Permit CITY OF TIGARD MECHANICAL PERMIT
to COMMUNITY DEVELOPMENT Permit #: MEC2012 -00166
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/03/2012
Parcel: 1 S134AD05500
Jurisdiction: Tigard
Site address: 10825 SW BLACK DIAMOND WAY
Project: HAWKEN Subdivision: BLACK BULL PARK Lot: 24
Project Description: Gas furnace installation.
Contractor: A TEMP HEATING & COOLING INC Owner: HAWKEN, NICHOLAS J & MARY A
16000 SE EVELYN ST 10825 SW BLACK DIAMOND WAY
CLACKAMAS, OR 97015 -9519 TIGARD, OR 97223
PHONE: 503 - 650 -5014 PHONE:
FAX: 503 - 557 -2990
FEES
Specifics: Description Date Amount
Furnaces < 100K 04/03/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 04 /03/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/03/2012 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ' /
Issued By: ,i�� �' _ Permittee Signature: vN -,¢. TfO
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
• FIVED
Mechanical Permit Ap li , : r
P l r�I: oil is l•: I r>NI.v
N. .___ . a City of Tigard APR 3 2012 1g la n �
13125 SW ]fall Blvd, ip,a d, OR 97223
Phone: 503.718.2439 Path 5°3.59 '1 Plan Ron.
Inspection Line: 503.639,4175 OF TIG :D nete,/B Ostia-Permit;
www.tiSard -w'g°v BUILDING DIVISION uxeed ar soolragez
`' ss tm l'n:mptl 0e
New caotultruCtion Addition /81Lr1ati02UINplacenlstlt
Mechanical Permit ' are based on the value of the work
❑ Demolition performed. Indicate the value ( to the newest dollar) of all
❑ ^r meebosatical material o u' men labor overhead and profit
.Y : . ... CAATEtyOk'Y :0`.LONBF$tc xa1v . ': Vahre:S
Commerriai
$i mily dwelIiug 1 -and 2- fa [] Tindushial 4.i.YVS s S. s'. •
l_ an 2-fa ❑ Accessory building For 3 en ass ek e
❑ Multi ❑ Maser builder ❑ Other. Description f, I Ea I mud
SlI% ID4OBSATIopi A111b' we Tim — B e :
Job site address: o Stet t K l a avl 0 IN l Az eo c o plan e6ovg ng
(ccquiraa yily ple ylaa®oent) 46.75
City /State/ZIP �'` f (y ,L,L Furnace loo,oaoBTU(ducwvest ! a6.7s 44. �
CO .,is 100,000+ B'Pl1(emes/veats) 54.91
Suitc/bldgJapk no.: I Project name: 1.4 ov k/ 1.44/ iA Heat pump
Cross street /directions to job site: (meats site east � W DOE � 61.06
Duct work 23.32
HLrdronic hot water system 2332
Residential boiler (radiator or
Wreck) 23.32
Unit heaters (fuel -type, not electric),
-
in wall. in-duct, suspended. etc. 46.75
Subdivision: ) Lot no.: Flue/vent for any of above 23.32
Tax map /parcel no.: Other: - - 23.32
....... .. ..: Other foal
• .. : ;,!. � - hem
, .:Z
.:' : �''::: •; + • ; ; ° : ,: _ � :: �:..::. • �. • � Water heatee
�( �/� / n y 23.32
..,_.S1- VL. p 0 ' � � ::. q - r 4. ..,,-(4.6,(1, 1n' S'3"A l i . fireplace 33.39
1 Flue vent for water heater or gas
. &sit 23.32
Loft lighter (PO 23.32
Woodjuilat stove, 3339
Wood fireplace insert 2332
'•. X'. .: Chimliny/1iAOr/$ue/vent 23.32
Nhtao: t C I- 4 URa/ K�, N other. 23.32
Eevls•onlnetlfelr.trhau4� and ventilation: Adds : f Q17, s ; e 1 e..,K. f lame s lit„ ► Be hood/other kitchen
City /Srtak1Z1P: A--C i 0 k / - i - 7-2/ 3 Clothes dr 33.39
Ckttins drS'at exhaust 33,39
Phone ( ) ■ ∎ Fax ( ) Smgle-duct exhaust (bathrooms,
r n--- toilet co mMitme utility rooms) 23.32 _
. ... • : :'.4 y ''; : '. a 40 __ _ AtliecnIwlspuce fans 23.32
Business name: Other
T 23.32
1tte1 Dicier;:
Contact name: 16000 SE Eve st. $14_15 for first tour; $4.03 for each additional
Addre R — Furnace, etc.
City/State/ZIP: :03•6504014 Gas heat auras)
WalvsuepentkNuart bed
Phone: ( ) Fax/ : 02) j _ 2 Lt U Water heater
E -mail: C b� C B it �e!�lp ea, i J L ow lace
BatebCne
. Business name: A-TEMP HEATING ANT) COOLTP41Nc Clothes d )
Addicts: 16000 SE Evelyn St. other:
addrallng OR 97015
City /Statc./Z1P : S S(LSllld Subtotal 1( _k. +5
Phone: ( ) I Fox: (r 0 3) 551„ (�' 'O Minimum permit fee ($90.00) 4 0 , 0 (j
Plan review (25% of permit fee)
CCB sic.: lig'�p stale surcharge (12% of permit felt) f) . v)
Authorized sigaa QQ J''�' TOTAL PERMIT FEE 0 0.9, 4 ,
Ttib permit application mina Ira permit b not within 180
r/� �Iias 1 , days after it has beau morpted ae couplets
is
Print name: 7 , 0 1111111.111113:Narg • Fee methodology yet by Th- Couoty Bioldiag Industry Service Board
L1)1m 1 Pteritsume.- Poanitapydoc 09/09/10 • 61T1' I1/02/COM/WE3)
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Somewhere between too hot and too cold there's.,..
F -
A TE111P
HEATING & COOLING, INC.
A y ■A+ +, (503) 650 -5014
16000 S.E. Evel n Street
Clackamas, Oregon 97015 FAX (503) 557 -2990
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