Permit •
CITY OF TIGARD MECHANICAL PERMIT
a.: COMMUNITY DEVELOPMENT Permit #: MEC2012 -00132
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/1412012
Parcel: 1S133DB02200
Jurisdiction: Tigard
Site address: 11593 SW 134TH PL
Project: SOLOMON Subdivision: BRITTANY SQUARE NO.2 Lot: 46
Project Description: Gas furnace replacement.
•
Contractor: SKY HEATING & AIR CONDITIONING, INC Owner: SOLOMON, CHRISTOPHER L & LAURA L
1637 SE NEHALEM ST 11593 SW 134TH PL
PORTLAND, OR 97202 TIGARD, OR 97223
PHONE: 503 - 235 -9083 PHONE:
FAX: 503 - 235 -0454
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 03/14/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 03/14/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/14/2012 $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: r rmittee Signature: / /
Call 503.639. 175 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.
03/13/2812 @8:47 5032350454
SKY HEATING AND AC
PAGE 02/02
Mechanical Permit Application --"' HR 11141( I I NI, ()NI:\
City of Tigard eV 061° Rccr 3 Aram Pt:matte.: C, etti3,
14 13125 SW Hall Blvd.. Tigard. OR 9 , . , .zi k _
I ' Phone: 503.7182439 Fax 503.598. 'Fe.
ilh fe °tiler Pcrmit
I I ‘ Inspection Line: 503.639.4175 \`‘\‘'‘ • '\‘'`..t4 Dam R01 Atm; El see Page 2 for
.:,:!:i)
roomer www.tigard 0% V Noti hod: .-1----6, Supplemestrit Information
Mechanical penult foes" aXc based on the value attic work
0 Now consttuction la Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition El Other: mechanical materials, equipmait, labor, overhead, and profit
Value: $
t .,- ./,-, - ', '.::,,;.;. " - .x'''.laWI.PAPMEP1-040,110.S.114W$0110.F.C.1::'-'
1:31 1 - and 2-family dwelling 0 Commercial/industrial 0 Accessory building For spedel Wawa= we otedlist
1:1 Multi-family 0 Mager builder 0 Other; nescription I QtY• 1 EA 1 Total
I Pr i f ron e r i ! W
lob site address: 11593 SW 134 Place (requires site &placunctitl 46.75
Femme 100,000 BTU (dads/vents) I 46.75 46.75
City/State/ZIP: Tigard, OR 97223
Furnace 100,0004- STU (dows/writs) 54.91
Suite/bldg./apt. no Project name: Solomon • Beat pump
(requite rite plan showing Oheemort) _ 61.06
CrOtg Street/directions to job site: Duct work 23.32
Bydronic 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
Subdivision: Lot no: Floc/vent ibr any of above 23.32
Other: 23.32
Tax map/parcel no.:
Other tel appliaacee
Wathihcatcr 2332
Gas fin:place/insert . 33.39
Replace gas furnace, reconnect to existing ductwork, electrieal and gas line.
Flue vent for water hemmer gas
fireplace . 23.32
Log lighter (gm) 23.32
Wood/pellet stove 33.39
Wood fireplacermsert 2332
;,:.i ::•:,:..errHiSlilttikOi*k . 1:. '' ': ::'' ., .; :.: . •,.., 2 , .7 Chimaty/linalflue/vent 2132
2332
Name: Chris & Laura Solomon
Environmental exhaust and ventihition;
Address: 11593 SW 134 Place Rangc hood/other kitchen
__ equipment ' 3339
City/Suitc/ZIP: Tigard, OR 97223 Clotho: dryer exhaust 33.39
_
Singe exhaust (bathrooms,
Phone: (971)255-5628 Fax: ( ) toilet compartments, utility moms) 23.32
. .. 1 :'..'.. 'S : .1 - :''AP***0 0 0 .4 . 4 t : '.' : :''....: . '.'.... !' .:. : ::.:. ::.?,' Atticktawls fills 2332
111 Business name: Sky Heating & A/C, Inc. Other: 23.32
Feel piping:
Contact name: Tami llageman
814.15 for first four; $4.03 lbr each additional
Address: 1635 SE Nehalem St. Furnace, cm
Gm heat pwnp
City/State/Z1P: Portland, OR 97202
WE wsuspcndecVunit heater
— -
Phone: (SW) 235 1 Fax; ; (503) 235-0454 Water heater . -
Fiit'Osec
E-mail: tami@skyheating.com , ,
Bathecue
Renge
-
13iLcinmts name: Sky Ilartiag & A/C, Inc. Clothes dlyer (gm) ,
_Other:
Address: 1635 SE Nehalem St.
.
City/State/ZIP: Portland, OR 97202 Subtotal 46,75
_
Phone: (503)2354083 f Fax: (503) 23.5-0454 Minimum permit fee ($90.00) qacto
. Plan review (25 YO of permit fee)
CCB tic.: 50244 - _
State surcharge (12% of permit fee) 10.80
TOTAL P.ERM1T FEE 100.80
Authorized signature: 4 a_44,4.42,6 (2..0.. ni. Permit appileadou expires if a permit b not obtained within 180
days after it bps hem accepted as complete
Print name: Tami Hagman — Date: 03/13/12 I • Fee methodology get by TN-Comity Building Indira, Service Board
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