Permit _„ CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00581
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/16/2011
Parcel: 1S136AD03700
Jurisdiction: Tigard
Site address: 10660 SW 71ST AVE
Project: ANDERSON Subdivision: VILLA RIDGE Lot: 5
Project Description: Furnace installation.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: ANDERSON, CHRISTOPHER W
PO BOX 241 ANDERSON, MEGAN
DUNDEE, OR 97115 10660 SW 71ST AVE
PORTLAND, OR 97223
PHONE: 503 - 691 -9699 PHONE:
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/16/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/16/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/16/2011 $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.
Issued By Permittee Signature:
_ice _� _, , _ «
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.
12/15/2011 17:18 503-691-8558 OREGON HEATING PAGE 01/02
.
Mechanical Permit Applicat - ) '1,%\\ FOR OFFICE USE ONLY
Received ______ -
w 13125 SW Hall Blvd., Tigard, OR 97213
L, , A Plan Review
l '' Phone: 503.639A171 Fax 503.598.1960 ,t/sC(*( S • :i0 \-' Dat Other Permit;
11 G.A.RD c/13y:
Inspection Line: 503.639,4175 Date Ready/By: lurk: gi See Page 2 for
1 'Ce °
Internet: www_tigard-or. 0
gov Notified/method: • N ....4 - Supplemental Information
• : • : •..: • .',. :' ? • " ' ,:. ... : . ' • 'TYPE, OF WORK ''. ": . • ... : : •: "• ‘: : ..00 OCIC E P4 E .: 11 $'' . 0f.04 1 -iIST I
Mechanical permit fees* are based on the value of the work
CI New construction kri Addition/alteration/replacement performed. Indicate the value (rounded to the nearest tloilur) of all
0 Demolition 0 Other: , mechanical materials, equiriment, labor, overhead. and profit.
CATEGORY or CONSTRUCTION _____ Value: $
- ::..., • • - • • • - :: :: ::: • ' ' • "' ' - . ''''; ...
jr1- and 2-family dwelling El Commercial/industrial 0 Accessory building
For :pedal information use checklist,
ID Multi-farnily 0 Master builder 0 Other: Description Qty. Ea_ _ Total
: . .. „ .,. ..
; :••':. '..., ' :, . ::: ,;•:;;:,:.;;,"•:: ' JOB 'an": INFOR.14101ol'il M1) LOCATION .: ':, . ': •• . : • : ....'• •;:•:. ,'' Heating/cooling
Air conditioning
Job site address; 0 C6 c) S W 7to Av ( 'r. v .i,e, site plan showingplacernent 46.75
City/State/ZIP: 77, „,i. 0 g q 7 2 . 7 2 . Furnace 100,000 BTU (doets/vento " 46_75 ' GI 7-S
. Furnace 100 000+ i3111 ducts/vents) 54.91
Suite/bldg./apt, no.: Project name; - 0 C) : Heat pump 61.06
Cross street/directions to job site: Duct work 23 32
.
Hydronic Jot water systcm 2.3,32
Residential boiler (radiator or
11 cir°ac
Unit heaters (fuel-typc, not electric), —
in-wall, in-duct, suspended, etc. , 23
Flue/vent for any of above 2132
Subdivision: Lot no.: _,
Other: 23.32
Tax map/parcel no.: Other fuel applances ,
..,-,.,, ...-.,.y ,, .:..;. ::•„:,•,:. tajtdbiiiiii0:,0 'WORK :,:.:::' :.,.; ; •,, , ,.::•; W ater heater 23 32
_Gas fireplace 33.39
. Flue vent for water heater or gas
fireplace 22.32
Log lighter (gas) 23.32
W ° 9 clip t Il et stwe 33_39 ,
Wood fireplace/insert
•.. ,.. 23.32
Chimney/liner/flue/vent
• 23.32
:•:,:,:,.::'„, i ';'''".',, !:' • . , l' ' " ‘ .: • fr . .fii10 . ..';‘. ! .::"' ';' other. -
23.32
Eovir exhaust and ventilation
Range kitchen
Address: /0 C 4 SW 71 ' 'Ire equipment - 33.39
City/State/ZIP: y , , 4 a r - 7 2 23 Clothes dryer exhaust 33
Single-duct exhaust (bathrooms,
Phone: (S () q. - q 1 1 I Fax: ( ) toilet compartments, utility rooms) - 23.32
2 23 3 . 3 32 2
IIIIIIIIIECEPMIEIIIIIIIIII ,•:: '.: "::;:' ,.' d(0*0.* ;:,:: ,:;,, Attic/ciawlspace fans
Other;
Business name: 0 io , , , i t , el 4 ir• II 'T ; , Fuel i,in•
• . 114.15 for first four; $4.03 for each additional
Furnace, etc. L
Address: 1 .• a 0. 5 . ie/ . 1 Ti itkee
GU heat pump
s - • _
City/State/ZIP; 'fa. tt • at " 4 ' 1 0 6 2 Wall/suspended/unit heater
. Water heater
Phone: (5 - 01 ) 0 i_ ‘ , Fax; ; ( )
Fireplace .
E-mail; Range
:...'`: ':"':';4J; • ''...":"..: ::.; ' "•." • : !" :'.•:.....:' ,.•:•":":' ONTEA)ETOE". . ':' : ';' :• : ,;',: .. ' • : • , ; :: ...::, Barbecue
Clothes dryer (gas)
Business name:
Other:
Address : '''' - HI e, • S et hicnre - ''` ‘‘
City/State/ZIP: , Subtotal 4C
1211 , brng!u1npen y_omit fee ($90.00) , 94:.
Phone: ( ) Plan review (25% of permit fee) .----
FINEEMESIE!ilMilliffiliMilIM : State surcharge (12% of permit fee) / 0, ii
TOTAL PERMIT FEE ,Co. 70
- . This permit opplicatiOn expires if a peralit is not obtained Within 130
Authorized signattre: ... : , - days after it ba t. been accepted as complete
Date: ./2 h's" 4 T'oe methodology set by Tri.C.ounty Btilding Industry Service Board