Permit a CITY OF TIGARD MECHANICAL PERMIT
511 ' • • CO MMUNITY DEVELOPMENT Permit #: MEC2013 00098
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/14/2013
Parcel: 1 S 134DB04400
Jurisdiction: Tigard
Site address: 11065 SW 109TH AVE
Project: Vanderzanden Subdivision:4HAN'S ADDITION TO THE CITY OF TI Lot: 6
Project Description: (1) gas furnace replacement
Contractor: A TEMP HEATING & COOLING INC Owner: VANDERZANDEN, MATTHEW L & CHIE T
16000 SE EVELYN ST 11065 SW 109TH AVE
CLACKAMAS, OR 97015 -9519 TIGARD, OR 97223
PHONE: 503 - 650 -5014 PHONE:
FAX: 503 - 557 -2990
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/14/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/14/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/14/2013 $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: AA " )- " Permittee Signature: 0)d APPL/ L/ ( o4
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 A CEIVED
City of Tigard 13125 SW Hull Blvd., Datc/B`d L.4 etaa 3 - o00 egg'
d, Tigard, OR 97223 FEB DateJey: a l/ 3 PamieNo.:
Phone: 503.718.2439 Fax: 503.598.1960 1 2013 Mu Review
i 1 r L • inspection Lino: 503.639.4175 Dmouay: (7117er P ,mil:
Internet wvw .tigerd- or.8uv CITY OF TIGARD tdatifi d M h a' ® see Page 2 for
BUILDING DIVISION 6enw �' t° ' ° �"°"
7°Y#eE Off' pu171Et]f. •
❑ New construction lLt Addltion/alteratiortheplacement Me l permit face ar a basal on the ratan of the work
Q Ne w
Demolition ❑Other performed. lndicata the value (rounded to the nears dollar) of all
-� mechanical meteriala, ci: ipwcnt. labor, overhead, and profit
• . CAT*0301? 0.0 CQNSTRY)CTIOIY . Value: $ O
$l 1-and 241,11,4 dine .. 10TIAi. EQUIP igNT P.SVEllatiSji _ S
S ❑ Commercial/industrial Q Accessory building For
0 Multi- family ❑ Master builder ❑ Otter
• Description Qty. Fa. Trna!
J .MT oN AND LC/CATION He atlnR/coullnII:
p ( [� p Air conditioning
Job site
_Lie
: q 6 65 s J I 0 �(� Au V OWNi 0 oa Oita Plan allowing plowman* _ 46.75 r-
City /State/ZIP: `I S d.>' 4 i. @ e. Q 4 Z � Furnace 100,000 H1Y 1 (ductu/vCUts) _ 54.75 b / • I�
` Kinn= 100,000+ BTU (denuiveam) 54.91
I Suite/bldg./apt. no.: Project name: V nkr 4.49 h � Heat pump
Oecui
Cross street/directions to job site: Duct ea site plan � c elacenanit) 61.06
_� wait 23.32
llizdronic hot water item 23.32
Residential boiler (radiator or
hydtonic) 23.32
Unit beaters (fuel-type. not dean*, �
in wa11. io -duct, suspended, etc. _ 46. 75
Subdivision: 1 Lot - __I Fltw /vast for en�of above 23.32
Tax map/parcel no.: f 23.32
(Other tact appliances:
' ' 01 S JE !T4ON `# `iFOBI6 •. .' Water heir _
2332
I e d I V o ` . . rep / ) n S , 1 _ Flue ve for water heater or gas 33.39
freplacc 23.32
-
J.-2.04 _ 23.32
Wood/pellet stove _ 33.39
Wood fireplacermsert 23.32
: f► ! `. 4Vf?h ER .. ' . Clrimny /lineo"13tre/vtart -
'17'T,F;4tFi#trJt 23.32
Name: M e • t O _ 23.32
ENE Umb e! exhaust and ventilation:
Addivls: 1 0 6.5 S4 (0 l .I • Range hood/other kitchen
City /State/ZIP; �� 0 0, _ 1I' '2-2 Q = �thes dryer 33.39
t � • ✓ Cloth drvrt exhalent 33.39
Phone: ( ) Fax; ( ) Single duct exhaust (batlanoms
t toilet compurtmetua, utility rook) 23.32
. - • .. 0 ANT :. . MON.TAPU • Altia/cmwle &ms -`
1 2332
Business name: er.
- _ 23.32 _
F- ping: •
Contact Hawn: 1
�� � - S14.15 for fast four; S4.03 for each additional
Address: OR Furoace, etc. f
l ' city....., 1 "} Cons heat pomp _ J
Wall/suependad/ header
Phone: ( )
Fat.:: (SD3 ) . j 5 .- • z ' 0 Water heater
E-mail: ra 6t± (.9 d`4em e h € fi, , ca Fireplace •
rrirai'`rru. ' ?tee
•
Barbecue
Business name: ATEMP ThG ANDCOOUNf,_INC 1 Clothes dryer(gs�
Address: 16000 SE Evelyn St. her .-
Ittepwacm., Ppmrr'TES'
City /State/ZIP: Cldtkam Subtotal Ili .
- 5A -S�lt 4
Phone: ( ) Fax: (S ,� "3) ;51- 2q 4Q Manurarm permit few {540,00
• CCB lie.: ,
'Plan review (25% of permit fee)
a _ State surcharge (12% of permit fee) TO. 0
Authorized signs I Tba TOTAL PERMIT PEE `Q p • Q
application expires Ira permit b not obtained within 150
V .� I days alter it tins been acceAted SA tnmplete=
Print name: o , . , 1:1 Date: � �il. • Fec m�odolo Itr sit b
Y Trio nary Building laduatry Service Beard
I:\ BuildawerniisVtnac.raocitappeee mane io
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Somewhere between too hot and too cold there's,...
F A-TEMP
HEATING & COOLING, INC.
A 16000 S.E. Evelyn Street — w "'w latpmpheating nom
Clackamas, Oregon 97015 (503) 650 - 5011
FAX (503) 557 -2990
X TO. 0 ( FROM; A -�77
ATTN: Pp,(m.46 DATE: 3
T PHONE: TIME:
FAX #OF PAGES:
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❑ URGENT
FOR, REVIEW
❑ PLEASE REPLY
S NOTES: f &x 1, .o tc - / cd 00.
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Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
11065 SW 109TH AVE, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
03/25/2013 00:00
MEC2013-00098
PASS - No C of O
Minor #353310
Violation Summary:
Inspector Contractor