Permit CITY OF TIGARD MECHANICAL PERMIT
111 ' COMMUNITY DEVELOPMENT Permit #: MEC2013 00119
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/05/2013
Parcel: 2S112CC08400
Jurisdiction: Tigard
Site address: 15679 SW 82ND AVE
Project: Acevedo Subdivision: LANGTREE ESTATES Lot: 16
Project Description: Install gas furnace and a /c. Placement of a/c unit must maintain 5' side and rear yard setbacks.
Contractor: WOLFER'S, INC Owner: ACEVEDO, JOSE M & LAURIE A
290 YOUNG ST 15679 SW 82ND AVE
WOODBURN, OR 97071 TIGARD, OR 97223
PHONE: 503 - 981 -4511 PHONE: 503 - 780 -6227
FAX: 503 - 981 -0801
FEES
Specifics: Description Date Amount
Air Conditioning 03/05/2013 $46.75
Type of Use: SF Furnaces < 100K BTU 03/05/2013 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 03/05/2013 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $104.72
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 N i cation 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 dir questions to OUNC b e 503.232.1987 or 1.800.332.2344.
Iss ed By: i �/ lkJ Permittee S / ,/_,111/ (
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 /28/2013/THU 11:49 AM IAIOLFERS HEATING FAX No.5039810801 P. 001
RECEIVED
_ Mechanical Permit Application bola OFFICE USE ONLY
City of Tigard eeet�e 49 /1 F EB •FEB 2 8 2 013 tar , . i1 1 Perm" Na: '
1, " 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.7182439 Fax: 503.598.196tI /lFTIGARD Date° OabetPar'te•
TIC. nrcD or inspection Line:. 503.639.4175 ISI I?ate Reod E See Paac 7 for
Internet, www.tigard -.gov BUILDING DN Natified/Metitod Supplemental Information
, 9W I@A ^�,1_ 4,:s" e • • y -,' 4 W . - ,,7 { ti u , 7--,--,,T , .. `4 t ' l`r��� l' ` ,' ,I i . s viju , . 6 1 x„ „'5, 1 1f D - • ..p _ ?., _ . : OS i Q T i •
Mechan permit fees* are based on the value of the
0 New construction 1 Q Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
O Demolition 0 Other: mechanical materials, equipment. labor, overhead, and profit.
J s'" _ Value: S
;, Er �tf# z t..r� D „ “, ' c O G . 4. - z 1 -' F "--+7 4 .7. t - .....IP �s. E r.... T
al -•trod 2- family dwelling ❑ CommerciaVindustrial 0 Accessory building For special information me Checklist
❑ Multi - family 0 Master builder ❑ Other: Description � Qty. I Ea. I Total
F c itFa'c� t -
—�� ; l enhnr/coolmg.
L _r ,, 1 ,. -t� i ^ __ . p t e, t : e 4 r;. _ . ,w A i r cond
�J__ v r. an fr
Job site address: ,` S — . '7 c i W -. a- - 4-l)`e._ (requires sire plan shower placement) ( 46.75 1 4673
Furnace 100.000 BTU Wets/vents) • J 46.75 11(0 -
City /StateIZIP: -Q.9,.,_ J 9 k 0 9_ ci` 7 AA 9 Furnace 100,000+ ETU (duets/vents' _ 54.91
Suite/bldg./apt. no.: Project name: � M b Hest pump
GSr jo Amt. (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
hydronlo) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duet suspended, etc. - 46.75
Subdivision: Lot no.: Flue/vent for any of above 2332
I Other: 23.32
Tax map /parcel no.: Other fuel appliances:
i+ • ;.JI` ',-7
I F v (i J , r r -"K '4 r y � � -, Water beater _ 23.32
Gas fireplace/insert 33.39'
Flue vent for water heater or gas
fireplace • 23.32
- Lox lighter (gas) , 23.32 •
Wood /pellet stove 33.39
Wood fireplace!msert 23.32
7.3w �� � "v - �'k d.
Chiron Hiner / Fue/vent • 2332
�: . t.t..'. i...1.15 %,..... t .. , 1 ka�w >- 1 a y i; - ' o Other. 23.32 ■
Name: — To t ( V • t5 Environmental exhaust and ventilation:
Address: 1 Z ( L ]' q < t.J D 4. tte___ Range hood/other kitchen
equipment 33.39
City /State/ZIP: I . e..r a.. 4 7 ; 4i Clothes dryer exhaust - 33.39
Single -duct exhaust (bathrooms,
Phone: ( So/ ) 7K'O — G3 - A Fax: ( ) toilet compartments, utility rooms) , . 23.32
F . .- � ' t., . ja ; i� a t+'! ^7 1 E+ rFj :: : -F p3 c o nud c�f xt µ i ?, u.1 :,al. Attic/crawlspace fats 2332
pusineSS name: j ( r/ ! n Other: 2332
1file i iT J (1- Fuel piping:
Contact name: . 1_ 4 , i , f I. $14.15 for first four: $4.03 for each ndditioual
Addr F� Furnace, eta
���v` . Gasheatpump
City/State/ZIP: k i i i t , ' q Wall /suspended/unit heater _
Phone: (J ) q g )- 4G l Fax:: ( j ) q f b U I Water heater
1 Fireplace
E -mail: { Slt.lr4 N Wol - rta .rl 01)' Range
L- ff'",1 ". '-, fi t - ..... - a ]t , Cttlr , .".ie"'. -7. 1� r � 7 . ;.� F T , 17 BBa r b ecue
4:02,4p -I •. Ti«� 1 o.0 1, .'S, 4 - =In fir;,,, Mr •3 .' , si,P 0 . , ,agel - . .
Business name: 1 NilfiII #�rl�tlr' / Clothes dryer (gas)
Address: /J, i l 511". Other:
i +IVII+gitegIViV `TIL'Ri153 @E1 3 I . �i •
City /State/ZIP: ` i 4r , I I / Subtotal g3.4,S
� � I Minimum permit fee (590.00) I��,
Phone: ( 1) ) / Q) - `"I J j I , Fax: (l n
) "1 g1 - Qa 0 I Plan review (25% of permit fee) 73,3 ' ' ' 1
CCB lic.: 4 • State surcharge (12% of permit fee) I f _p.
( zg-ii3 TOTAL PERMIT a
1 - r - 1.h. .,ewnIt . ,nli.ntinnl..oi..e Ir n* nnI( i nnl nhtninctl Vilh h I80 i1
RECEIVED
FEB 28 ?013
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