Permit 101/9// & pr s v 7 j //1/6-741 a
CITY OF TIGARD MECHANICAL PERMIT
'F'! - COMMUNITY DEVELOPMENT Permit #: MEC2011 -00554
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/02/2011
Parcel: 25111 AD16200
Jurisdiction: Tigard
Site address: 15042 SW 91ST AVE
Project: CARMICAL Subdivision: MALLARD LAKES Lot: 28
Project Description: Gas furnace installation.
12/9/11, REPRINTED permit to include gas piping for ram and fireplace.
Contractor: SUNSET HEATING & COOLING Owner: CARMICAL, PATTIANNE
0607 SW IDAHO ST 15042 SW 91ST AVE
PORTLAND, OR 97239 TIGARD, OR 97224
PHONE: 503 - 234 -0611 PHONE:
FAX: 503 - 234 -0439
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/02/2011 $46.75
Type of Use: COM 12% State Surcharge - Mechanical 12/02/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/02/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
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 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 0 :es .
41) VIP r,
��
Issued Bye .w— _ .. •ermittee Signature:
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.
CITY OF TIGARD MECHANICAL PERMIT
2 -'.. COMMUNITY DEVELOPMENT Permit #: MEC2011 -00554
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/02/2011
Parcel: 2S111AD16200
Jurisdiction: Tigard
Site address: 15042 SW 91ST AVE
Project: CARMICAL Subdivision: MALLARD LAKES Lot: 28
Project Description: Gas furnace installation.
Contractor: SUNSET HEATING & COOLING Owner: CARMICAL, PATTIANNE
0607 SW IDAHO ST 15042 SW 91ST AVE
PORTLAND, OR 97239 TIGARD, OR 97224
PHONE: 503 - 234 -0611 PHONE:
FAX: 503 - 234 -0439
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/02/2011 $46.75
Type of Use: COM 12% State Surcharge - Mechanical 12/02/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/02/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
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 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.
lap
Issued Byt - Permittee Signature:
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.
12/D1/ 2011 14: 01 50:32:341d4:3 SUNSET HEATING PAGE 02/02
. .
. .. . . .
Mechanical Permit Application I ir.012 0111( E USE ONLY
1 0 : - City of Tigard 0 ..0- Permit No • ,
i 3 ?ZS SW Half Blvd., Tigard, OR 97223
Phone: 503,639,4171 Fax; 503,598.1960 C
IN P13Il P.CV1CW
r 15 \\ Dam/BY: Other Permit:
k
,ildIA:6 Inspection Line: 503,639.4175 ,. true Ready/By: Jura! Iii See Pagel for
t‘e.i; •i Internet: www.lignrd-orgov CC- Gt .: N
- . , Supplemental Informatian
00 \
• ' • • ' . •...;'-' .:' ,:**' ;. '1 'i: • ks;: — 0:- .•','..:* .., ...... . •.::: ,',.:0Miiitt04Vigl!;!'§0..„.Y14,7.7.•:=4q• 09-4S
Mechanical permit fees* arc based on the value of the work
ID New construction jr,),ddii ion/alteration/replf performed. Indicate the value (rounded to the nearest dollar) of. all
LI Demolition 0 Other; , mechanical material& equipment labor, overhead, and profit.
' ' . ....:.:.. ' - ..•-' tkiidbiii( -betirii4ilitiCtiOI ''' : :'... ':.. '::: ' H :: Value: $
. • ' "; ' .. ' '-''''''' ' ' : '•." ''' . .......". ' .' ' ' '' v ' .. " - I(DigiiFSITUI • ' : kt i .tihigl i ■et : AVI'ais'Pt ..' .'
and 2-family dwelling 0 Commercial/industrial E] Accessory building
FM' medal information um checklist.
0 Multi-family 0 Master builder Ei Other; Description il_Lt Jy. Ha. Total
.. . • ::::: : is: :. :•..',.: V.* gii L `''0.) .1 40.0tti*r*.f .., :,'h: . 7::":::'.:: , :1 Ileating/cooling
Job site address: 16 01-42- Su.....) 7 Q-J- Ave..„
1 I- Air conditioning
(requires sile plan allowing placement) 46.75
.....--
city/Statc/ZIP: maid (L e7-12?-LY v , Fumacc 100,000 BTU (ducts/vents) / 46.75 AL:75
Furnace )00,000+ BTU (film/vents)
Suite/bldg/apt, no.: Project name: \ )Q'T c' 1` \ ...E 6
,4 .
Cros5 streetAlireetim --- a 10 job site: Duct work 23.32
.,
hol._.
