Permit CITY OF TIGARD MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00241
T [ G A R 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/14/2012
Parcel: 2S 1128812100
Jurisdiction: Tigard
Site address: 14078 SW FANNO CREEK PL
Project: Waggoner Subdivision: COLONY CREEK ESTATES NO.4 Lot: 101
Project Description: Replace gas furnace with like kind
Contractor: SWANSON HEATING Owner: WAGGONER, TIMOTHY L &
1284 S A;PINE ST WAGGONER, ERIN J
CORNELIUS, OR 97116 14078 SW FANNO CREEK PL .
TIGARD, OR 97224
PHONE: 503 - 357 -5098 PHONE: 503 - 620 -4981
FAX:
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 05/14/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 05/14/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/14/2012 $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
issuan is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili Notification Ce -r. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or irect questi.ns to OU . by :. 03.232.1987 or 1.800.332.2344.
Is ued By: / / Permittee Signature:
E N..„..\.. L atiezini
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.
Mechanical Permit Application
FOR OFFICE USE ONLY
Received 5 ®
City of Tigard Date/13y: / Permit No.: "�
I q
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review /
Phone: 503.718.2439 Fax: 503.598.1960 DateBy: Other Permit:
T I G A R D Inspection Line: 503.639.4175 Date Ready/By: kris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
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 all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
• CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1 - and 2- family dwelling El Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 14078 SW Fanno Creek Place (requires site plan showing placement) 46.75
City/State /ZIP: Tigard, OR 97224 Furnace 100,000 BTU (ducts/vents) I 46.75
Suite/bldg. /apt. no.: Project name: New furnace Furnace 100,000+ BTU ( ducts/vents) 54.91
Cross street/directions to job site: Hall I Fanno Creek Place Heat pump
(requires site plan showing placement) 61.06
Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
Subdivision: Colony Creek Lot no.: hydronic) 23.32
Unit heaters (fuel -type, not electric),
Tax map /parcel no.: in -wall, in -duct, suspended, etc. 46.75
DESCRIPTION OF WORK Flue /vent for any of above 23.32
Replacing an old furnace with a new efficient gas furnace.
Other: 23.32
Other fuel appliances:
Water heater 23.32
Gas fireplace /insert 33.39
® PROPERTY OWNER ❑ TENANT Flue vent for water heater or gas
Name: Tim & Erin Waggoner fireplace 23.32
Address: 14078 SW Fanno Creek Place Log lighter (gas) 23.32
City /State /ZIP: Tigard Wood/pellet stove 33.39
Phone: ((503))620 -4981 Fax: ( ) Wood fireplace /insert 23.32
® APPLICANT ❑ CONTACT PERSON
Chimney/liner /flue /vent 23.32
Business name:
Other: 23.32
Contact name:
Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City /State /ZIP:
Clothes dryer exhaust 33.39
Phone: ( ) Fax: : ( ) Single -duct exhaust (bathrooms,
E -mail: toilet compartments, utility rooms) 23.32
CONTRACTOR Attic /crawlspace fans 23.32
Business name: Swanson Heating Other: 23.32
Address: 1284 S. Alpine St. Fuel piping:
$14.15 for first four; $4.03 for each additional
City /State/ZIP: Cornelius, OR .
Furnace, etc.
Phone: (503) 357 - 5098 Fax: ( )
CCB lic.: 601 i 61A0 ti Gas heat pump
\ Wall /suspended/unit heater
: C
Authorized signature ,� 'w
r Water heater
Print name: G -•. n 4.9 O n g I Date: 5-, 1 Li 1 z -
I:\Building\Permits1MEC- PermitApp.doc 03/07/12 440- 4617T(I1 /02/COM/WEB) g L 4,11 ,I -I-' * /610-g)