Permit CITY OF TIGARD MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00109
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/29/2012
Parcel: 2S112CC13300
Jurisdiction: Tigard
Site address: 8493 SW BONAVENTURE LN
Project: SCHULTZ Subdivision: TANIA PARK Lot: 8
Project Description: Furnace installation.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: SCHULTZ, KRISTINE B
PO BOX 241 8493 SW BONAVENTURE LN
DUNDEE, OR 97115 TIGARD, OR 97224
PHONE: 503 - 691 -9699 PHONE:
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/29/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/29/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/29/2012 $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: r l � !! _
`i /rte /�'/ �9 /i T.�rian
Call 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.
02/28/2012 15:15 503-691-8556 OREGON HEATING PAGE 01/02
Mechanical Permit Applicatio e FOR OFFICE USE ONLY
City of Tigard ets'
6 ■ 1
O
% % " Received
Dme/By. , ATAAM Pftmallo.: 1,4.— • • 10'
,...... ,._
!p ..-- 13125 SW Hall Blvd., Tigard, 0 , Plea ReNiew
Phone: 503.639A171 Fax: 503. 8.1960 et - p -1.3 Date/By: Other PenZit
TIGARD Inspection Line: 503.639.4175 ' '. c\ 3 % V Dale Rawly/By: 62 Sao Plage 2 br
Internet www.tigard.or.gov ,st 4S.N Noti6caltalethod: En Supplemental Issionnadoo
-
' • . - • • • .• . • • • • •
TYPE OF woktk•V • . . . • • ... .. ..... .. . . OoliOnii K* -- 4
im. •
. ... ..... . . .
st•' Mechanical permit fees* are based on the value of die worie
El New construction AAdditiOrealterationimplaccmcnt perfcemcei, Indicate the value (rounded to the nearest dollar) of all
ID Demolition O Other mechanical materials, equipment, labor, overhea and profit
Value:
._______CATEGORY1 '.• ' ....).
All- and 2-family dwpnine 0 commerciayindustriai n Accessory builiting
For special ft:fair:orlon use checklist
0 Multi-family 0 Master builder 0 Other: Description J i Qty. I J Total
' ,.:'....::::'..",• . : •%•.' ... F:•. .• ;MB SITE INFOR1121010 il4D.ILOCATION -; 2 : . •'. .% .• . :::: : . - Heating/cooling
Air conditionmg
Job site address: g SW gn,ve Lone. (requires site plan showing placement) 46.75
City/State/ZIP: r at. OR V 229 Pomace 100,000 BTU (duets/veers) J 46.75 1/6 gr
•.) I Furnace 100,000+ BTU (ducu1vente) $4,91
Suite/bldg./apt. no.: Project name: /2 - 00 7 ty Heat purnp 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 (fild-type, not electric),
in-wall. in-duct suspended, etc. 46.75
Flue/vent for any of above 2332
Subdivision: . I Lot no.:
Other: _ 2132
Tax map/parcel no.: Other fuel appliances
5::::::.>,..':::•.P.,.1*Oili#O.,10Ci#:#5*.:;-;',,.•in:. ••;;;.y. Water beater 2332
Gas ftseplace 3339
l i/fa I/ Fie 6-ri d ee • . Flue vent for water heater or gas - fireplace 23.32
— Log lighter (aas) 2332
• Wood/pellet stove 33.39
Wood fireplace/insert 23.32
2332
s ' - •` 4. ' 6' ."--'• • 20.47iiii 1:41: , ...,.......,..:L:::. , •-`, • ' ' ' - ...,,,.....-..::. Ch_LI EPA flineefluchent
-; • - .,,,-..: 4 - . iki; . ... A. 1134mr.., .. . :: .......,..7.,• • e,• ,••• ,. .; - .. .... .. . „:- ,•• '-'...:::, -.•‘• - :: , other 23.32
Nanie: Environmental exhaust and vendladon _
Range hood/other Icitchen
A dd11385: ?act? Siff emathhi-ta-d. tore equipment _33.39
City/State/ZIP: 771 g 6,4 0 iz 17 2_,_2/ Clothes diver exhaust 33.39 _
Single-duct exhaust (bathrooms,
Phone: (SU3 ) e2 f._8•6 02 Fax: ( ) toilet compartments, utility roOmS) 2332
. ; ' :: ...; .: .:,:.: J r. ... ........ ' .. ,. 0 ..ecOricepEitgoN ..7: .. ,....:,..; Atticiciawisliacc foils _ 2332
Rosiness mama: 0
, an . /1.0%/12 . 7. am,/ /I Fuel piphrg
Contact name: 2g,e,ft' Gaily e4- 314.15 for first four: $4.03 for eacb additional
Furnace, etc,
Address: /9100 ,p,../ lla'ffb ,el
Oas heat remm .
City/State/ZIP: r.; w A tie. Oit 1 10e2 Wall/saspendeeVunit heater
• Phone: (-CO Cil - licl 9' . 1 Fax: : ( ) . Water heater
Fireplace •
E-mail: Range _.. . .
'''f'''.`'" . :? ' • - '-'''' •" ''''.•:.'''' CONTRACTOR '' ' • "... ..:' ., ' • • : ' -s • Barbecue ,
. .
Clothes drye_r(r,p
Business name: — -S fli.e... 0 s a 60.-e,
Address: . ,, .,..:. ..;......,. . ...'_41ECEIANICAL .., , . . ... . " .. • :: • , ,„
City/State/ZIP: Subtotal 4'': Fr
Knimum permit fee ($90.00) 90. 00
Phone: ( ) i Fax ( )
Pte review (25% of pamit fee)
CCB lic.: f--4 . State surcharge (12% of permit fee) /ago
- TOTAL PERMIT FEE Alp . yb
Authorized signature; . .- • ThiS penult il ppliez 'ion expires if a permit is sat obtaincd wisbin iao
der after it has bees accepted at complete.
— * TIM menwInInov eat h. Tri-r.remtv Anilrlinc. harhuery Service Baud