--
CV) H rank; 1_ 23.32
— 4 o k U k iikt., ,
Residential Wier (radiator or
hydronic) 23.32
----_r '.1
Unit heaters (fuel-type, not electric),
— \r),\-17* 'O
r)( ,-.(/
Cw . (A 0 ---- -- in-wall, in-duct, suspended, etc.
Flue/vent for any of above 46,75
—
23.32
Subdivision: At:4
.
, if ..• ".: •
Other . _I 23.32 ._
Tax map/parcel n6 • Other fuel appliances -
Water heater 23.32
_ . .. < Gas fireplace
__ 33.39
I c ., A 42 -
a4:a1/16 Flue vent for water heater or gas
__. IL
fire ilea 23.32
' Log lighter (gos) 23.32
Wood/pellet stove 33.39
Wood fircylnec/iniiert 23.32
,; ••••• ,71,Ti 2332
, • .• • ,., , .. : , - •`!"" Chimney/liner/flue/vent 23.32
. ROiltn-ty OWNER c •• ,:..:';, k: c .i. t:tstP.- - -1....•: . . , ': .. .• . :i ., • . : . : .•..:7 Other:
,—.-- . _
N ff ..... .... co ,,:)'T Environmental exhaust and ventilation
— Range hood/other kitchen
Address: I CYO_ 3 equipment 33.39
— ..._._ •Ir— -
(,:ity/.5intor/.11711Xtai,_ Oe...,9 11 3-?-t Clothes dryer °Outwit , 31.19
— Single-duet exhaust (bathrms,
oo
Phooi.i: ( 56_62 _. /5 (‘) 3 Fax: ( ) . toilet com)artments, utility room!) 23.32
. • El Aillxiiiitv .:-:::"•:.:.....‘: . Attle/cnnvispace fans 2332 Othcr , I 23.32
I liisineAs name:
. ,. _ Fuel piping_
C itcl name: $14.15 for first four; $4.03 for each additional
Furnace, etc.
Gas heat pump
Cily/Statr/ZIP: Wall/suspended/unit heater ,
heater
Water ae
l'holic• ( ) Fax: : ( ) ... .
— - Fireplace
...... _____
: :: : : - :'' : '..;:••,COr 4 Tt A C 1 »t *.• .:. :'. ..., ..'-. , • ,• : •.., . ., ... y••. ,• .,:. , • Barbecue
---
I3usiness name: Clothes drycr (gas)
.SILI1 Set Lie...et:A-1A( c. crpt I
.... _ Other;
Address: 0(170 5j 1 ((Ail r . iree,',1". ..:, : :.i::.:46ewitta ;...• . . .
City/Statc/ZIP: P ty tr2,' 0117 31 Subtotal
Minimum permit fee ($90.00) • Phone; (cibj) 2.7)■-ii-t.)11, 11 F 26r- (5D3 ) Z- .34 -0 , Y) Plan review (25% of permit fee)
CCB lie.: i ( 0 FS „,,,--) . .r<11 —
State surcharge (12% of permit fee)
TOTAL PERMIT FEE
- ,fitaL
This permit application expires Ira permit is not obtained within 180
Authorized signature: s- days after it hos hrrn accepted ns complete.
Print name;
A 1 IA , ' *eze) Data; I /dij , " Fcc methodology set by Tri-County Building Indusfry Set-vies! Board
A4.1.44111' ts • revurnnArumn■
12/01/2011 14:1 5032340439 SUNSET HEATING PAGE 02/02
Mechanical Permit Application FOR o VFICE LSE ONLY
: - City of Tigard '01•44C
...c.) Received
-, ' " 13 i25 SW Hall i3lvd., Tigard, OR 97223 pmait Oh /// ATT-- Permit No
,, Flan Review
■:''. , ' ^ ' , Phone: 503.639.4171 Fax: 503.598.1960 C
I II
1 . 0\ Dated3y: other Permit:
fitari inspection Line: 501639.4115 \. „pate Ready/By: kris: El Se,e Page 2 for
9 :;••9 •':..:.,' Internet: www.tigard-or.gav c., lAk"11 ' ed/Methed: L'1.6, Supplemental Information
, • . .
" ' AT . : ,. : . ,k 1 , . , ' '. :'' . .: , 'titiMi4tittiitii&:80 ti .
