Permit u CITY OF TIGAR MECHANICAL PERMIT
'� tt • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00689
T I G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/31/2012
Parcel: 2S111DAl2400
Jurisdiction: Tigard
Site address: 15405 SW HARCOURT TER
Project: Tseng Subdivision: APPLEWOOD PARK NO.3 Lot: 117
Project Description: (1) gas fireplace replacement
Contractor: SUN GLOW INC Owner: TSENG, PAULINE
2428 SE 105TH 15405 SW HARCOURT TER
PORTLAND, OR 97216 TIGARD, OR 97224
PHONE: 503 - 253 -7789 PHONE:
FAX: 503 - 253 -7693
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/31/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/31/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/31/2012 $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 503.232.1987 or 1.800.332.2344. / (( a (�Q
Issued By: Permittee Signature: ad r' I O nv
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.
Mechanical Permit Application OR 01 1 It_ I (1N 1 1
l O E SI.
City of IV l y , , � 3(I t.9- Permit Na. ,a - Xtp
IN U 13125 SW Hall Blvd., Tigard OR 97223 Plan Review
II ' Phone: 503.7181439 Fax: 503.598,1960 DEC 31 201? Date/BY: other Permit:
T t c , n inspection Lim 503.639.4175 pore Read /s : awls, El See Par 2 for
blond! www•tigard -or.gov Vin OF VGA .' :,hod: - 1.-)p Supplwncntni Information
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Mechanical permit fees* arc based on the value of the work
❑ Now 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: S
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�r` �� �Y IY.r,:: �t. C� 1 �. � 4 �! .^Sw.y f.��P N.Ij�.y��,{]��jj���L��
r: �(, �i�':a� .d. 1iy .'.TJh i',' . : � � ����.1 '��.:'., �� Q�3 �•1/'l,v
- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information uaa checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description i Qty. I Ba. I Total
gw ; -� , � � ,. ., q rt z;l Heating/cooling:
n - . 1.:• .� Air conditioning
Job site address: I 1.40 j (,J 1._.\ Cf, m L txuf ,.1/4 --cea- (t?' Inquires site prim showing Dlacemm 4C +.75
Furnace 100,000 BTU oilers/vents) I 46.75 44•775
City/State/ZTP: -1 (6._ t C) .. Q a-a- - Furnace 100,000+ BTU (duet.dvonda) 54.91
Suitc/bld d t. no.: Project name: Had pump
g aP Inquires 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
hv dronic) 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: Lot no.: 23 32
Other: _-__
Tax map /parcel n0 oth fuel a . , fiances:
*' Water heater 23.32
5u • i'ir• , o c t it+^ � ► n.ii� i� DI °. , : ` . t .,. ;t? Rw l;,
` fi.�reatur :t - r Gas fireplace/insert 33.39
Q p n lJ1�... S
� �jk, , gas
Flue vent for water heater or
�� p. � (� fireplace 23.32
•- Log Ii,Shter (gas) 23,32
Weod/.e11et stove 33.39
,,., - Wood fireplace /insert 23.32
r�+�i ; r� tr":ii � ^,^w . , Chimney/liner /flue/vent 23.32
ri a at, ;l " w ..tA` ii llI f ' r:� Other _ 23.32
Name: ---is �'!1 Environmental exhaust and ventilation: --
• Range hood /other kitchen
Address: 1 5005 S l..t) ULt r C1. d�_k rk r:e rr LC4-' • ui rent 33.39
City/State/7_TP: --- ' LA d. 1 0 "Ii?--_____4_,. Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax ( ) toilet compartme utility rooms) 23.32
,'r:',::;'4:::, v � n g i , ��✓, «7 ;.�e " y a . y; 7 J Attic /crawl - ,mace fans 23.32
, d _ r ;
- t e �: Other: 23.32
Business name .� Fuel Qipinfi:
SUN GLOW, INC. -
Contact name: HEATING & AIR CONDITIONING S14.1 for first four; $4.03 for each additional
2428 SE 1 05th Avenue Furnace, etc.
Address: LOW Portland, Oregon 97216 -. Gas heat .um.
City/State/ZIP', (503) 253 -7789 FAX (503) 253-7693 Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater ...
Fi lace
E-mail: ('r1l\e\511,3 to C.mn - \od.J ∎n C.rr
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Business name! SUN GLOW, INC. - Other:
Address: UN HEATING & AIR CONDITIONING 4'. ".7 re Va,c;+ a ?q " :. ' .:ta`:? ;.' el
2428 SE 105th Avenue Subtotal
City /State/Z.1.P: LO Portland, Oregon 97216 Minimum permit fee 090.00) ti to q O • O °
(503) 253.7789 FAX (503) 2S3 7fi93
Phony: ( , pl review (25% of permit fee)
,
CCl tic .: `7 �.. State surcharg p ermit fee) 1 O
' TOTAL PERMIT FEE LO 0 .'t e
This per appllcntion expires if* permit is not obtained within 180
�,_
Authorized signature: L , , 1.r:� 0..x -n�} -. days after it has been accepted as complete.
1 • Fcc methodology net by Tri.Couniy Building industry Service Board
Prins name :C_ c k - a._ otr date: / d l 13 r l , ,
m »unat, 1 , wor,mlboArc- p.itnpr 02ro7/12 44D.4e17 (Ilro2/CO14/WEB)