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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2012 -00567 13125 SW,Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/31/2012 Tft'' 9 Parcel: 2S104AD06300 Jurisdiction: Tigard Site address: 12915 SW WALNUT ST • Project: Hanson Subdivision: 2009 -055 PARTITION PLAT Lot: 1 Project Description: (1) furnace replacement • Contractor: SUN GLOW INC Owner: HANSEN, ERIC L & LESLIE A 2428 SE 105TH 12915 SW WALNUT ST PORTLAND, OR 97216 TIGARD, OR 97223 PHONE: 503 - 253 =7789 PHONE: 503 - 579 -1950 FAX: 503 - 253 -7693 FEES Specifics: Description Date Amount Furnaces < 100K BTU 10/31/2012 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 10/31/2012 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 10/31/2012 $43.25 Occupancy Grp: Stories: Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1 or 1.800.332.2344. Issued By: f . O p ' ' e fJ1 i /,T Permittee Signature: � �}PP/i�t'►� - gold Call 5 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Mechanical Permit A, I • 1� ` ''� FOR OFFICE. USE. ONLY 11 City of Tigard 1 V Received Permit Nn,+ .- 't 13125 SW Hall Blvd., Tigard, OR 972�C 3 blrtdl3Y. 1oI3 t I yt M 6 odd 1� - � 5rc i Pi Phone: 503.71$,2439 Fax 503.598.1960 D an Rovl,lw (� � Y Y /B : nlo/B luri+: y: Other Permit: T I r A 1t D inspection Line: 503. 639,4175 V� li 1`t s Dote Read Internet: www- tignrd- or,8ov Pr, S gee Punt l for NntNotified/Method: 11 (p npplemcntn information SO '` Ao.;j: »'ti :?:ire' • ""u : ::<. ",:x gar' -;"; cy� n�i:.` <.�'. °,..r�< 'y ;'�,�"`'• k :z y '.xyy:. .�.. ;, � t�. .:.'� " Y:'s { .. . f ' -y i'' ..� �a.:!'0'� . Y ���{ ,W�'R• rx" t ^�,;: •t, -. �� '� '+.;: v�b�liA• A,`LE�7':�.L',���J1'�11�U7�7,�r ir:, U��� „, 4.lW::ID A�'�4:." �•� ., ?-, re.;: : :�::�: .:`r,.V. •.., :% �i:: �:; �'�:`..,<t.�i'sr.��; : £I ' .: : �s.?rr - ...'_, :. .. .... ,a�. ,.,', -,(.. ,...,.;�'k_ .. . .......... �. C - Mechanical permit fees'" are based on the value of the work ❑ Ncw construction ,w ddition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materialkcquipmcnt, labor, overhead, and profit. 1'e �‘' •rR,'ur:� a''".;- q!I'4'ti:s:';' .'�, ° �£� ^ y;�:.. ; •.�.:.�:� -l Value:$ CAA:` ;cif?# i N .. .,.:�..: } t.�,.� r.::,, :� :.,, ..:� , � � . t x c;� �'r ;;,n� ��. / ❑ Accessory building c � " "��� ,:4��; :;:E �- i;�"�2?�t,��gs�,tiu�is��' >.i�`� 1 -and 2- family dwelling ❑ Commercial/industrial industrial ry g Forspecial information use checklist. [] Multi - famil ❑ Master builder ❑ Other: Description Qty, Ea. Total �, ti s ,.:E.. :y )Hain - . v. :: fl4'tk :, .. i•., r 1 µ \� / "•����V \ r., .. ':4: i`,Y Air e conditionin - Job Job site address: (a 9 j 5 s W 0 P1 4 -l- - S� ulres sit I an ahowin Incemcnt 46.75 City/State/ZIP: T--� �j �,�. Furnace 100,000 BTU (duets /vents) I 46.75 y b • -1 S ^ 0 R. / i _ Furnace 100,000+ BTU (duets/vents) 54.91 Suite/bldg. /apt. no,: Project name: Heat pump -- _(moires Rite plan showing placement) 61.06 Cross stnect/dir'eetions to joh site: Duct work 23.32 - Hydronic hot water system 2132 Residential boiler (radiator or hXdronic) .. 