Mechanical permit fees* arc based on the value of the work
0 New construction ldttion/alteration/repni performed. Indicate the value (rounded to the nearest dollar) dell
0 Demolition 0 Other: mechanical materiels, equipment, labor, overhead, and pLofit.
• $
. .. : ;:' ''' . ' S,.: tkii4bikit:iii'HNS*Ar.JeililDI , .:1 ".. ' .::, ''' . ' ,: ' .• • „ ... alue . . . . .
• • '. •••• '• 0 .• , . ' . • . - ' —..-....-----..— — - - - — ..'.: i' .. ilidkiiii .V
14titA.i its4 •
and 2-family dwelling 0 Commercial/industrial p Accessory building
Foi. special irtformation use checklist,
0 Multi-family 0 Master builder 0 Other; Description .• I QtY. I sa. J Total
JOB , 40.6itmtii:&4iii;i06iitt(W.: ?': Hr: ,,: .:,,...., .. =:'.., Heating/cooling
. . ,
..or i , Air conditioning
Job site address: )6 01-49- sc.,...) (,v,,it,.., silo plan showing placement) , 46.75
-ti
city/State/VP: t
........--- iald —7 Furnace 100,000 EITU (ducts/ven(s) / 46.75
, CX__, e l p-d
Furnace 1 00000+ BTU (Ibets/yenta) 54.91 _
Suite/bldg./apt. no.: Project name: ..Sis_etplmip__________T__226.____
. „,.
c..05, su-ccudirectimm to job site: Duct work 23.32
flydrOniC hot waterlystem 23.32
Residential boiler (radiator or
hydronic) 23.32
— Unit heaters (fuel-type, not electric),
in-wall in-duct sus•ended etc. 46,75
Flue/vent for any of above 23.32
Subdivision: Lot no.:
.-- Other: 23.32
Tax map/parcel no.: Other fuel appliances ._
" 7-----7 7 ' ..::. ',- .,.,:bts •.:,. , , .. : .: , ., ; ,. : ; f;i , ;,,•.:., Water heater 23.32
33.39
Flue vent for water heater or gas
fireplace 23.32
• Log lighter (gas) 23.32
Wood/pellet stove .. 33,39
— Wood firsplece/insert 23.32 .
Chiraney/linerfEtte/vent 23.32
_
, PR cjitRty . .tiWi.0:::., : ' ...';. 1. ::. : . 1:1'.:107Mf Y, ...'
.. ......_____ .:■.....; — • • . Other: 2132
a
Nme: 64-11_,,, , „, AA __Ca6 d ,
Environmental
...__........______ ..,9...,... . exhaust and ventilation
Range hood/other kitchen
•\'iriress; 1 ..e., nct 1 c...6,...)____,51.1314.. equipment 3339
.._ ......_. t •-•• •-•-' et —
C2_ 6 11 o-gY cio,lief; dryer exhaust 33.19
Single•duct exhaust (bathrooms,
,
Fax: ( ) . toilet compartments, utility rooms) 23.32
El A :'. ' .,' : .' :. 1 '' ': ,..,: ',:1 :': Attfc/crawispace fans 23.32
Other; 23.32
Rosiness name:
. . . ..___. ,. . Fuel piping
Conl aci name: 114.15 for first inuri_14.03 For each additional
-----
-- ' Furnace, etc.
/■., it
Das heat pump
Ci:y/Stair/ZIP: Wallislucodcd/unit heater
. —..
t
h
ter heater
l'ilinic • ( ) Fax: : ( ) Wa .. .
Fireplace
F. Rartge
._._ — ...
•'' ..; : .. '.!'.:!;!,.: 0**,1*1161t. ''. ': ,:, , ,%: .,,;:. .. ::,• : Hathecue
Clothes dryer (gas) --]
i3usiness name: .S1.■fli Set ii-le.echoV, ‘i''. Com 1 to .
— Other;
Address: (3170 5 ut., 1 c.11 0 ' : iree,j .: :.: :: .:•:;! • . . .
City/State/ZIP: f ty“ A ivide L co A 1 z y1 . subtotal _
Minimum permit fcc ($90.00)
Phone: ( .f 2 -Dip I 1 Fax: (5U3 ) i 3 -. 0.L'Yl Plan review (25% of permit feel_
--
CCI3 lie.: 1 1,1 0 F5 _-.---") ..`",(7 State surcharge (12% of permit fee)
• TOTAL PERMIT FEE
This permit application expires Ira permit is not obtained within 180
Authorized signature: days after it has hren accepted as complete.
Print name : "" 6 :. ,,, , ,,, 4 „ 4 „,
I Date: I 2 4 li / Fee methodology 'set by Tri•County Building Induery SCI Board
,
,f AA A411n rii orom-nnnrumn1