Business name: Other 23 32 K� �]} AND COOLING, C: Contact — I'M pipin 1 Contact name' • ,6006., St 51 4.I5 for first four, 6J•03 For eriCh additional Address, ' Furnace, Bit Clackamas, OR 97015 . City/State/ZIP; 503-650-5014 Ci asheatpun tp Phone ( ) : 0 Wall /suspended/unit heater _ Fa . t�J ) 56q- ( -Q V Water heater E -mail: J irepla c - ,_ ., Range CONTRACTOR Ittibec ue buslnesy name' C'lnthcs dryer (:2,a5) T — Address, "t irrma INO 0001 NG, INC Other #. A : - • •; V1CC11ANICi L PERMIT 1 "I ES" Cit Ci,r.'!:'1 Iri O _ 1 97015 _ _ , subtotal , Phone: ( ) I Fax: ( SV3 ) SS q , Nllnitltuln permit lee ($90,00) w �_ I �{ Plan review (25°/r ot permit ft c) CC'13 lie.. State surcharge (12° / of permit lee) r { . TO1AL PER141IT FEE '— Authorized signature. This permit application expires ill permit is not obtuiaed within ISO Print name.: y _ Joys after ii Ilex been uccegtud nu coln1310o, p 1 �,;vT - e / I 1 ' " Pee ingtllnSloloc3 3t31 by Tri- C'omnn Iluildittg iutlitStn S nnmd Z8 3Jdd JNILd3H 8 d EIGHLSSEOG ZZ ZZ TZBZ /�Z/68 E pir SEP 713 2 Temp-Heating & Cooling, inc. ally0E- , BUILD DIVISiolv SITE PLAN Prepared 4,1 Date: 9— — Customer Name; &v. e. Address /7 Customer Phone: rs // Property Boundary Line . . • - Rouse • ZO 39Vd ONIIV3H dWal_ V 12166ZLS9EOS TT/E/8