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Permit I "`t CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2013 -00023 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/14/2013 Parcel: 2S109AD02100 Jurisdiction: Tigard Site address: 14550 SW 130TH AVE Project: Vallereux Subdivision: WOODFORD ESTATES Lot: 13 • Project Description: (1) furnace installation Contractor: OREGON HEATING & AIR CONDITIONING Owner: VALLEREUX, JERRY E & SHELLEY A 19300 SW 118TH AVE 14550 SW 130TH AVE TUALATIN, OR 97062 TIGARD, OR 97224 PHONE: 503 - 691 -9699 PHONE: 503 - 481 -6147 FAX: 503 - 691 -8556 FEES' Specifics: Description Date Amount Furnaces < 100K BTU 01/14/2013 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 01/14/2013 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/14/2013 $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. Issued By: I AL ` — Permittee Signature: © 4PPLI v LL 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. 01/11/2013 15:50 503 - 691 -8556 OREGON HEATING PAGE 01/02 Mechanical Permit A liea FOR OFFICE USE ONLY r City of Tigard no sy- ( i P it ' i i 3 --000 N.....- 13125 $W Ball Blvd., Tigard, OR 97223 JAN 1 4 2013 Ran Review Other Pe Phone: 503.639.4171 Fax 503.598.196 may: See page z for '( G A t: t Inspection Line 503.639.4175 CITY OF 1'IGARD Rnh r ( S��e taform Internet www.tigatd- or,gov BUILDING DIVISION . T, :. l 2 , 8 ®ut.E.,- VS 'CSC - GYP W fee. ees• ar E' t),P = '•'. �: .. i� :, ,� ; . •- - . . Mechanical permit a based on the value o f the work ❑ New construction � Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical material equipment labor, overhead, and Profit- Value: $ _ - CATEGORY ;' OF UCJHTOIY,:: ', k•'',•'''1"0--;.'''-,!-- c „ -..r r.. , , .. ]S .• N Rl i► i?0?4E1! C % 51 gT E1► 7 S Fk S*- . '1- and 2 -family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist ❑ Multi - family ❑ Master budder ❑ Other: Description I Qty. I Es. 1 Total .. . . LQCA�!'IOIY� ” . Head eooti 8 1T B Rt►T1 TOB INFO . , -.. rll([, . Ave. r conditioning Job site address: Y it/550 j,� 130 /'T (moires site plao showing placemrn 46.75 �7 Furnace 100,000 HTU ( data) 46.75 City /State/ZIP: Poi - d miii _ Pl3 q T �,27 _ - Furnace 100,0001- BTU(ducuhvrs) 54.91 Suite/bldg. /apt no.: Project name: Va ii e r_e w x _ _ Heat pump 61.06 Duct work 23.32 Cross street/directions to job site: Hydronic hot water system 23.32 Residential boiler (radiator or hydronie) - 23.32 . - . Unit heaters (fuel -type, not electric), in wall, in -duct suspended, etc. 46 - . — Flue/vent for anv of above 2332 Subdivision: Lot no.: Other . _ 23.32 Tax map /parcel no.: Other fuel a • diances ., '• ::; ... • - ... :. Water heater 2332 c ?: "+ , .. 3339 ,. ..:.. A) SCRI> YI�OI� ':17F`:Vt ::'��';�. � .r ;�:��` ':a';': �,'•••` Gas fireplace - �+ Flue vent for water heater or gas f7 r+cwli /iw Phn [R fireplace 23.32 1,0 li ter 23.32 Wood/pellet stove 3339 ` Wood fucplaccrinscrt 23,32 Chimney/liner/flue/vent 23 2 2332 ER — , " Ni" PROPERTY .OWN „ :: . :,. ' " . .. , =d ' �`,;: "' Other. 3 Name: / " . / • e , • ventilation Environmental exhaust and venation . Range hood/other kitchen Address: i f S n S �! . i.maul• 3339 n Clothes dryer exhaust 33.39 City /State/7IP: `tom / 02 Single -duct exhaust (bathrooms, Phone: (5 ) ji — C Fax: ( ) toilet compartments, utility rooms) 23 32 '' CONT Attic/maw a ce fans X,ICANf .. _ ; 0, . PERSON ' ' : _. '; ?;c 2332 Business name: (2 � f - Fuel pipit�r t Contact name: `� u ,] — $14.15 for first four; 54.03 £ or each additional It c GC on . Furnace. eta - Address: l9To S , N8 ;tt Are Gas heat City/State/ZIP: q 6, pR 91o6 weer heater Tunis heater — Phone: GSo3) C ' /- `169 Fax: : ( ) Fireplace E -mail: _Ilan c: �:. :.. Barbecue ... Clothes dryer (gas) J Business name: 0 -. w , .., . Other: . Adams: Woo 5i, 1/8 eice `� "' c .r ?c ..... . .. - Subtotal City /State/ZYP: 7uat`cF3 . oR RQl.? Minimum permit fee ($90.00) go. Phone: ( o3 ) 69 i_ q cQ Fax: ( ) - Plan review (25 %ofpermit bee) CCB lie.: / 72/7 2 6 State surcharge (12% of permit fee) / O f* TOTAL PERMIT FEE J 00 • If This permit application =pins if a wait is not obtained within 180 Authorized signature: .a I ' , days after It has beta accepted as complete. !� Gil, Date: ( 9 • F methodology set by Tri-County Building Indmtry Service Board Print name: K /C �...L.