Permit CITY OF TIGARD MECHANICAL PERMIT
• • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00494
T I CARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/27/2012
Parcel: 2S110AB01900
Jurisdiction: Tigard
Site address: 14292 SW 114TH AVE
Project: Falsetto Subdivision: COLE'S ACRES Lot: 6
Project Description: (1) gas furnace installation
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: FALSETTO, AMANDA
1005 INDUSTRIAL PARKWAY 14292 SW 114TH AVENUE
NEWBERG, OR 97132 TIGARD, OR 97224
PHONE: 503 - 538 -1950 PHONE: 503 - 747 -7352
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 09/27/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 09/27/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 09/27/2012 $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 5503.232 .1 19987 ,, or 1.800.332.2344. /► / /i /4-71 , 1
Issued By: �.C.�.l � �
v� lX a Permittee Signature: �. ' 1 0 V
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.
09/26/2012 12:22 FAX 5035380165 1 002/003
•
blec)tanical Permit APP111-akit . ' - TEM ,
. Received
d►oia -oa
City of Tigard - 13125 SW iiitil 639a a' 171 T so3398.1 0 S c P 26 2012
• inspection Ube: 503.6391t175 i Date Reedy/By: esee
I1LD'�t DIVISION.
: Nss► sc r ass `:
• Sue are based on the value or the work
Indicate the value God to the neatest dollar) of all
❑New construction Addia°Nattecaticc/zsplac� performed_ .,, J +.... � � ..
0 Demolition •
— Value: $
• GAY • O'Lt .COd JGnc F1'1<A><: r "
1- and 2- >lemily dwelling ❑ Corn cialrmdus>ria1 (] Accessory building
1 - , Fos .,.. use chedbhst
y CI Master builder ❑ Other. Description mini Total
JOB SEI'B "P - j.OfAt
ad 1�Z�2 5th iI L i t - > :. 46
Job site Pomace 100 000 BTIJ du Wve fa ` _'•
o
I ` �� • Forme a 100 001» 3113 the rivaea Ma 54.91
`� 61.06
Sa�b�8 nix: Project name:t Hoe 2332 find work
( sweet/directions to job site: f{ ,.,r hotwatrar . 2332 WM
- 23.32 IN
[fait heaters Obc14Yrie, not electric) Ma
x332 r
Subdivision: Lot ao.: .. 23.32
lno.: Other fuel a,. i,. , . - . z; 32
Water holm 23.32
O» ,�YDK
• Ph* vent fbs water he or gab Mill
6=�� d . A 2332
1 NM 23.
•: - —
wood. asst r 23.32 MOM
Chimnevilinerdinetvent 7 2332
y . 1201i1Ort other: IMII
Z A F ►! X72— . r ,:. •.•_'•: =� _ , and ventilation
Address k- ! a 5...1,3 OA 3339
-1 Clothes , . _ as _ 3339 7
City •� ~ 2 � L � � `�� SiagtodaeAesJra�(bathroveoa, i
Phoney: �i/ -,3 2._ ' ( w7et .,. rooms ∎ 23.32 ME
la.`.UV (]. C.OlirtAcr Other. . feu I
Bu "�°' FOUR SFAsONS HEATING
Cotdacd name: - 514.15 for first four 54.03 for each addftkand rMIII■
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Address: (3as heat
cam: w . � r �
" r r = - c • _ • ) . waas heater
Phan. ( ) r ' 'MIM
Seal
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>> name: Other er
Ate: Subtotal _
1005 IND USTRIAL PKWY '
(�/S�erLiP - , -. flee ($90. ∎ 1 j
Moe: ( ) _ 'J NE BERG e - 197132) Plan review or *a) e) �/,, .
Gal tic.: act --4.52___ TOrALPERMIT • AI Waal
Authorized eignp &ye awe et Wsbwm mewed es -: - , - -
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09/26/2012 12:22 FAX 50353801'65 IJ001 /003
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F PAGES (including cover): 3, OF ( ,
FROM: Four Seasons Heating and Air Conditioning
1005. Industrial Pkwy
Newberg, OR 97132
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Phone: 503 =535 -1950 V19\4-00
Fax 503 -538 -0165 R 'A
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Sent By: . a_
E- Mail: ( Ck f ,� @fourseasonsheatair.com
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