Permit CITY OF TIGARD MECHANICAL PERMIT
11 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00650
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/10/2012
Parcel: 1 S 133DC 10600
Jurisdiction: Tigard
Site address: 13235 SW BRITTANY DR
Project: Kroner Subdivision: BRITTANY SQUARE NO.3 Lot: 62
Project Description: Replace gas furnace.
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: KRONER, SHERRY S
•
1005 INDUSTRIAL PARKWAY 13235 SW BRITTANY DR
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 - 538 -1950 PHONE: 503 - 605 -6101
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/10/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/10/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/10/2012 $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.
, dekj?zi rid. 2 ..._
Issued By: Permittee Signature: e z - Li �/J /0 ,,"
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.
12/10/2012 14:41 FAX 5035380165 fJ003/003
Mechanical Permit Applicatio (,I; t;l l I( t 15l 1) \I.,
E� � � w ewived I I /W. - it No
City of Tigard DatefOr /e2 a /.Z- Pam �1Eet:2042 /r ■ <
13125 SW Hall Blvd,
503 82439 Tigard, OR 97223
5981960 D EC 1 2012 Plan Rewisw
• Other
Inspection Line: 503.639.4175 a ri rt Date Ready/By: revia: 65 See Page 2 for
Internet: www.tigard-or.gov CITY OF TIGARD Notified/Method: : Supplemental Information
Ft111t- Il� D�11 .
.
Mechanical permit foss 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
Value: $
CAATECOiW CO ICTR
HE61JI fENTtAiE:'EQIJMEIwTIS]i"SfFP$&•
1 -and 2- family dwelling [ I Commercial/industrial ❑ Accessory building For. special iido,matlon use cheetaht.
0 Multi- family ❑ Master builder ❑ Other: _Description j Qty. j Ea. Total
• Heating/cooling
' f ' 1 Air oonditirming
Job site address: /32,55- 5 U) o 1 G�, y b r I f„Q., titres site • - ehowin .. ler 46.75
p Furnace 100.000 BTU (duets/vents) 46.75 PM&
City/State/ZIP:
`r;�a L/'� I - � . �. haroaCa (ductsvcats) 100 BTU / _ _ 54.91 .
Suite/bldg./apt. no.: Project name: i< O V1 C U` Heat pump
e t' (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
hydroniF1 23.32
Unit heaters (fuel -type, not electric),
in -wall, in-du sus ded, etc. 46.75
Subdivision: I Lot no.: Flue/vent for of above 23.32 ,
Other: 23.32 •
Tax fnap/pareel no.: Other fuel appliances:
• )h Eli WORK' Water heater 2332
�] _ p I ace C--,' a t vac lj Gas fireplace/insert nsert 33.39
1 °` wCl - G Flue vent for water heater or gas
fireplace 23.32
Log lighterlgas) 23.32
Wood/pellet stove 33.39
Wood fireplace/inscrt 23.32
)ye, f .��.... Chimney/liner /flue/vent 23.32
• .
"' ' ' �4,aE!�O�P:R7�Y OoW1iFE�;�' � � "' . M , . ;�' Y !�'Jtvi�
�+ Other. 23.32
Name �, rn Environmental exhaust and ventilation:
dress; 3. 3( raii I t t4 Y 12r(►r4 -r Rangehood/other kitchen
Ad
equipment 33.39
City /State/ZIP: —1" 4 c /1 r,Q q '7 2. 3 Clothes dryer exhaust 33.39
Phone: J i r ` Single -duct exhaust (bathrooms.
( ( Q ° ,.,,- 6101 Fax: ( ) toilet compartments, utility rooms) _23.32 • ' • ..: 1►1pP1 ICANF ' . ,1. , ! jtCY 1PERSON . • • , Attidcrawlspace fans 23.32
Other: 23.32
Business name: Fo seAentiaii4EATING Fuel �pimE:
Contact name: AND AIR CONDITIONING INC. $14.35 for first four; $4.03 for each additional
Address: 1 Oub INDUSTRIAL PK 4 Furnace, dc.
NEWBER R nR 97132 Gas heat pump
City/State/ZIP: , Wall/suspended/unit heater _
s r
Phone: 7 3) i 0 { Fax:: (50? 3z "d / 6, Watrr heater
E -mail: '' `'�
� F� lace
s LQ-rC i kikr SQ. S ia.4 t C C1 Range • (i :: . . , . • ' Barbecue
Business name: POUR BEASON* HeAriNn Clothes dryer (gas)
Ate AMU AIM CONDITIONING I Other
1005INDUSTRIA( PKf& Y • - • .:. • , MECHANICALIP RM1T FED' : ,
City/State/ZIP: NEWBERG, OR 97 X 53 $' i l �ia s- q (1 97132 Subtotal 4 (fir 7 S
Phone: ( i Q I Fa ( v3 5
503) — Minimum permit fee ($90.00) , ...-
Plan review (25% of permit foe)
CCB lic.: 9.115 a-- State surcharge (12% of permit Re) /0 , �
C. TOTAL PERMIT FEE Jjc�
Authorized 6lgrtantre:
This permit application expires If a permit is not obtained wlthln LSO
days after it has been accepted as complete.
Pr'itrt IMine: f ` a H e .- -Ha A Date: (�� /](/ /V 1 sz • Feo methodology set by Tri- County Building Industry Service Bond
l: 1BuildIngPPesmi tEr,Pa,mtApp.doc 03107 /12 4 40 40 1,1 0 trovCOMAVEel
12/10/2012 14:41 FAX 5035380185 Z001/003
RECEIVED
DEC 1 0 2012 i
\ ‘) Y , ‘ - ' - 4 '' j 'Illih'''1 7 t" BJ MISION
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NUMBER OF PAGES (including cover): 3
FROM: Four Seasons Heating and Air Conditioning
1 Industrial Pkwy
Newberg, OR 97132 cio e Li
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Phone: 503.538-1950
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Sent By: 1)1 avl e.----
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E-Mail: 01 1 6.0..e., ®fourseasonsheatair.com