Permit y CITY OF TIGARD MECHANICAL PERMIT
II : f - COMMUNITY DEVELOPMENT Permit #: MEC2011 -00453
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/13/2011
Parcel: 2S115AD03801
Jurisdiction: Tigard
Site address: 10943 SW DOVER CT
Project: FECHNER Subdivision: DOVER LANDING Lot: 19
Project Description: Gas furnace installation.
Contractor: ENERGY SAVERS INC Owner: FECHNER, BRYAN W & KIM A
P.O. BOX 2829 10905 SW 78TH AVE
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE 503 - 512 -5338 PHONE
FAX: 503 - 512 -5339
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 10/13/2011 $46 75
Type of Use: SF 12% State Surcharge - Mechanical 10/13/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 10/13/2011 $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 - "- a ion - -.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 di -ct questions to OU by c ' g 503.232.1987 or 1 800.332 2344.
Iss -d By: i Permittee Si /, • i
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.
From Jeremy Hickman Fax• +1 (503) 512-5339: I., ,, • ED
lurn Faou +1 503 598-1960 Pa • e 2 of 3 10/12/2011 8 23
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i1 Crty of Tigard Received Aar
Permit No . ,_ -
I _1125 SW Hall Blvd , Tigard, OR g7"""4"
1 °
11 NI ■••• j: . — ... ',
Phone: 503.718.2439 Far Dateiliy: 503 598, BO 1 3 2011 i
Other Permit'
In - t Line - 03 (39 4175
sPcc Km me ' D . ) . . crry0Frit'A9D Date Readyfliy Juns' 0 Sec Page 2 for
,":"A:n:;• interact_ wwwitgard-or.gov 1 ‘,3 i Notified/Method. r—r-J36, Supplemental information
BUILDING DIVISION ._ . -- --
.,..._ . ..
TYPE OF WORK ' „ COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
_
-- - Mechantcal permit fees* are based on the value of the work
0 New construction l Addition/alteration/replacement NI Indicate the value (rounded to the nearest dollar) of all
0 Demolition El Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGORY OF CONSTRUCTION . „
RESIDENTIAL EQUIPMENT/ SYSTEMS EEF:S*
....
,1,41 I- and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special injOrmatian use checklist
0 Multi-family Ell Master builder 0 Other: Description i Qty I Ea, 1 Tot
JOB SITE INFORMATION AND LOCATION Ilear!tig/cooling:
-- - Air conditioning
Job site address: 10943 SW Dover Ct. re( wires sac dim showing placement) 46 75
Furnace 100,000 BTU (ducts/vents) I 46,75 46.75 - City/State/ZIP: Tigard, OR 97224
Furnace 100,000+ ITI (ducts/vents) _ 54.91
Suite/bldg/apt, no.: I Project name: --
Ifeat pump
luires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
_
- —
H dronie het water system 23.3
- --I
— .... _ Residential boiler (radiator or
hydronic) 23.32
,_ . _____ _ - __
-- Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended. etc. _ _ _ 46.75
_ . . _ _ .. .. _
FIue/vcritior any of above 23.32
„
Subdivision: Lot no.:
Other 23.32
Tax map/parcel no.:
Other appliances:
DESCRIPTION OF WORK - ' Water heater 2332
Gas fireplace 111 33.39 MN
Flue vent for water heater or gas
Install new gas furanee I fireplace 23 32 E
_ I Log lighter (gas) 2332
I -
Wood/pellet stove 33.39 MEM
_ Wood fireplace/insert 23 32
41 PROPERTY OWNER ' I 0 TENANT Chimney/liner/flue/vent 23_32
Other
23 32
Name: Kim Fechner
Environmental exhaust and ventilation:
. _
. -
Range hoodiathet kitchen
Address: 10943 SW DOVER CT.
31.39
_ _ __ _ ._...._ _ equipment
City/State/ZIP Tigard, OR 97224 Clothes dryer exhaust T 33 39
— --, Single-duct exhaust (bathrooms,
Phone: (503)516-3154 Fax: ( ) toilet compartments, utility rooms) 23.32
NI APPLICANT 0 CONTACT PERSON Attic/crawlspace fans 23.32
Other 23.32
Business name: Energy Savers Inc
FuelinpIng: ___
Contact name: Jeremy $14.15 for first four; S4..03 for each additional
Address: PO BOX 2829 Furnace, etc
— Gas heat pump
--
City/State/ZIP: Oregon City, OR 97045 Wall/suspended/unit heater
Phone: (503) 679-1724 Fax: : ( ) Water heater
Fireplace
E-mail:
CONTRACTOR Barbecue I
Clothes dryer (gas)
Rosiness name: Same as above I -
Other. I
-
Address:
MECHANICAL PERMIT FEES*
_ _ --
City/St Subtotal
Minimum permit fee (S90 00) 90 00
Phone: ( ) I Fax; ( )
Plan review (25% of permit fee) ..
CCB lie.: 107926 . 3 State surcharge (12% of permit fee) 10.80
I
TOTAL PERMIT FEE 100.80
. ... riermit 4noliration iiriviri, if 4 riivervait ic 4.t 46.4i..4,4 4.■.),;„ 11711