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Permit CITY OF TIGARD MECHANICAL PERMIT a : • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00122 Date Issued: 03/07/2012 T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 1S135DA02701 Jurisdiction: Tigard Site address: 11260 SW 90TH AVE Project: BROYLES Subdivision: GRAHAM ACRES Lot: 29 Project Description: Gas furnace replacement. Contractor: WOLFER'S, INC Owner: BROYLES, JENNIE A 290 YOUNG ST 11260 SW 90TH WOODBURN, OR 97071 TIGARD, OR 97223 PHONE: 503 - 981 -4511 PHONE: FAX: 503 - 981 -0801 FEES Specifics: Description Date Amount Furnaces < 100K BTU 03/07/2012 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 03/07/2012 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/07/2012 $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: ? LO* 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. MAR /06 /2012 /TUE 02:47 PM (OLFEAS HEATING FAX No, 5039810801 P. 001 Mechanical Permit Application � FOR OFFICE USE ONLY 1111 C125 W Tigard ` D 3 ©ili r�7 .�1 _ i • _ �: 13x25 SW Ball Blvd, Tigard, OR K �1 Plat Review _ Phone: 503.718.2439 Fax: 503.59 - t 01 Date/9Y Other Pima* • T I c; A R D Iaspeetion Lim 503.639.4175 6 Date Ready/By: RI See Page a for Internet: www.t Bard -or gov O � \GR p Noti ed/Method: MI Supplemental Information a 0' _ i ;• r , -F , . V.T. , . :- ,l 1' n j 1j:,. -, , r . o ��'.7f �r " ti i�:ij 6,t.r.fw.. i . � l {f r . 4 .. `,r w -1 a t4% - .,,. 11rA..;Hi -r i , ,' < z, :_ : . .. .1 � .�, .�1 , S �C'r l - c l i k e f� m s� *4 r, . n L, - . - ... r • r n J *" Mwh pQrait fees' are b value of the work ❑ New construction ►�� Addition/alterati • ?.0 , - .. cement . performed. Indicate the value (rounded to the nearest dollar) of all . ❑ Demolition ❑ Other. • . mechanical materials, aquipmenk labor, overhead, and profit J9 d'i- 44f t6Sr•° .., w,r� , �, i,_ y i .., T � Value. ,D cZo Oti a c o r. ,. s 4 t; t :c6 � .. + ' . � i ..:It ti*r�,iri^ •y.�- ,r•,ol .. ]>'r }v ^;e2.�: �. �..a �'�. ..� .� .iw.._a,. �.. "y'� . u� yr, �..„ : ,: -u ® 1- and 2- family dwelling 0 Commercialfmduabtial ❑ Accessory building r For epeda[information use chec*L . ❑ Multi - family 0 Master builder ❑ Other: Description I Qty. I Ea. I Tel *i i t a i w r - r -, err F' en:• l i '..!''','..:4.", Heatinp/mang: s} w I+.�r1 { "i c� i a t4b ?lr �a�ta c crr.s o „� 1w� i4 + �.� 1 y r Air conditioning Job site address; 11260 SW 90 • • (requires site Mae showier; elacemem) 46.75 City /StatelLiP: Tigard, OR 97223 Furnace 100,000 BTU (ducts/vents) 1 46.75 46.75 Furnace 100,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt.no.: Project name: e v Heat pump I v (requires site plan showing placement) 61.06 . Cross street/directions to job site: r 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, inn -duct, suspended, etc. 46.75 Subdivision I Lot no.: Flun/vent for any of above 23.32 Other. 23.32 Tax map /parcel no.: Other fuel appliances: ;•47- r `, y, h c F 1 e 9 1j?+n • " ° , � 1;- ?' .�,i} � a a , " ^4.-L'. r= Water heater 23.32 r. �a +gin. . .._r.J.r. ac_ fir • Replacement of Gas Furnace fireplace 33.39 Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) ' 23.32 Wood/pellet stove 3339 Wood Sre�p�lla�c&h s 2332 • �ert vent X3 'J -, J -- ! - : ` ' ` N nT^� t• r'y .I • J A . 7 t v { L r -&-,1.---)--7.. . / ; 4 _ , c ' , :. Chimney /hn &thi& 2332 • • Other. 23.32 . Name: Jennie Broyles • Environmental exhaust and ventilation: • Address: 11260 SW 90th • Range hood/other kitchen eneipme It 33.39 • City /State/LIP: Tigard, OR 97223 • Clothes dryer exhaust 33.39 Single duct exhaust (bathrooms, Piton= (503)668 -1217 Fax: ( ) 1 toilet compartments, utility rooms) 23.32 : Ip a xw -,,, ..-„ .l :.. RIM e F tvr , ol� l ' - - • At[ic%rawls 23.32 .r?l.�l', 3 r '- , i+�i't�kl.Ye- 'G..nry n�,Z 1 , y....:5:. -.. y .. Business name: Woifers' Heating Other 23.32 Fuel pipit Contact name: Jennifer 514.15 for first four; $4.03 for each additional I Address: 290 Young St Furnace. etc. • Gas beat pump City /State/ZIP: Woodburn, OR 97071 Wawsuspendedhmit heater ' Phone: (503) 981 -4511 Fax: : (503) 981 -0801 Water heater E -mail; jenpufer(r�wolfersheating.com Fireplace Rauite 41f . r ', .:4'1,`-i `G t. ®'07 Otto ' 1 7 " � u ' tt -..:.1 ' Rarbeme Business name: Wolters' Heating Clothes dryer (gas) . - Other Address: 290 young St • a, ,^ ; •rr e . ,r i r. I�` City/State/ZIP: Woodburn, OR 97071 Subtotal ' 46.75 Phone: (503) 981-4511 Fax: (503) 9814801 Minimum permit fee ($90.00) 90 Plan review (25% of permit fee) CCB lic.: 1911 t /� . . State surcharge (12% of permit fee) 10.80 • J , / l / // V �_� TOTAL if FERMI' FEE 100.80 Authorized Sigtla tl�l� ((l..r/ /U /lJ� Th in permit application expire; if a permit is not obto reed within 180 day? utter it has been accepted ad complete. Print name: Jennifer Winning a te: 3/8/2012 * pee methodology set by Tri- Coutuy Building Industry Service Board 1: tduMinelPeusttsltaC- PeraitApp.doc 09/09 /Ie 440.45171'(11/02/COM,W2B)