Permit CITY OF TIGARD MECHANICAL PERMIT
m COMMUNITY DEVELOPMENT Permit #: MEC2012 -00411
T i G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/06/2012
Parcel: 1 S125DB10000
Jurisdiction: Tigard
Site address: 7198 SW LOLA LN
Project: Nicholas Subdivision: RAZBERRY PATCH, THE Lot: 20
Project Description: (1) install NC Must be placed within 5' side yard setback and approved rear yard setback
Contractor: WOLFER'S, INC Owner: NICOLAS, SARAH D SEBASTIEN
290 YOUNG ST 7198 SW LOLA LN
WOODBURN, OR 97071 TIGARD, OR 97223
PHONE: 503 -981 -4511 PHONE: 650 - 906 -2952
FAX: 503 - 981 -0801
FEES
Specifics: Description Date Amount
Air Conditioning 08/06/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 08/06/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 08/06/2012 $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. 1 �] cirri , 1/
Issued By: Yl Permittee Signature: OA c
fR-( irri 01-
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.
AUG /02 /2012 /THU 03:04 PM WOLFE D FAX No.5039810801 P.001
•
Mechanical Permit Application
AUG 0 2 2012 FOR OFFICE USE Ct \1.�
City of Tigard .�.�/ p D at a W t L y Permit Na.�(EC, two f -
t n j3125
25S Blvd. Tiger , OR 9 223 CITY OF � T IGtfiu/ pT Omer Permit
7l C+ n hi) b• Line: 503.639.4175 gpu,D1NG DN ,,, s Ready/By: EN 13 gee PaYa 2 for
Internet www.tigard or.gov Notified/Methodd Supplemental Information
�'ti^4 r I•+ •X ' .r _..'� 'J • t y., U I'W i l p t • r.+ .. r .. M a......"' r 4:= i= 1 Y '0 � 141 I�1'7PJ'J1 e•, . � ^°tWr•
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
El „. El Other: mechanical materials, equipment, labor, overhead, and profit
Value: $
. a ��w� , A - --rr� 4 z '° .
, Cr \ i C U 7 'C [�:I -'"1- FJ'tr10 N ty•.,: .ti.. -n.i' '.7 -`t: :i �T�
(k1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building - For medal information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. J Ea. I Total
- - ,dam 1 ° , ,, ' 7, ,i' . .7.72 7 xs •
r -- .,-. =e• .... F-1- w = . . -^ Air conditio
Job site address: 7/ / 0 . _ / / ( reauir site plan ehowina placement) , 46.75
r, � / 2 Furnace 100,000 BTU (ducts/vents) 46.75
/
City/State/ZIP: Furnace 100,000+BTU (ductslvents) 54.91
Suite/bldg. /aptno.: Project name: Heat Pump
(requires site plan showing placement) 61.06
Cross street/directioes to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
' hydronic) 23.32
Unit heaters (fuel-type, not electric).
• in -wall, in -duet, suspended, etc. 46.75
no.:
Flue/vent for any of above 2332
Subdivision: der. 23.32 •
—
Tax map /parcel no.: Other fuel appliancee -
4<- a ,. -.5 a e: 7 a .4 F`�l a :« +7- . 1 Water heater '
__ r ti 2332
rt :_. N "_? _ H= �.- -� ^_ -i. 33.39
Gas 5rcp a utseri
' ref, f 7W - �� Flue vent for water heater or gas
C/ fireplace 23.32 •
- — Log lighter (gas) 2332
Wood/pellet stove 33.39
Wood fireplace/insert � 2332
., W----7 Chimney/liner /Due/vent 2332 • ti l a , . ' lam, "i a} ' ' n? ,t ) ,t - � `" ., ' „' - 1 - - .. = "_""- Other: _ 2332
Name: ` i / r , ' Q// Environmental exhaust and ventilation:
Range hood /other kitchen
Address: e / f equipment 3339
Cit
/State/ZIP: ! &at' U g Clothes dryer exhaust 33.39
!' l/ Single -duct exhaust (bathrooms,
Phone: / / ---• i d / ', j toilet compartments, utility rooms) 23.32
---- - -�,rc t. - ='s.,5 :, , fhns 2332
• +-'' -:: -- .1 G1 g",U - ,. ^ 4 � P :71`27 ' 't " -t ' - '-' OttiGcrawlsp
ace Business name: �`_- .. tiy.`�� the
Busin 23 3
e: a r _. �. Imo/ / Fuel i in L :
Contact name: / S14.15 for first tbnrj S4.03 for each addltlonai
`` ”" ` Furnace, eta •
Address: /y U ) .4 . Gas heat pump
City / State/ZIP: 1 j 0 / 1-7611 Wall /suded/unit heater •
Phone: ( 5) Gig )..... LIG f Fax:: (t) q g) " D $D I Water heater
1 Fireplace
Email 1 CO- °) W04' a 1 b>r Range
•,...�. ' 4 m Ir, , eJ- :: y r T ~ . , ' Barbecue
6 Clothes dryer (gas) •
t liE.'4 AL :'M: i other:
Address: � i l 1 A i A i
City/State/ZIP: A j al /01 / r Subtotal
`v
i n p Minimum permit fee (590.00) W-
Phone: 5 V3 ) 1 Fax: ( °f 4 ' 0:01 Plan review (25% of permit fee)
CCB lie: 4 I I State surcharge (12% of permit fee) • •
. TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorised signature: days after It bus been accepted os complete.
Print name: " lC ..?S t Ca • I it, Date; •ION • ' Fee methodology set by Tri County Bonding Industry Service Hoard
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