Permit •
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CITY OF TIGARD MECHANICAL.PERMIT
1111 3 . •••• COMMUNITY DEVELOPMENT Permit #: MEC2012 -00286
T (CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2012
• Parcel: 2S103DCO2100
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Jurisdiction: Tigard
Site address: 13850 SW 114TH AVE
Project: Seibt Subdivision: VIEWMOUNT Lot: 9
Project Description: Replace furnace
Contractor: BULL MOUNTAIN MECHANICAL Owner: SEIBT, ALBERT T & DARIAN J
13580 SW RHETT CT 13850 SW 114TH AVE
TIGARD, OR 97224 TIGARD, OR 97223
PHONE: 503 - 612 -6677 PHONE: 503 - 372 -9156
FAX: 503 - 692 -3084
FEES
Specifics: Description . Date Amount.,
• Furnaces <.100K BTU 06/04/2012 $46.75
Type.of Use: SF 12% State Surcharge - Mechanical 06/04/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 06/04/2012 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
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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: 0 Li ��' 111 pg9 C i 17 D
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.
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nral:10•71) From: 05/30/2012 14:18 #848 P. 001/002
51
Application 3 0 2012 b�
Mechanical Permit Application :O ll o i l lc 1.. IN.: O N I ..;
City f Tigard G11Y OF TIGA D PM Penmit e/ , P AA _Oa ,
,� • 131 SW Hall Blvd, Tigard, ORGING IVI ION • Phone: 503.718.2439 Fax: 503.598.1960 ,;. ► Other Permit
1 - e c A 1 , �-, inspection Lane: 503.639.4175 flew -�.; { * •
Internet: www.tigard-or gov � 1� 41 Q ': .T ( r _ Suppleme information
= ''' . f'• `A' Y v `P fG yek t •n c% i i :,1 ye.�v.��.--1 01K r7 eL ��'�a�Ll r.LT��lMlra i.Jd�S.Ti R...���� � f�'�'� �^I�����i �Y�` w"`+.= f' ..'L'�.L._..��__...._�...�.i�i)
Mechanical permit fees' are based on the value of the work
❑ New construction ® Addit ion /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other. mechanical materials, equipment, labor, overhead, nndprofit.
�.- •; iffin ��f /��� "��oIr GO..�.,;, �`M'- . os lz Value: S
t7;'�'�E::�, x s+n+:�wim:.:�-0 r � r c , u, "'�''�- .�...' .. Jr'— � •a..,«��....gYy.�`p- ._p..p. --,:
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For greds!Wonrrmlon use chedt!!hs t.
❑ Multi- family ❑ Master budder ❑ Other: Description I Qty. I Ea. I Total
R s ;v 3Il���0 11hikin lei A O ROWAXs :: Heatimg/eooung:
Air conditioning
Job site address: 13850 SW 114 Avenue (requires site plan ehowiaa placement) - 46.75
City /State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts/vents) 1 46.75 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldgJapt. no.: I Project name: Seibt 161 Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 2332
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel-type, not electric),
in -wall, induct, suspended, etc. 46.75
Subdivision: I Lot no.: Flue/vent for any of above 23.32
Other 23.32
Tax map/parcel no.: Other fhel appliances:
: i ..1 M c ns 7 ; .. !? •, . -;gin ° -
: , r= '• Water heater 2332 .
replace furnace Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (Rea) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
a , r -F x�° w , a- r Chin ney/liner/flue/vent 23.32 •
�. � ?� ! we a.e: r= . a,�xo 3r L"��e �� �Li Via; " *fit Other: 23.32
Name: AI Sent
Environmental exhaust and ventllatlon:
Address: 13850 SW 114 Avenue Range hood /other kitchen •
equipment 3339
City /State/ZIP: Tigard, OR 97223 Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: (503)3729156 Fax: ( ) toilet compartments, utility rooters) 23.32
��. a? , , _, , . a Attic/craw
x a; � � } °� t?TIACi' lspace fans 2332
Other 23.32
Business name: -
Fuel piping:
Contact name: $14.15 for first four; $4.033 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspendedhmit heater
Phone: ( ) I Fax:: ( ) Water heater -
E -mail: Fireplace
Range -
.J..4i Wain:44.4:: 1F:I .:v+_ 1..F !*4• q7 " i.g T`riais 4n.r "'° ux Barbecue
Business name: Bull Mountain Heating Clothes dryer (gas)
Address: 6520 Rosewood Street ; 4 Other RVf,
City/State/ZIP: Lake Oswego, OR 97035 Subtotal 46.75 '
Minimum permit fee (590.00) 90.00
Phone: (503) 6126677 I Fax: (503) 6923084 _ Plaa review (25 of permit lea)
CCB lie.: 157814 / / State surcharge (12•x6 of permit fee) 100.80
Mr / TOTAL PERMIT FEE 100.80 -q/ Authorized si r i : . . M ' T ide tit day Rv It been a cte d as complete. within 180
I Print nettle: Jack :: , . en I Date: 05/30/12 I • Fee methodology set by 7ti.County Building industry Service Board
l:1Bwtda \ P \
gamitsMEC- • •,, : .,. dac 03/07/12 44046m(Il/7/COM/W®) ,