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Permit
CITY OF TIGARD MECHANICAL PERMIT s • COMMUNITY DEVELOPMENT Permit #: MEC2013 -00094 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/13/2013 Parcel: 2S 115AA06600 Jurisdiction: Tigard Site address: 16430 SW 109TH PL • Project: Schlachter Subdivision: REBECCA PARK Lot: 23 Project Description: (1) gas furnace installation Contractor: WOLFER'S, INC Owner: SCHLACHTER, JANINE R 290 YOUNG ST 16430 SW 109TH PL WOODBURN, OR 97071 TIGARD, OR 97224 PHONE: 503 - 981 -4511 PHONE: FAX: 503 - 981 -0801 FEES Specifics: Description Date Amount Furnaces < 100K BTU 02/13/2013 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 02/13/2013 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/13/2013 $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: Permittee Signature: tN PP Ph C49 -rOkL 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. FEB /13 /2013/WED 09:27 AM WOLFEAS HEAT {{ II � NG FAX No 5039810801 P,001 /001 Mechanical Permit Application RE E FEB 1 2 2013 ! BW PC0 ( 3 - bOD I - 13125 SW Hall lvd., Tigard, OR 99223 Other Permit: Phone: 503.718.2439 Fax 503.598.1960 arelBy: TICARP Inspection Line: 503.639.4175 C ITYOFTIG AItI�ateReady/ny: — lurlr til See Papa2for w Internet: ww,tigard- or.gov BUILDING DMSIfed/Metl'ad ' Supplemental Information ,' is' r r w ':"c ii DitB Mir"'" (Writ,' i i9i "trio 4 ' ' i s ,, l yyr il , _ • tip, 1 t "— % =� Y "" ` b ` "� Mechanical permit fees* are based on the value of the work 0 New construction CitAdditian /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all b Other mechanical materials, equipment, labor, overhead. and profit. Q Demolition Value 3 � ,1- 73' -.�,w w ". Y ii v,..d .. -4 ' , .. - LU`Xil a • �_ .. ,,, :.•_rt. 1 "Lt p .w""`-- 7:.LL':". '''' m15'�`„'_, - ..-'Sr_t!'PI WAget a,1- and 2- family dwelling © Commercial/industrial ❑ Accessory building For special Information use checklist. ❑ Master builder ❑ Other: Description Qty. Ea. Total Multi-family e ,,,, , ._ Heating/cooling. - ota y d r ` rar . .17 ( (l td i ALi . L.. ._.. . . tt- 44 -4' Air conditioning , �,?,•.�. f. 46.75 {req uires ea p lan show placement) Job site address: a p B. - -_— r 1 � .� • �`dma�tt700:000•B�t(ducts/v_ ate) • d 46.75 City / State/ZIP: "-1 t ** C. Q . S --a 1 Furnace 100.000+ BTU (ducts/vents) _ 54.91 Suite/bldg./apt. no.: J project name: T��) g2j'18.fi.< Heat 61.06 ( site Ian showin placement) Cross street/directions to job site: _ . Ductwork 2332 • Hydronic hot water system 2332 Residential boiler (radiator or hydronic) 2332 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 -. --' Lotno.: Fluevent for any of above 23.32 Subdivision: 23.32 Tax map/parcel no.: Other fuel appliances! � : - ,t „ r . �., • Water heater 23.32 • t, Gas fireplace /msort 3339 Flue vent for water heater or gas ftrplace 23.32 - — Log lighterigas) 2332 Wood /pellet stove 3139 Wood fire •lacerinsert 23.32 -- • �•-� -� Chimney/liner /flue/vent 23.32 - 1 - 7; 6 -+ - - I Y� k ,, E II trj el f + -•r * to , `-,- ;-xj .23.32_ • Environmental exhaust and ventilation: Range hood/ether kitchen Address: tS t n �t e2 & y © i _ PL- equipment 33.39 City / State/ZIP: ..,—'" / ' a; 1 Pa L./ Clothes dryer exhaust 33.39 f a. _ v Single duct exhaust (bathrooms, si Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32 �. 71 S ^ r 2332 1714.7-7.2- raw fi "'�, '1" _ w w r � t- a fi " ... AtttrJcrewlspace fans r/ t n . h h t'� t - T _ rl v . n "_, Other: 23.32 name: ns: ` p f S • 'Q!� Fuel piping: Contact name: 1 v _ — . .. _514.15 for first four; 54.03 for each additional I -- Furnace etc. Address: "t" ' Ges heat pump . City/State/ZIP: �, k � I ., _ ' i -71 Walt /sus(.r„nded/unitheater • Phone: (' pj �- ) oi O - 4i � I l Fax:: (j) S g ! . ' Water heater • - • Fireplace ry 1(L ) w 0 0. rsw,e Range - , ., . , -/�V,.��. ��" 1 . ry' Barbecue ",- - r ,....--7 - u•...,. u r}.� -•.. .. e . } '�...�ti•� dS r- , r "a6�s- ......—� - I - at' —.— - -- clothes di ver (PaS Business name: 1� / f 4.-j? tt� Ili Other: Address: 4 [, -, . _ 1V CI AIVT �r " ty 4 / /J 1 f ( , w �� I Subtotal Ci / State/ZIP: (� _[ • Minimum permit fee (590.00) 10 .X Phone: e5)(121-1-611 Fox: ( qg - Qgj o I Plan review (254 of permit fee) CCB lie.: ; ' q IL__ ____....-- - State surcharge perm ri TOTAL PERMIT FEE ; _ ✓/ , �, This permit applieation If a permit is not obtained within Authorized aitrnature' C `^� "' >, ;-9 days niter it has been accepted as complete ` a a+9 - o .. t ,4:41S . .