Permit CITY OF TIGARD MASTER PERMIT
' COMMUNITY DEVELOPMENT Permit# MST2011 -00187
Date Issued 10(28(2011
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 251030804100
Jurisdiction Tigard
Site address 12290 SW MARION ST
Subdivision WILLAMETTE NO 2 Lot 20
Project BERINGER
Project Description Above ground oil tank on a concrete pad with fuel supply lines
BUILDING
Floor Areas Required Setbacks Required
Stories 0 Bedrooms 0 First 0 sf Basement 0 sf Left 0 Parking Spaces 0
Height 0 Bathrooms 0 Second 0 sf Garage 0 sf Front 0 Smoke
Dwelling Units 0 Third 0 sf Right 0 Detectors
Total 0 sf Value $4,500 00 Rear 0
PLUMBING
Sinks 0 Water Closets 0 Washing Mach 0 Laundry Trays 0 Rain Drain 0 Urinals 0
Lavatories 0 Dishwashers 0 Floor Drains 0 Sewer Lines 0 SF Rain 0 Storm Sewer 0
Tubs /Showers 0 Garbage Disp 0 Water Heaters 0 Water Lines 0 Drains Catch Basins 0
Bcktiw Prevntr 0
Footing Drain 0 Ice Maker 0 Hose Bib 0 Backwater Value 0
Drywell- Trench Drain 0 Other Fixtures 0
Other Fixture Units
MECHANICAL
Fuel Types Air Conditioning N Vent Fans 0 Clothes Dryers 0
Heat Pump N Hoods 0 Other Units 0
Furn <100K 0 Vents 0 Woodstoves 0 Gas Outlets 0
Furn > =100K 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc /Feeders Branch Circuits
1000 sf or less 0 0 -200 amp 0 0 -200 amp 0 W/ Svc or Fdr 0
Ea add! 500 sf 0 201 -400 amp 0 201 -400 amp 0 W/O Svc /Fdr 0
Mfd Home /Feeder /Svc 0 401 -600 amp 0 401 -600 amp 0
601 -1000 amp 0 601 +amp -1000v 0
1000 +amp /volt 0
ELECTRICAL - RESTRICTED ENERGY
SF Residential
Audio 8 Stereo N HVAC N Security Alarm N Vaccuum System N Garage Opener N All
Other N Other Descnplion Ecompasing N
BUILDING INFO
Class of Work Type of Use Type of Constr Occupancy Group Square Feet
OTR SF VB R -3 0
Owner Contractor
BERINGER, BRIAN J & ANN L FIRST CALL HEATING & COOLING CO Required Items and Reports (Conditions)
12290 SW MARION ST 1650 NE LOMBARD ST
TIGARD, OR 97223 PORTLAND OR 97211
PHONE PHONE 503- 231 -3311
FAX 503 -286 -5194
Total Fees $269 56
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other applicable law All work will
be done in accordance with approved plans This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center Those rules are set forth in OAR
952 -001 -0010 through OAR 952- 001 -0090 You may obtain a c Kt e rules or dir t questions to OUNC by calling 503 232 1987 or 1 800 332 2344
Issued By —,ossG- ...0"-- ermittee Signature 'e
Call 75 by 7 00 a m for the next available inspection date r
This permit card shall be kept in a conspicuous place on the job site until completion of the project
Approved plans are required on the job site at the time of each inspection
10/27/2011 THU 8:43 FAX 5032865194 FIRST CALL HEATING 0002/011
41 t D, w3{
1 ) °-''-° V • ° ° Permit Applicatio t FOR OFFICE OSF ONIN
City of Tigard ECE
Rece,Bed 1 D perm N o
" 13125 SW Hall Blvd, Tigard, OR 97223 �E� Y m 'JCb
I Phone: 503 718 2439 Fax, 503 598 1960 Plan Renew
2 r� r Other Femur
TIGARD Inspection Line: 5036394175 O 2 1 2 01 Ome Re argil III
ReadyTy S See Page 2 for
Internet www ngard -or goy Notified/Method. 1 '0 i JI
CITY OF TI 0 i . Supplemental Information plr�t�� GARD
. M���
9 7,,, , _' r : -` .,;TYPE'OF 6 P,4.. "j ' X a 'CbMt�'It
6f ���pc.pp��yy��yyt '� ", CIA `L�F &E"`S�HEllUL$- fIISECHECKLIS7'
❑ N ew consnucnon Mechanical permit fees" are bas .: -- work
❑ Addition/alteration/replacement performed Indicate the v: . n e. . - of all
❑ Demolition ❑ Other: mechanical materials s ui.mcnt, lab. r, ov rh - ... e - .
