Permit U CITY OF TIGARD MECHANICAL PERMIT
g ' COMMUNITY DEVELOPMENT Permit #: MEC2012 -00611
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/27/2012
Parcel: 2S104BB01600
Jurisdiction: Tigard
Site address: 14359 SW WINDSONG CT
Project: Bridgman Subdivision: CASTLE HILL Lot: 51
Project Description: (1) furnace and gas water heater replacement, reconnect to existing duct work, electrical and gas lines
Contractor: SKY HEATING & AIR CONDITIONING, INC Owner: BRIDGMAN, HAROLD
1637 SE NEHALEM ST 14359 SW WINDSONG CT
PORTLAND, OR 97202 TIGARD, OR 97223
PHONE: 503 - 235 -9083 PHONE: 503 - 524 -2514
FAX: 503 - 235 -0454
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 11/27/2012 $46.75
Type of Use: SF Water Heater 11/27/2012 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 11/27/2012 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 11/27/2012 $19.93
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. �� ��
Issued By: 7l kai Permittee Signature: 0 q
U !' PP(,l vLJ/
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.
From:5032350454 11/26/2012 15:46 #261 P.002/002
Mechanical Permit Ap Ill I IT CEIUEf FOR OFFICE USE ONLY
City of Tigard ` Received_ PermitNO4 A., OrX
13125 SW Hall Blvd., Tigard, OR 97 Plan Re ' �� G 2 Phone: 503.7182439 Fax: 503.5M 2 12 Plan Review Other Permit:
Date�By:
TIGARD Inspection line: 503.639.4175 Date Read . Jtais:
and - or. ov Y BY: S upplemental Information VI See Page 2 for
Internet: www.li
g g CITY oF TIGARD c Notified,Method: 71 C Supplemental
"^ T" - .a 'z ). ' 1 _ _1 = :s ' . ? . _ S � CAJE ` r_: '. CAW S. TST'. ` ,
y - " ` -, ,, - ' •.: , _ - , ,. _ -- " ' . ' . '' . v,y - ' ? -- ` Mechanical permit fees' are based 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, equipment, labor, overhead, and profit.
� 3� , - . - ,AY Hj iitUt IOIli ;' Y ; Value: $
' :, A A -f1 C ST ; F -
0 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
- V :4101$ 'S I'iE` ); Q1kMA(ON' ND LOCAT�t� - . Heating/cooling:
- . Air conditioning
Job site address: 14359 SW WINDSONG Cr. (requires site plan showing placement) 46.75 _
Furnace 100,000 BTU (ducts /vents) 1 46.75 46.75
City/State/ZIP: TIGARD, OR 97223 -2646 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: I Project name: BRIDGMAN Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric).
in -wall, in-duct, suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision: I Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
t _ . »F -o?E 'wo _ `:: - = Water heater 1 23.32 23.32 •
Gas fireplace 33.39 I
REPLACE GAS FURNACE AND GAS WATER HEATER RECONNECT TO flue vent for water heater or gas
EXISTING DUCTWORK, ELECTRICAL AND. GAS LINES. fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
-- -` -,3:; Chimney9iner/flue/vent 23.32
,--?;
'`° . Other. 23.32
Name: HAROLD BRIDGMAN Environmental exhaust and ventilation:
Range hood/other kitchen
Address: 14359 SW WINDSONG CT equipment 33.39
City/ State/ZIP: TIGARD, OR 97223 -2646 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)524 -2514 Fax: ( ) toilet compartments, utility rooms) 23.32
= lij ; AP I;;ICtA :g , '-- '. J1 AD coil-1i 41.' -PEggp ' _ Attic /crawlspace fans 23.32
Business name: SKY HEATING & AC, INC.
Other: 23.32
Fuel piping:
Contact name: TAM1 HAGEMAN $14.15 for first four; $4.03 for each additional
Address: 1635 SE NEHALEM ST Furnace, etc.
Gas heat pump
City/ State/ZIP: PORTLAND, OR 97202 Wall/suspended/unit heater
Phone: (503) 235 -9083 Fax: : (503) 235 -0454 Water heater
Fireplace
E -mail: TAMI @SKYHEATING.COM Range
} ' _ Barbecue
Bus name: SKY HEATING & AC, INC. Clothes dryer (gas)
Other:
Address: 1635 SE NEHALEM ST °,`7 ' _ , -„
City/State/ZIP: PORTLAND, OR 97202 Subtotal 70.07
Minimum permit fee (590.00) 90.00
Phone: (503) 235 -9083 I Fax: (503) 235-0454 Plan review (25% of permit fee)
CCB lie.: 50244 State surcharge (12% of permit fee) 10.80
. c.ki TOTAL PERMIT FEE 100.80
This permit application Authorized signature: wr days after It has r been ace pted as complete.
thin 180
Print name: TAM! HAGEMAN Date: 11/26/12 ° Fec methodology set by Tri -County Building Industry Service Board
I:. Building ,Pmniis'MEC- PamitApp.doc 09'09 440-4617T (I1 /02'COM•WEB)