23.32 --- - Unit heaters (fuel -type, not electric), in -wall, in -duct. 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: . « ;; A y °: � l�� ;.rye ". % %� 9000 : A ' ,1 1 :C?V� '. =, ;.' . "y_" t ,. v �« W ; ater heater aT D . g t .: , A, �. .: -- , .-.4' .-1,., :,.... k ;.. ' : ; e ,.r.,:..a,. <, 23.32 Gas fireplace /insert 3.3,39 a� o „ nn /Y't 0../._Q--- _ Flue vent for water heater or gas lul C�� fireplace 23.32 -- Log lighter (gas) _ 23.32 - _ Wood /pcllct stout 33.39 Wood fireplace /insert 23.32 i�t , k� +' 1>�Ol'Jili (3 x ;. '4.�i,, �. µ. �,y.,,- � is Chimney/liner/flue/vent 23 -32 . �' '�; � � i t''Y Otller: 23.32 Name: EJ:LC.. -1 1../2.41.k..:0--- 1, ..r `✓� terv - ■-- , _ I:nvironmcntnl exhaust and ventilation: __ __ Address: I a °! 1.5 J (RA) �` U -� S 4 Range hood /other kitchen h equipment 3339 City/State/ZIP: --1- , , d © R '1 Clothes dryer exhaust _ 33,39 • Fes: - Single -duct exhaust (bathrooms, Phone; ($� r J - ) r7 3 ( ) toilet compartments. utility rooms) 23.32 '' 'wi' ;;:.. ,,,,A b T ' iPI'L` js? a ><?c 1 � (J ` r :... 0 V Attic /crawlspace fans 23,32 • Other 23.32 Business name: SUN GLOW, IN - Fuel tin P p g. Contact name: OU HEATING & AIR CONDITIONING 514.15 for first four; $4.03 for each additional 2428 SE 105th Avenue - Address; Portland, Oregon 97216 - Gas heat pump City /State/ZAP; (503) 253-7789 FAX (503) 253.7693 Wall /suspended/unit heater Phone: ( ) Fax: : ( ) - Water heater E -mail: - Fireplace _ sage „ Ia,..,z . 5ci;t4i:::',;.r,. ..:�,. ..6 %�y� y,,� °,:i; .er .. } o :w. !-. ' ,;� ! 4 "'' xat 7 41d ;., #SA t + "lr ,: I '.' 14. r ,�Cl'l)'ti17'�tF1 ' J.1 .. .{ ..o r : 's i :'...„ ,,I; T ", : ,, Barbecue Busincs name: Clothes dryer (gam SUN GLOW, INC. - Other: Address: HEATING & AIR CONDITIONING ' . s y � fP ; 2428 SE 105th Avenue :::,,...{ ;.0 N.,> .. .:.'..., . :.; i' .,• p City/State/ZIP: LOW Subtotal y 0, • - 5 Portland, Oregon (503) 2 Minimum permit fee ($90.00) 0 • a O ['hone, ( ) (503) 253.7789 FAX (503) 253.7693 "� C Plan review (25% of permit ice) CCB lie.: k 3 I State surcharge (12% of permit foe) )e) . (6 a - TOTAL PERMIT FEE 1 t7 (`) • q:4 Authorized signature: -- �� 80,-Q--Q- This permit application expires if a permit is not nbtnincd within 1$0 rinys after it has been accepted ns complete. Print name: r J,.s,-, i:4- . S ll,. Date: /0 , 3 L I z...._,] • FCC mcthodolojy set by Tri -County 13uildinn Industry Service Board f; 1Au11A1ng1PcrmltalMIRC •PermItApp.rlor, 0:07/12 441)- 4017T(II /n2 /COM /WIi9)