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Permit CITY OF TIGARD MECHANICAL PERMIT • • q •• COMMUNITY DEVELOPMENT Permit #: MEC2012 -00613 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/29/2012 Parcel: 2S110BD00500 Jurisdiction: Tigard Site address: 11790 SW WILDWOOD ST Project: STEVENS Subdivision: SHADOW HILLS Lot: 3 Project Description: (1) gas furnace removal and replacement, (1) flue /vent Contractor: SERVICE NOW OF OREGON INC Owner: STEVENS, MARLIN K & 12042 SE SUNNYSIDE RD #359 WERNER, CYNTHIA K PORTLAND, OR 97214 11790 SW WILDWOOD TIGARD, OR 97224 PHONE: 503 -445 -2440 PHONE: FAX: 503 -445 -2443 FEES Specifics: Description Date Amount Furnaces >= 100K BTU. 11/29/2012 $54.91 Type of Use: SF FlueNent For Any of Above 11/29/2012 $23.32 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 11/29/2012 $10.80 Occupancy Grp: Minimum Fee Adjustment - Mechanical 11/29/2012 $11.77 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: C, Permittee Signature: ©ikt /.PP /- (ID' li 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. • Service Now 5039541885 p. Mechanical Permit Annhicat101 FOR OFFICE USE ONLY ri p City of Tigard REiV. �,��� tiY D.de/uy: b f s�� r /�,� Permit No �i ') A/1 a 00443 13125 SW Hall Illvd.,'I'igttrd, OR 97223 NOV 2 8 2012 Plan Review Other Permit: Phone: 503.718.2439 Fax: 503.598.1960 Date/13v: TIGARD InsptctionLine: 503.639 D:dcltcadyrliy: Jura: El see Pup 2for Internet: www.tigurd- ur.guv BO 'rl'FE OF r ►'ORl1 r ITY OF ' • �� NctiGcd/Mclhad: trio tiupplrmeutal Information V IIDtN v G DWISI,I', COMMERCIAL FEE SCIIF.DUI.E — USE CHECKLIST Mechanical permit lees* an: bused un the value of the work ❑ New construction gr Addition /alteration /replacement pertimned. Indicate the value (rounded to the nearest dollar) of till ❑ Demolition ❑ Oilier: mechanical materials, equipment, labor_ overhead, and profit. - ----- Value: $ CATEGORY OF CONSTRUCTION — RESIDENTIAL. EQUIPMENT/ SYSTEMS FEES* 1- and 2- 1:ullily dwelling ❑ Commercial/industrial [] Accessory building For special informnlon use rbi'i•k/1sr, w ❑ Multi li ❑ Master builder ❑ Other: Description w' [ Qty. I Ea. I Total JOB SITE INFORMATION AND I.00 'ION Ilealiug /cooling: •._, Air conditioning Job site address; r 0 0i 574- ( re quires site plan showing placement 46. 11 � lc1/ w 9 Furnace 10(1,(100 H'I'l l (ducrslvents) 46 7 75 City /Slott l /_II': �� � /l • l Q/Z_. q -7 2 C/ F..... : IOQ000+ f1T11(ducwvcnts) 1 54 91 Project name: hcf' er . bl Suite/bldg. /apt. no.: ' l J P eat pump (require, site plan showing placement) 61,06 Cross street/directions to lob site: Duct work 23.32 _ I lydronie hot water system 23.32 _ 0u e- rc e ((/ .. Residentia boiler (radiator or hvdronic) 23.32 Unit heaters (fuel -type, not electric), _T in -wall, induct. suspended, eta:. 46.75 Subdivision: Lot no.: Flue /vent for any of above J 23.32 , -„ Other: 2332 Tax neap /pared nn.: _ 011m- fuel appliances: _ — DESCRIPTION OF WORK Water heater 23.32 . — X , n Gas fireplace /insert 33.39 A pmege 4 l eP (e t' 3 1- ' AG er- , Flue vent for water heater or as — fireplace 23.32 — Log hghte(gusl 23.32 _ - _ Wood /pellet stove _ 73.39 Wood fireplace /insert •_ 23.32 Ea' PROPERTY OWNER 0 TENANT 23.32 ( �t Other: 21.32 Name: L " . "-- 1 . /5/ /e '/A 1 °r 4 42 " f /l er 5J 'ust,i Environmental exhaust and ventilation: Address: / Range hood/other kitchen , equipment 33.39 - C ity /Slate /.11': Clothes dryer exhaust 33.39 - Si - duct exhaust (bathrooms, I'hone: ( ) u Fax: ( ) toilet compartments, utility roams) _ 23.32 . , APPLICANT © CON'T'ACT PERSON Attic /crawlspnce lens 23.32 Rosiness name: rater �4.� - 6 ' Fuel _ 23.32 I _.... Fuel piping: , -• Contact name: 1:14,I5 for tint fnnr; 54.113 for each additional W ^ Fumaee. etc. Address: .- _Gas heat pump City /State/ZIP: ._, Wall /sospcndcd /unit heater - Phone: ( ) lax:: ( ) Water heater _.. . Fireplace _,. E-mail: _ _ Runge CONTRACTOR ._ ,�-�'' Clothes dryer (gas) Business name: r a/ C t ° . O 4, -�/J L , 4 Li Other _ Address: / )oV �h • S ii A y5 / 3 $? -^ MECHANICAL I'EItMI FEES* Y Clot L/ /1} lJS at / d/5 Subtotal Cit /State/ %IP; y Minimum permit Ice ($90.00) Phone: (5/ ) t./ 9 $ ,2 Y0 Fax: (' 3) WS- .Z 6 1Y 3 Plan review (25'% ol'pemlit Ice) CCU lie.: / 6 / 5 9.-- g(aK( (4 �_ t' State surcharge (12 % opunntt 112e) r � TOTAL PERM I7' FEE f 0-Q . av / / This permit appliealinn espin + il, permit n Hot obloined within IMO Authorized signature: r r C �/ day, Orr it has been accepted as complete. Print name: tale; ��2 e// I • Fee mCthndpinyy an hv'1'ri -Cuum 11uilJinp; Industry Service Rnaril I \Ii,,iIJiniU \M .C.eenuiIAi.i,, d.a+ 01 /07/12 its_ t 17T ( I 1l02/COM/W5li)