Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00196
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/20/2012
Parcel: 281 11 DB00100
Jurisdiction: Tigard
Site address: 15200 SW ALDERBROOK DR
Project: FLECK Subdivision: SUMMERFIELD NO.8 Lot: 429
Project Description: Gas furnace replacement.
Contractor: WOLFER'S, INC Owner: FLECK, ROBERT S
290 YOUNG ST 15200 SW ALDERBROOK DR
WOODBURN, OR 97071 TIGARD, OR 97224
PHONE: 503 -981 -4511 PHONE:
FAX: 503 - 981 -0801
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 04/20/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 04 /20/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04 /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.
APIWArab
Issued By • Permittee Signature:
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.
APR /19 /2012 /THU 02:06 PM WOLFERS HEATING FAX No, 5039810801 P. 001
Mechanical P ermit An pIicatiod?EC t EIVED rolz uh•r'IL�L UsL ONLN
City of Tigard r , 11 G
: 1 ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.718.2439 Fax 503.598.1960 APR 1 8 2012 Date, y: Other Permit:
T I G A R D Inspection Line; 503.639.4175 [bite Ready/By: 13 See Page 2 for
Internet www.tigard- or.gov CITY OF TIGARD Nefied/Method: $upplanental information MI BUILDI . •
-- 7.? .1VM1 17,, -~ :34:1 _ " 1 H�.:f.!.. - ' '•V� \ r' 4r_ Y -�.. - •1.u.Lli-.i�i- ch
' "� ° '�` — Mechanical permit fees* are based on the value of the work
❑ New construction Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of di
0 Demolition 0 Other: • mechanical malerialr equipment, labor, overhead, and profit:
: , +- 1, ;mei. ad ,7 ri m a tl d? � i . oil. � $ Q -1 d
-- "' �,•�,- „ �� � p.�"^ -�"�`� ,�Yc o [t J�'c�+` to tea' • ,.- .-= •: -,.. �,. `^•.. . r;. , ! . �- _ n �;:.
Ar I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building Far special in ornration use checklist
❑ Multi - family ❑ Master builder 0 Other: Description I Qty. I Ea. I Total
T fey Heating/cooling:
� ' � _._ O;, ��m o r n o:r��/ W ei i'n''t. Y[u o r ,,,.
F --.: ; --v” A ir c ond itio n i ng
Job site address: 6 D Ii /& ' 'I (teethes site plea showing placement) 46.75
n Furnace 100,000 BTU (ductalventa) I 46.75 6,'I5
City/State/Z P: r.� , f / 722h1 Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldgJapt. no.: I Project name: Heat pump
(requires she plan showing placement) 61.06
Cross street/directions to job site: . Duct work 23.32
• Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 2332
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, eta 46
Subdivision: I Lot no ; Flue/vent for any of above 23.32 .
Other. 23.32
Tax map /parcel no.: Other fuel appliances:
M ^ i •- w.l`7 ,EF,F ;fit'' '.t. .._..."' i h- _-� Water heater 2332
EL „..W:. , 'te -?_-=r �ILJA ; 1... ar Ga fireplace/insert
33.39
F ' . / / /, ' /_-• I Flue vent for water heater or gas
fireplace 2332
, / 1 _ _ Log lighter (aril 23.32
Wood/pellet stove 33.39
Wood ftreplacelmsert 2332
j
, e t 1 ,TrIt s .. . � n 01 , ,N ^-. ` Chimney/liner/flue/vent 23.32
.a., - _..11. G " V { t-n. .�E_ l [ .- .-^'y T'7tir . n ...... , Other 2332
��, /' ! _ Environmental exhaust and ventilation:
>r�jrj �- ,, y ' . Range hood/otber kitchen .
Address:
ice• J t.,40 t'A AA ..I equipment • 33.39
City/State/ZIP:
14 . /. A Clothes dryer exhaust 33.39
)� — . Single-duct . ((bathrooms,
Phone: Pax: ( ) toilet compartments. utility rooms) 23.32
rw r- w . 6 `
. ci c"'ri ~- „ V w- E] ic 4a /A p eels -2-q-- �:"- ` :. Attidcrawls atefans ; 23.32 -
yam: r - , � s 6r! ��^ d..� „ ,u� t t �� ,., -
p
i�� _ Other. 2332
Business -tamer !/ r l « Rust t • S pt' --
.
Contact name: i S'_ .6 _ SKIS for first four; 54.03 for each additional
Address:210 . an / tit - Furnace, etc.
Gas heat pump
City /State/ZIP: 1 j 1 4 _ 1 / ' / / p Wall/suspended/unit heater
Phone: (",3) /'d l� - Fax; a (` 3 �''/. O 6 I Water heater
Fireplace
E-mail
/ r . / Ill/ CO Range
• -^h , •. -ca =" ,"*Ls.' .l_ t=ry T� � r-e— , - :;.. � f-.-? -
,s, �^ r ..aeM •. � .1H+ �� ,.,.; : , 1 1; rr.- "'a+iv'TM':.n - ue-. , , Barbecue C lothes a
E ilT iMr Clothes dryer (gas)
� Other
Address: / / 0 ii Q ,lf
cit • r 41 ,, , .., ,. r 0 Subtotal it
( Minimum permit fee (590.00) q a . •
Phone: (� q 21 — 1 f" � 1 I Pax! ( 7 j) '1 'I o� Plan review (25% of permit fee)
CCB lia: I I <-- State surcharge (12% of permit fee) I 0 • tr..) .
TOTAL PERMIT FEE I D - g)
This permit application expires If a permit Is not obtained within 180 .
Authorized signature:
days after it has been accepted an complete.
Print name: S � j - - f I Date: A e I q • l a I Pee methodology net by Trite aunty Building loduemry Service Board