' ' CATEGbitVdetONSTRTICTTON ',`;S irChr.�"`,LLecrsF," "s° `, "' e Ti� l���
'-e _ - rvr. „ : ? 8RES1DE N , 1 4QUI P MENT , % STEMS FE.: ' 2
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For spa . • ■ in „ - . . ur.
❑ Multi - family ❑ Master builder ❑ Other Description Qty Pa 1 Total
3 °- t aM: ;1' e - s" g /cooling:
JO$;,$ITE �llVFOR: rIATI O V A' NI )w'I;.00A ..,- s>.%.,% rrx. °.:;:)
� 1 A Heatin con
Job site address. ' a,2 pp 5 IN , r _ - t'G n C f • (requires sae plan showing placement) 46 75
City/State/ZIP --l^ ,_,, p O � IC /_ d� / A 3 Furnace 100,000 B 1 U (ducts/vents) 46 75
I l C -e "t , Furnace 100,000+ BTIJ (ducts /vents) 54 91
Suite/bldg /apt. no Project name r; n 1( >r Heat pump
} a "" s f1� �� (regimes site plan showing placement) 6106
Y4'toss sttceVdirecnans to job site Duct work 23 32
l;:- Hvdronic hot water system 23 32
vl Residential boiler (radiator or I
= hydrontc) 23 32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc, 46.75
Flue/vent for ony of above 23 32
Subdivision, , - - Lot no,.
Other 23,32
Tax map /parcel no
Other fuel appliances:
,-x, ,. ^.,x, n
- � "d; ' DESCRIPTION' ?OFPWORIC"M, 8 i„t #stt?N;, ";`s*'*3'!', �7!4 Water heater _2 3.32
Gas fireplace 33 39
7hs-Ec�1c.k ,erg o
pr:)-C. O. x G \liot�
n dl Flue vent for water heater or gas
l0 -�00u2 cjyt l I. r he m-, \ - ran I. fireplace 23 32
IV em., Log lighter (gas) 23 32
Ch fly anIre.4 ?� W' W FgLi Wood/pellet stove 33.39
St DI, '.j L, ne$ Wood fireplace /insert 2332
:44 PROPERTI'e,9WNER`, jd, r'i „ ;,?,, " >`�;' NI',4'�SNA'L r,4 :4 Ky?'� 0: Chimney /liner /flue/vent 23 32
"'"" . ,: t,i,i Other: 23 32
Name ((jj
t V1'`t C..,Y1 � Y1�Y"
J� ,. Environmental exhaust and ventilation. ; i ddress: (aaq ui 0 S Cr our on °s N. Range hood /other kitchen
0 � equ 33 39
Ci ty /State /ZIP; • .-'' ( CA.Y`Ck i O lI � 1 A)...3 Clothes dryer exhaust 33.39
:-
Single-duct comparxhents (bathrooms, t utility
I, ;�tipne, (51)3) 7 _. �{ � y a Fax' ( ) toilet compattments, unhty moo
ms) 23 32
N- 1:4,'APES1Cii$T.:; rd' „ % 4, `g: r..,,,,_..; :[Jr, colTAd �ikS6 „tip' Attic /crawlspace fans _ 2332
, i- Business name: First c_cAm W }^ i � 0 1 l h Other 23,32
\� Y 9 Fuel piping:
( � - Contact name' L1 l r ` 914.15 for first four; 54 03 for each additional
� - Address H 50 it / - f . i„co-nbourct Furnace, etc.
01-;, Gas heal pump
City /State /ZIP:
r � r IC Alcor-0 8 u �1 Wall /suspended/unit heater
. ) 1 - -hone. 6b3) of 31 - 3 31l Fax . (5(a QV, -5 Water heater
E =mail m h n o r e.. Q -C 4 rift-Cca.AI . cap
Range
-.- ,` - ;,,',.,,: ) l;- °; k"rC,ONTRAGTR(, O Y,'r, nn Fireplace
- - n ,Cttt'-„y?x3:.t'” . { + ...'F : ;a . "'a Barbecue
P,1ssiness name- Ft r-M- C &i, Ik a-� s „ C ( h n Clothes dryer (gas)
Address, ) (p SD ALE l ei mh. -rLX Other
:%,12dMECHANICAL PERMIT FEES" .
1 ;a; C�,ity /State /ZIP Po c r\ A. / ( � 2 Subtotal
- hone (03 P 3 I ` 3 3 I I Fax ( 5Q3) gO p & ^ 61 9 Minimum permit tee ($90.00)
Plan review (25% of permit fee)
',0,8 he 1'U .70 30 State surcharge (12% of permit fee)
( l qqq TOTAL PERMIT FEE
Authorized signature. D T hu permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
pljjt name' 2 \rrl le _ Q \-- Date: /0 - - ap(/ * Fee methodology set by In- County BmWmg Industry Service Board
i ( ,gwarlipernaeaiEC PennittApppp doe 09 /09,10 440•4617T (1
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