Permit CITY OF TIGARD MECHANICAL PERMIT
s • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00512
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.718.2439 Date Issued: 10/09/2012
Parcel: 1 S 133DC08400
Jurisdiction: Tigard
Site address: 11730 SW 134TH TER
Project: DeBartola Subdivision: WINTER LAKE Lot: 14
Project Description: (1) gas furnace installation
Contractor: WOLFER'S, INC Owner: DEBARTOLA, YVONNE Y
290 YOUNG ST 11730 SW 134TH TER
WOODBURN, OR 97071 TIGARD, OR 97223
PHONE. 503 - 981 -4511 PHONE' 503 - 310 -7624
FAX: 503 - 981 -0801
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 10/09/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 10/09/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 10/09/2012 $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. nV^/
Issued By: Permittee Signature: V 4,Op(f 1, b sgatZti
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.
OCT /05 /2012 /FRI 03:47 PM WO RS HEATING FAX No. 5039810801 P.001
�E(v ED OFFICE USE ONLY
Permit Applrca o l�utz - r u.vl.Y
City of Tigard OCT 0 8 2012 DB i4 q I r' Permit No: -�7S' /Y
" 13125 SW Hail Blvd., Tigard, OR 97223
2 • Phone; 503.7182439 Fat 503.598.1 Ty OF TIGARD Plan Review
Other Permit:
Date/By:
i l t: n T.D Inspection Line: 503.639.4175 pU�LDIt 1G Date Ready/ E1 See Page a for
Internet: wwwxigard- or.gov Notified/Methofho d: Supplemental Information
,, y , , a l Lti, r.M , - , �.r'„ 'YA�"' ..,- --"':7 , , ,z - � - -t-- -- a1 - �,:�' , �. , r•!Sa '6
-- ,''t�: � -- ,• r ._� -•, f ��'� " Mechanical pemut fees* are ba 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, equipmerllabor, overhead, and profit.
"� Value: $
117%1141 �" '` ,„,n Pa ° : te n :ra u - t.:.�.,° ,,l.
o r1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special Information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 _ Total
1 W 11W SI
ii •rrna . -. -.- u -
'0 0.. dl iea r JI'F a , f: '1--u .� , r ' -", Heating/cooling:
irc n diti oling:
• 1.. . '�+' �' Air conditioning
Job site address:.//754 6W / y,! / �'L WOO site tan Armin lacement 46.75
Furnace 00 BTU (duetsveata) 46.75
Vie/ ..� . ��
City /State/ZIP: y � Furnace 100.000+ BTU (ducts/vents) 54.91
Suite/bldgiapL no.: a Project name: Heat pump
to uiues site plan showing placement) 61.06
Cross street/directions to job site: Duot work 23.32
Hydronic hot waterystem 23.32
Residential boiler (radiator or
hydronic) _ 23.32
- - Unit heaters (fuel -type, not electric), •
in suspended, etc. 46.75
Subdivision: ' Lot no.: Flue/vent for any of above 23.32 •
Other 23.32
Tax map /parcel no.: Other fuel appliances:
at ,1 t' lAk . ... - w, Water heater 1 23.32
- '��h' �" rill C y C Nt 7 �..
��:... / / Flue vent �� 1,- � �:.
• tiff it / , . f - Gas fireplace/insert for fwater 3339
/,;;//�� ent or wer heater or as
fireplace 23.12
Log lighter (gas) 2332
Wood/pellet stove 33.39
Wood fireplace/insert _ 23.32
,� ` - - - w Chimney/liner/fiue/vent .32
4, ��T' t d ,.0 (, ,1• Ir a Wy;9 v� '" - �" iLE. � ° ;L t ° _''
. J_,M. . - .•..,.c..T ,� : ; ;: �u - ,, ; . w.._..,....,..._ Other: 23.32
Name: /, e 6- i / if, Environmental exhaust and ventilation:
Address: /!15 / Su) /3 T.Qrraze, Range hood/other kitchen
equipment 33.39
City /State/ZIP; / e. ,_ ., r,./ /' / , r ,3 Clothes dryer exhaust 33 -39
'7 C3/ , FaX:
r'
Single-duct compartments, exhaust (bathrooms, ro oms) 23 -32
s,
Phone:
( / ( ) �y �( toilet cote utility rooms)
`Flrt y,• ,�; r�;M�!� ��, +; Attic/orawispacefatts 23 -32 i
.. ..
:" �u l e i .w • ��11� / � '.sr. �•N.R�w4 �. �
u �.: d
Business name: 0 :IS ' n ii t/j (]tiler 2332
W J,� I Fuel piping:
Contact name: jJ.sl CGS r 6 $14.15 for first four; $4.03 for each additional
Address: y / �/r� I '�l Furnace, etc.
" y `�" l Gas heat pump
City/State/ZIP: 3 G j .. / J 1 q11', WaWsuspended/unitheater
Phone: 03)3) ci g t- 4t 1.1 / • _ r.�Y1c,, ( , j) 61 El —O kD I Water heater
Firepl
E -mail: , 1 (ea ) W 01 -Cie ofyi lb/ _ )Y�1 Range
� e..,,�r w- ' ,..,n•r ,�.: a �to i a - -.. " ,..:, .:�
'�yr`�• -, M - �- .•,� t..�.� ?r:+.� -� 9 • ' � ......��..�... Barbecue Business name: `� n )4S , J)_.�-{!�� Clothes dryer (pas)
Address: L ' ' �1"i r j J'L' t �', U •� + ; c ° ��� I,�' T.�i1� ..��:' , «
. �avt'' . °41t �
Ac ed: : tate/Z1P: �I g itr 1 Subtotal r/_ .
�� Minimum permit fee ($90.00) 010 --
Phone: c03) q�11- `1"✓ I ( Fax (M3) gel - DAD I Plan review (25% of permit fee)
CCB lie.: 4 ja State surcharge (12% of petit fee) a.
...r TOTAL PEBt1Vd1T FEE { O15
Authorized signs This permit application expires If a permit is not obtained within 180
;-- .- days otter it has been accepted es complete.
I Print name: , I r7 = -r'v. I Date: 1 0 15 J I 't._. I • Fee methodology set by Tri County Building Industry Service Board