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Permit CITY OF TIGARD MECHANICAL PERMIT 1111 ', " COMMUNITY DEVELOP Permit #: MEC2011 -00506 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/09!2011 Parcel: 2S103BC06300 Jurisdiction: Tigard Site address: 12132 SW LANSDOWNE LN Project: Robnett Subdivision: FYRESTONE Lot: 2 Project Description: Replace gas furnace. Contractor: CHASE HEATING CO Owner: ROBNETT, AARON & STACY 2236 NE 82ND AVENUE 12132 SW LANSDOWNE LN PORTLAND, OR 97220 TIGARD, OR 97223 PHONE: 503 - 254 -1274 PHONE: 541 - 543 -4133 FAX: 503 - 254 -1816 FEES Specifics: Description Date Amount Furnaces < 100K BTU 11/09/2011 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 11/09/2011 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/09/2011 $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 dir- • questions to OU by calling 503.232.1987 or 1.800.332.2344. Iss d By: / /' , Permittee Si 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. Application __ -- - - - - - 0 Ti ri•,l<,.,1- r -ic -i t st.:c.0:0 -- ------- - ---'- 11� g �� �! ltacaeved Permit No , a pp, IN y ® Tigard Date/13y. � ,, o��� 13125 SW Haft Blvd•, Tigard, OR 97' " Plan RovjcAv _ Phone: 503.718.2439 Fax: 50 ri rt% Dat*3/lar; Other Permit; I 1 ft .4 1.) Irtspectton Line: 503.639,4175 7 O� �� l Date Ready/13y: Lurie: See Page 2 for Internet www,tigard -or.gov r' G S \( Notified/Method: Supplemental la�forma ion � ,l• v' t %,f-,': 'i ' t : � i�"; ';' '+� i' •rx� a .r 3 Ef. 5.�+,rA�OiNE.Y (, t'' t � ,�' i. G�i -� i.,,, wry t� M R 1 .v ✓ b i' ' l+ 1. r�\ d- 1 ` '•, .:5 : t'.,. •�,k ' '' ,` '� ✓, �' obi ; � � Mechanics! permit fees are based on the value of the work ❑ New construction ! ddition/a1.tetap performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demoiiticm 0 Other: mechanical materials. equipment, labor, overhead, and profit. �'o. „ M � .: .[ :. '. „ . . , ■� ,t w'f. .; ' :2,' r: .t4,' @� �, �, }rte :,. ,. �• ^,,,., , ;. . r : ' ,,, � . ,. 1, :. .. ., .n.■.. 4 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For speetd 1nfnnatfan use checJdiLL ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total 41i :.$ V , . A}� ,, !( 1 > , „ „ r `, , • Heating/cooling: • ,� lY ' PO M A i ,M, r t .r % , Air conditioning Job site address: ,p — .4.../ / AI. , / . Y i (requires site plan showing Placement) 46 -75 --Ct477‹ , Furnace 100,00013 (U (duets/veins) L 46.75 City /State/ZFP: 7 [ A . • / V •• .. 23 Furnace 100,000+ BTU (dr>ci Jvems) 54.91' Suite/bldg. /apt. no.: Project name: Heat pump (requires site plan showingplaooment) 61.06 Cross street/directions to job site: Duct work 23.32 l-Iydronic hot water system 2132 Residential boiler (radiator or hydronic) 23.32 Unit heaters (Mel -type, not electric), in -wall, in -duct, suspended etc. 46.75 Subdivision: Lot no . Flue/vent for any of above 23.32 Other. 23.32 Tax map /parcel no.: Other fuel appliances: _ r 'i l:',,: �., 4 Y � .4x; ",. i•.•,y beater 23.32 t r ° , T,�t ( • ^ : .FI.04S' , ;:.! . •!•:';', '• ,�t cdS; ;; 1 \' l ,a' !'" .. k r).. • • Water Gas fireplace 33.39 fi r� '/ / rir i PIM/: Flue vent for water heater or gas lace 23.32 . :_/ •it►. 4' Lug liphur (gas) 23.32 Wood/pellet stove 33.39 Wood fire lace/insert _ 2332 , a Chimnc /liner /tiue/vent 23-32 : • . ')'!: ,''k' . . .. '�" y � :..,,. .; a , : ,�^ :,1,., , ..yn ;�ai:?�i.K,� %.,3 +.` -'"�: g '>, 't,'Sj'i:" '(.^ y A t.G. i 0 �"!.' v i 5 M � ` � 'w'.k ; , .; ' Q ; .. Y .0 .tl h tt 'i.,, 1} 9 ,', x ! : .. �,.- Other: 23.32 40 Name- L p I Environmental exhaust and ventilation: , ilia ) Range hood/other kitchen Address: / r -.orL . I • I / .. J.' / equipment _..,. 33.39 Clothes er exhaust. 33.39 City/State/ZIP: / / `)C Single -duct exhaust (bathrooms, Phone: ( 544 .. Fax: ( ) toilet compartments, utility room , s 23.32 ''',' •> M S ,��'4014P` :' ) ;\ ' , ' , . , , t, ,. ' r ` '' Attic/crawispacefans 2332 Other: 2332 Business name: ) nel, piping: Contact name: $14.15 for OW four; $4113 for each addidoual Address: Furnace, etc. Gas heat pump City /State/ZIP: Wall/suspended/tlnit heater Phone ( ) Fax: : ( ) Water heater l F'i - .lace E-mail: Au .,w.,. :r�''. ,��Y "'f 4ri'F t4:�.e s�r;Sc;.: ,;q \ ;, < r ; ' ' 9l ! ,7 ; r - r ' 1 �1 �' , ,,=4 i;,, ; t' B i ta t l • , ` f' T l , rc t t � Barbecue R : , .ClOtheS dryer (gas) Other Address: . ■ i ■ .. ./ l•. a , r a. igl �� ; � ' �, k �Hl ✓ j fi' l.h „ rtil .''' r I , � � ° r' k1N q .Tl,; / },' Y r ,n ; I 1a I / i /. AN .0. • - 4CJt� Subtotal Minimum permit fee ($90.00) q0 P Fax: ltaric- `� �� ( (25% '� t�7 � � -+• � � / � Plan revie (25/0 o£permit fee) + �. + © Ste surcharge (12% of permit fee) / i i TOTAL PERMIT FEE i p' I . 7 A Authorized si (e-l— This permit application e,ipirea if a permit is not obtaioml within 180 ] days after it has been seraph n as complete. Print name: 4 / / 2 ! i Date: ` {, 1 l • Fee methodology set $y'Pri- County Building industry Service Board tAraonisgq'ermitkaC- armitApp.dos 09/09440 440.4617T (11f02/com/w1318)