Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 00045
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/20/2012
Parcel: 2S112AC01300
• Jurisdiction: Tigard
Site address: 14905 SW 74TH AVE
Project: Rivas Subdivision: FANNO CREEK ACRE TRACTS Lot: 18
Project Description: Replace gas furnace.
Contractor: WOLFER'S, INC Owner: RIVAS, ERNIE
290 YOUNG ST 14905 SW 74TH AVE
WOODBURN, OR 97071 PORTLAND, OR 97224
PHONE: 503 -981 -4511 PHONE: 503 - 347 -4677
FAX: 503 - 981 -0801
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 01/20/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 01/20/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/20/2012 $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 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: OA} �14 / / Cf7 770
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.
•
JAN /20/2012/FRI 09:05 AM WOLFEAS HEATING FAX No, 5039810801 P.001
Mechanical Permit Applic ' r i FOR 01'1 ICE USE. ONLY
City of Tigard - l q Dat U . �eo20 / 0
Received / ozd .. a Permit No O
' l 13125 SW Hall Blvd., Tigard, OR 97223 Pl y , $ev
IIN
Moue; 501639-4171 Fero: 503.598.19` Other Permit:
Y AN 2 0 2012 DateB
T I GARD Inspection Line: 503.639.4175 Date Ready/Br Jude: El See Page 2 for
Internet: www.tigard- or.gov l'toti6ed/lvlethod: Supplemental Information
CITY OF TIGR RD
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tatl rs, .+hivd 7 �' .. •� � , ;lE'dt, `,>✓�o u�i2ti, •/
['New construction . ® Addition /alteration/replacement
performed. apical Indicate are based (rounded to the nearest the value of the work
performed. Indicate the value (rounde d ollar) of all
❑ Demolition ❑ Other: • mechanical materials, equipment, labor, overhead, and profit. -
h�.i w, «, w w"», y` �1 , Ili ��,q�wx, ,f H w y Value: $
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LEI 1- and 2- family dwelling ❑ Colzam.ercial /industrial 0 Accessory building III'
For special information use checklist.
❑ Multi fa . ❑ Master builder CI Other: Description I Qty. I Ea. I Total
e a�ts tI g r' lc,# ;, t ,§ firaggs,. ` 0' a' , "i I t ''' ,Beating /cooling .
Job site address: 14905 SW 74' Ave Air (requifires res site plan ti plan
showing placement) 46.75
City/State/ZIP: Tigard, OR 97224 Furnace 100,000 BTU (ducts/vents) 1 46.75 46.75
Furnace 100 ,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: I Project name: 57289 , Heat pump 61.06
Cross street/directions to job site: . • . . Duct work 23.32
Hydronic hot water system _ 23.32 _ __ _
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel-type, not electric),
in- wall, in -duct, suspended, etc. 46.75
Flue /vent for any of above 23.32
Subdivision: • I Lot no.: Other 23.32
Tax reap /parcel no.: Other fuel appliances •
C *; "a' ' ti " . rrf , Ate rip i Water heater 2332
@ o %; y 2 ,M. •J S 1 h tf I• , 0 . • a 0 t ti ,. ;m �' fi f° •
fl w13 bms . �. ». ts r� ;'a,rix•FK • 33.39
Installing new gas furnace replacement Gas fireplace
g g P Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32 .
• - Wood/pellet stove 33.39
Wood fireplace/insert 23.32
^ .. »W , »»„ i lib; , � i w », ry1 > . �, Chimney/liner /flue/vent 23.32
41:';:i.,'11:714' i : (l . 2 » 1LF1I r ,» »rM r S t E r ® r ` FL . ∎ r r ,r
,. � t .. , �,"% »i ,» + . , � , � � , r1 : ., 4 . • mil Other: • 23.32 ■
Name: Ernie Rivas - - Environmental exhaust and ventilation .
Address: 14905 SW 74 Ave Range hood/other kitchen (
equ 33.39
•
City /State /ZIP: Tigard, OR 97224 Clothes dryer exhaust 33.39
• - -- Single -duct exhaust (bathrooms,
Phone: (503)347 - 4677 Fax: ( ) • toilet compartments, utility rooms) 23.32
""', ,, } �7� ,fir u "' . �" ti Attic /crawls ace fans 23.32
Ni M X� {{ m R p # ,° 1T 1 9 1I 0 p
Other: 23.32
Business name: Wolfer's Heating - Fuel .1d _
Contact name: Jennifer Winningham $14.15 for first four; $4.03 for each additional
Address: 290 Young St . . Furnace, etc.
Gas heat pump
City /State/ZIP: Woodburn, OR 97071 • Wall /suspended/unit heater
Phone: (503) 981 -4511 Fax: : (503) 981 -0801 Water heater
_ Fireplace
E-mail: jennifer@wolfersheating.com Range
Hag n r �� xn », a nd t
"ei" i% !z' » i u. fl it ',•+.S'�nu sr�l vn�u' x �t'� 6 6 5 ' iiN«YY6d %'n' ,1 Barbecue
a k ,•• . �a w5 Owl h lJ � r t y�;r, ifiAix � IA 'i . • �"''Yk
l�Ml�d�t�!,���ik� Fdl ,�� »�;�5'M�krlr���P�wa�i�Ws+ rya: �*', �,klY�' �:° 3v° �,.! ���I��@ Ikl�tl� "I�'�lill;�'" a••M; �
Business name: Wolfer's Heating
Clothes dryer (gas)
Other:
Address: 290 Young St iRii l is ii`: i �' ii , `?,Y! "! ! 1?! ?4 ' V;u V i' ,;
City /State /ZIP: Woodburn, OR 97071 Subtotal 46.75
Phone: (503) 981 - 4511 Fax: (503) 981 -0801 Minimum permit fee ($90.00) 90.00
Plan review (25% of permit fee)
CCB lie.: 1911 State sur (12% of permit fee) 10.80 %
1.
TOTAL PERMIT FEE 100.80 !/
t f ", , , This permit application expire if a permit is not obtained within I8o
Authorized signature: U1 A ll l days alter it bas bean accepted as complete.
_ Print name: Jennifer Winnin VVV ��` Date: 1/20/2012 n Fee methodology set by Tri- County Building Industry Service Board
Li t/ idirketPennitsVvIEC -PennitApp.doc 10/01/04 440.4617T(11 /02/COM/WaB) -