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Permit , � CITY OF TIGARD MECHANICAL PERMIT 14 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00558 - . Date Issued: 10/25/2012 - TIGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 �,�� Parcel: 25111 DD15400 Jurisdiction: Tigard Site address: 8721 SW HAMLET ST Project: Crowder Subdivision: MILLMONT PARK Lot: 31 Project Description: Gas furnace. Contractor: FOUR SEASONS HEATING & A/C INC. Owner: CROWDER, CHRISTOPHER A & LESLIE J 1005 INDUSTRIAL PARKWAY 8721 SW HAMLET ST NEWBERG, OR 97132 TIGARD, OR 97224 PHONE: 503 - 538 -1950 PHONE: FAX: 503 - 538 -0165 FEES Specifics: Description Date Amount Furnaces < 100K BTU 10/25/2012 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 10/25/2012 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 10/25/2012 $43.25 Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas • 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. Issued By: Permittee Signature: 0 A 7 �G /e4L77d�/ • 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. • 10/24/2012 13:16 FAX 5035380185 Z002/003 atchaniesil PermitADDlJcatwon RECEIV City of Tigard OCT 2 4 ,2012; 0 2s / NQ E�2e /2 -doses • 13125 SW Hon Blvd, Trend, OR 97123 � / Room 503.639,4171 L 903 63 Fare 503.598.1960 nl 1 1 OF A 9 y' Other Porn_ t li www.vgard -or goe BUILDING DIVI 0 ! . ; .... ` ' smiatemzisl lafanurrien — TVP>e.: or wont. I3LB .. • Mechanical permit lies' are bawd an the value aides work ❑ New construction 1;a4driifon/aherado hep}aCement performed. Indicate to value (rounded to the nearest dollar) of all ❑ Demolition 0 Other: mechanical n a c t, labor, ovErhead, anal . CAndowt .rani' T1d r Y . value: $ --1 ECIESIDEICIIAL / sysr :. . • - and 24=11y dweiling ❑ ComumerciaUmdustrial 0 Accessory buiidi;.g tg For . • - ttr�6rr+tarion use clncckiist Mtrii -�mily 0 Master builder 0 Other: p ; ip Qty. Ea Total • JOB sue *weitydrilicitu Aim LorainON ' , Air conditioning Job site address: y 1 2, % .3 (.A Aping Lt7E' r , try rhe vbo t>>>oa per) 4635 , , o ch r Furnace 100000 BTU ( ) 1 46.75 / ► Furn l00 B'11.1 idam/ve u) 549I Smlodbldg./apt. no.: ! Project name � s I Heat cur, 61.06 Cross sue tidoecxione to job site Dam work I 23.32 Hydtorric hot water hem 1 23.32 Residential boiler (Jaen or l c� 23 ' _ Unit heaters (foeltype, not electric), io -walL in -duct, suspended, ae. 46.75 Floe/vent far any of above 23.32 Subdivision: Lot no.; Other - 2332 . Taos map/parcel no.: Omer nrelupp9mroes . Dom OP . Water halo r 23.32 .. .-- r ' - ' Gas fmpiace 33.39 MI 5 h+r1io 1 Floe vela kr water hater or gas fireplace 2332 l — ioa lighter OM) 2332 _ Wood/petin sortie 3339 ! Wood firepl®dinsert 23.32 j Chi nmv/lineciflueven 2332 . . - 1 FR parry owls • . _ . . l c .'Fret ' J Other 23.32 Nam= an' 5 ' i I i.,, (LoLj4. 4' Environmental e>,imoat pad ventilation Aches: ' 1 2 L aes i Is Range hood/ether latches eaubtmeut 33.39 C"rg _ dBdAee 'Z, tGothes err a 3339 • Phone: (fa) • . ; Pa= ( ) I toilet com paos, utility rooms) 23.32 _ • • . £ •APPuCANt 0 CONCACT PERSON AtticicrawispaceDas 23.32 to -.-..-.-- other: 23 Ruthless Fnei Su* Calm SOUR ! S14.II5 for first foc!w, 54.03 Ibr etch additional lRC- rte. et Aad�: C �� p�t } AN j Gas heed City/SUM/ZIP: ) 1005 INDUSTRIAL PKWY Was endad/oaitheater � i Water heater NPWINM '41 p —1 Fireplace E : I ' Rye • F� . Barber= Clothes dryer (des) s A ND AIR cp % • _ 1 .. l address ALP T . City/State/ZIP: � k1� P &rimed ( ) NPWBE GM F ) I Minimum permit the ($90.00) G•• Plan review (2596 of permit the) CCB lie. ' -- 't 1 c 3 Stm sartbcage (1295 of rtut foe ' :+. 1 TOTAL PERMIT ,., • .,O Authorised , I This permit apgstati6n if a permit is .. • • whir� �ie.�.Y`l �! *�-( : —.._. j dna Ater tr has boa accepted as 12:=2", t7 RUM, ` x motha�lojyartby Tri.CamtyBoldingIndoorp:. , _ Bend L dor itvoll09 44.0.461?r .lI arccor R8)