Permit . CITY OF TIGARD MECHANICAL PERMIT
114 2 ','. COMMUNITY DEVELOPMENT Permit #: MEC2009 -00465
Date Issued: 09/03/2009
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 639 4171
Parcel: 2S103AA01600
Jurisdiction: Tigard
Site address: 10830 SW WALNUT ST
Subdivision: Lot: 0
Project: Edwards
Project Description: Install new furnace and duct work
Owner: FEES
EDWARDS, LES M AND MARCIA L Description Date Amount
10830 SW WALNUT Furnaces < 100K BTU 09/03/2009 $14.00
TIGARD, OR 97223
Duct Work 09/03/2009 $10.00
PHONE 12% State Surcharge - Mechanical 09/03/2009 $8 70
Minimum Fee Adjustment - Mechanical 09/03/2009 $48 50
Contractor:
FOUR SEASONS HEATING & A/C INC.
1005 INDUSTRIAL PARKWAY
NEWBERG, OR 97132
PHONE: 503 - 538 -1950
FAX 503 - 538 -0165
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types
Gas Pressue.
Total $81 20
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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503 246.6699 or 1 800 332 2344. J
Issued By: Permittee Signature: off/ Q ,i(CCG U ��
Call 503.639.4175 by 7:00 a.m. for an inspection that business day. D
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.
09/01/2009 09 36 FAX 110
- J (--'
Mechanical Permit Application 7- {' _,,\,, 1 ()1: ()I 1 It I. I ' () \ 1 1
,i ' City of Tigard ■ Received
Dato/By. PIrrnit N° 146 &ge I ? ' .- 01/ 449 S "...
1.11 114 -'- 13125 SW Hall Blvd., Tigard, OR 97223 S E Z 17 Man Review Other Permit.
-111 Phone: 503.639.4171 Fax: 503.598.1960 Daren3y,
• --,,.:,, Inspection Lim: 503.639.4175 . „, Im Ready/By: kris. RI See Page 2 for
Internet www.tigard-or.gov "ir \ ' ,.," , V ' ' -;(led/Method: Supplemental Information
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• Mechanical permit fees* are based on the value of the work
0 New conslruction ti1 Addition/a1terationfreplaccment performed Indicate the value (rounded to the nearest dollar) of all
[3
Demolition 1:1 Other: mechanical materials, equipment, labs overhead, andirufit. ,
I■ Value: S
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51 and 2 dwelling 0 Commercial/industrial III Accessory building
For special information use checklist.
ID Multi-family ID Master builder 0 Other: Description [Qty. I 63- Total
j '. . ; Headier/coding
Job site address: 1 0 A . W c t 51- Air conditioning or heal pump
{requires arte plan showing placement) 14.00
City/State/ZIP: 'fl ci a r • 1 (9 / 7"I7,. - Furnace 100,000 BTU (duets/vents) 1 14.00 /Li .LCSI3
/ Furnace 100,000+ BTU (duers/vera%) 17.90
SuiteThldgJapt. no.; Si Project name:
G as heat rump 14.00
Cross street/directions to job site: Duet work ' 1 10.00 AO 0
• Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
- Unit beaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 14.00
Flue/vent for any of above 6.80
Subdivision: I Lot no.:
Other: r 10.00
Tax MP/Ph/Del no.: Other fuel appliances
' . ' ''','‘-': 7' ' ‘ ,. L . s .."'" . 4 . • ; ' ' ,'-'' ' 1, 4 .. h t '' ' ' ' '' it&: 1 ''''' .: Watur heater j 10.00 L
Gas fireplace 10.00
- vIs4 - A I t het4) rr) atC42. ki,A
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
,..
_
Wood fir 10.00
,. . . Cmn
hiey/liner/flue/vent
•;‘.i- w ' • - . r, : • • 10.00
' 4 ' .;." ‘-' , ' . 4 ' - ' .' --' • Other: 10.00 _
• ■ -
Name: - , 5, . ' I , / Environmental exhaust and ventilation
Range hood/other kitchen
Address: oq 0 ,,, e I A 411‘ equipment 10.00
-7
City/State/ZIP: ... „4 0 crr 7 zz..3
tA1! Clothes dryer exhaust 10.00
Single-duct exhinist (bathrooms.
Phone: (S 0 tot ' 31 t Fax (r• ) toilet compartments, utility rooms) 6.80
'ReAiwrtk 244 ' , 'i" ' '. , ,':, . !' II ''.....',:'./ :' ' ,..', ,, I ' ',- /. :... ,; akra P _ 10.00
_ Other: 10.00
Business name: Fuel piping
Contact name, P.3 IL A AND AIR CONDITIONING. INC. - $5.40 1br first four; $1.00 far each additiona
Address: 1005 INDUSTRIAL PKWY Furnace, etc.
NEWBERG, on 97132 Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: (503) S 3b itC) I Fax: : (5 ) S 34‘ 0 I e cs- Water heater
Fireplace
E-mail: ( A Ke. N.
, . ri... , , i r. e v‘ Range
; 4 ■ • • V v •' • 7. 4. ' V 40 7r7W 17 ilrg' Barbecue •
Business name: FOUR SEASONS HEATING • Clothes dryer (gm) _
Address:
AINIU AIH tiONUITIUNING, INC. Other: J
1005 INDUSTRIALPKWY %'"W ,
cit NEWBERG, OR 97132 Subtotal
Phone: ( &.5 ) 53$ 1450 Fax (523 ) s313 pu,c _ Minimum permit fee ($72.50) '77 , S - 4 0
Plan review (25% of permit fee)
CCB lic.: Cj 71s g'-`'61 I State surcharge (12% of permit fee) -1.70
..-. TOTAL PERMIT FEE B' L Z.9
Authorized signature: `if his permit application expires if a permit Is not obtained within 180
days after it has been accepted an complete.
I Print name: LI Nell; 14 I Date: ell% / • Fec methodology set by Tri-County Building Industry Service Board
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NUMBER OF PAGES (including cover):
FROM: Four Seasons Heating and Air Conditioning
1005 Industrial Pkwy
Newberg, OR 97132
Phone: 503 - 538 -1950
Fax: 503 -538 -0165
Sent By: C 14r IS WI !^ .
E- Mail: tit r ®fourseasonsheatair.com