Permit a CITY OF TIGARD MECHANICAL PERMIT
s : COMMUNITY DEVELOPMENT Permit #: MEC2012 -00345
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/03/2012
Parcel: 2S 111 AB07700
Jurisdiction: Tigard
Site address: 9425 SW INEZ ST
Project: Froelich Subdivision: PENROSE TERRACE Lot: 22
Project Description: Install (1) A/C Must be placed within the minimum 5' side yard setback and the approved rear yard setback.
Contractor: WOLFER'S, INC Owner: FROELICH, CALEEN
290 YOUNG ST 9425 INEZ ST
WOODBURN, OR 97071 TIGARD, OR 97224
PHONE: 503 - 981 -4511 PHONE: 503 - 459 -9867
FAX: 503 - 981 -0801
FEES
Specifics: Description Date Amount
Air Conditioning 07/03/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/03/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 07/03/2012 $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.
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Issued By: Permittee Signature: Oia AW C l l Oki'
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.
JUL /03/2012/TUE 11:17 AM WOLFERS HEATING FAX No. 5039810801 P.001
Mechanical Permit Applic FOIL UN1•1Ci USE ONLY
City O #Z'1 Tigard C
Plan RevnRi
Received l)12- Permit Ngii j�1a 3
1 t; ° 13125 SW Hall Blvd., Tigard, OR 7 Aa
Phone: 503.7182439 Fax: 503.5911.196( t 3 2012 1> y: Other Permit •
T I ,-, u , , lnspection Line: 503.639.4175 JUL Date Re /B g( See Page 2 for
Internet www.tigard -or.gov Notified/Method: Supplemental Information
CITY OF TIGARD
f -. , 4: T,r ' ". mI f :',1Ila l.j' •1 " •ky 6` s;h.tr * tt 4 i'ii a ;N n a ;. i ?:rlo6 i, TAXON •
Mechanical permit fees* are based on the value of the work
0 New construction A, ddition /alteration/r'eplacenlent performed- Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit
Value: $
;1.13,424. ; Yi' {! y+" 41 ::'Atefca 126 -cane aryl a''e•i, nt.4..Ir, n r a 1, ∎,-, 4°' 1-
t ge 1 and 2- family dwelling 0 Commercial/industrial 0 Accessory building For special b{lbrmailoa use e9eecklist
0 Multi- family 0 Master builder 0 Other: Description I Qty. I Ea I Total
16.1.1', �^ r � y r yr ' h n ' i}r+n �a Fleeting/cooling'
' .' : `w�y� ' Ire h ', o.. .i v , ,,.. w A54,,, (e441 ,.. -,7M ' r ,, '� . lin 6= ' N� rotu
:,
/� r �� - Air conditioning
Job site address: q 4,9 s w u Vt t Si (requires site plan showing placement) I 46.75 44
� O} I [� a.24 Furnace 100,000 BTU (ducts 46.75
City/State/BY: r Furnace 100,00+ BTU (ducts/vents) 54.91
Suite/bldg./apt.no.: Li Project name: Heat pump
(requital site plan shoving placement) 61.06 '
Cross street/directions to job site: Duct work 23.32
•
r
I Hydronie het 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: 1 Lot no.: Flue/vent for any of above 23.32
Other. 2332
Tax map/parcel n0:: yy Other fuel appliances:
�+ i �' r rr� J. is l �4 :' P q"'P y 0 ,I �MdT,i,,,,a 4 fiWLs�' rv -+� {8'a :
!''' x4 Water heater
a�.er;t�Lr„i�.. ��1. i �>( / { nt . ? i,i�`�,C,�,r {,1:�„ tilt? �nr» M�rM6' I., �iEci' n�i>tti'�;.J �•. 2332
Gas fireplace/insert 3339
•
IASI-111J Flue vent for water heater or gas
, fireplace 23.32 • r ! t1 Log lighter (sass) 23.32
• Wood/pellet stove 33.39
Wood fireplacrfmsert 23.32
;,� 4 �1^r" r l '," ' ,'.1,41-1,7,-..4-1..„: r 9 „ `I,`r r- r,l �� i ,.,�, r , al i• ,w_ +l 4* Chimney/liner / flue/vent 2332
W /�fll F l1 , e J r rl 40 "1. ' 4 �+ , � , 44-o.
m F h. w r nr A� R ell , +snT .. 27sr 15 �d "4 .t; - Other: 23.32
Nye T Environmental exhaust and ventilation:
Address: ,� U Y i St ' Range hood/other kitchen
equipment 33.39
City/State/ZIP: III / $4.03 for each additional
/ q Clothes dryer exhaust 3339
Phone: ( i ) ! ' / i I.. Fax: ( ) � t Single-duct comp rt exhaust (bathrooms,
ty rooms)
71 nr� � YT r',r • -r' ✓rn ,c,rr . . toilet compartments, U .
�, rile ms 23 32
^Mx n r'r/,q .� {.7 Fi �'p" G,r�nr �i r4 >7� x 1 p fir...+ x > ,t : h , x fg iTt � r4 7L .....1-, ;1, 4�+ FEN � ti � } • 0.c 1 : ; tr-cw"u, Attie%rawlspaCe fans 23 32
Business name: i �� rA Ic�� � �� /� � ' 2 ! ,ad- / fie: 2332
Fuel
s d L L T.� r Main: 14.15 for
Contact name: / $14.15 first four,
Address: 910 [lit M s-t ' Furnace, etc.
Gas
City/State/ZIP: ! 0 0"l Q i I h p Wall/sWall/suspended/unit ndede
d/unit heater
Phone: () Cj $ _ 4G +, Fax: : (M3 ) • ,1... j Water heater w
Fireplace
Email: a.teQ @ W 01 r . a y , Lt/ 0_ann Range ,
1u 8n 14UP �, IL ki4 .3'eL a ^ l .,l,,' 7 „ 1�-7m,1 +^ ini . ...,4iti:, aV° Barbecue •
Business name: i ' �� . ti + + I ' 1 � • m , - / Clothes dryer (gas)
Address: / i) ` • Other: h
city/state/zip, : At 6176- Subtotal I �
� A
j : ( n� ` hR � M permit fee ($90.00) l
Phone: r t y C � ) Plan review (25% of permit fee) I
• CCB lie.: 4 State surcharge (12%ofpermit fee) 10 . �(u i
/ TOTAL PERMIT FEE 100. i()
AutboriPed sign . This permit appintiOn expires if a permit is not obtained within 180
_ days after it has been accepted as complete.
Print name: `sS ( = - Date: 'd- • Fee methodology set by Tri- County )3ulldina Industry Service Board
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