Permit o a CITY OF TIGAR® MECHANICAL PERMIT
;� >: , , , COMMUNITY DEVELOPMENT Permit #: MEC2012 -00683
.TI (3 AR D l 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/09/2013
• Parcel: 1 S 135DD00701
Jurisdiction: Tigard
Site address: 11740 SW WARNER AVE
Project: Nelson Subdivision: HOFFARBER TRACTS Lot: 38
Project Description: (1) Air Conditioner (on roof) and (1) Furnace replacement
Contractor: HORIZON MECHANICAL LLC Owner: NELSON, DAVID
2639 SE 176TH PL 9712 SW ALABAMA
PORTLAND, OR 97236 TUALATIN, OR 97062
PHONE: 503 - 849 -4902 PHONE: 503 - 804 -0262
FAX: 503 - 761 -1048
FEES
Specifics: Description Date Amount
Type of Use: COM Permit Fee 01/09/2013 $207.21
Class of Work: ALT Type of Const: VB Plan Review 01/09/2013 $51.80
Occupancy Grp: R -2 Occupancy Load: 12% State Surcharge - Mechanical 01/09/2013 $24.87
Stories: Info Process /Archiving - Sm $0.50 (up to 03/06/2013 $1.00
11x17)
Project Valuation: $5,000.00
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm: 1
Gas Pressure: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump: 1
Appliances
Vent Fans: Vent Systems: Total $284.88
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
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. ' ` '/� n '�1 is �/
Issued By: p / / / pl (uuY llccC Permittee Signature: C 4- t D
viX / 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.
HORIZON MECHANICAL INC. 5037611048 p.3
12/27/2012 10:56 5035981960
RECEIVE E 11 CITY OF TIGARD PAGE 01/
Mechanical Permit Application 1 , (, f; ; l l ,.,l IA tin: ,,11.
Inspection nine: 503.639.4175
n City of Tigard DEC 2 2 012 LB; N MI e - ( , r � 1 .. r , , (/,3 • • - 13125 SW Hall Blvd.. Ti QR 977.23 •• O► o
Ph so3.71N.2439 Fait: 503.591.1960 � I'I'y�FTIG � ' r .., _ i. � ' '�v; 4 0. .,Onto Peewit:
t 1 t :., r i i y • ' : ,va _ Q! See PYt 2 for
rntemet: www,tigard- or.gov BUILDING DIVISI 11 • ' . had: •, ,� I f Sappie tai r�.non
�+ r I.IR' WOAI{ . ra.9CI 3fjJLt - t3ti . 1i .:
• ID New construction d Addition /attereti repl occefent r Mechanical permit fees• are based on the value of the wort "
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical material • i • meat labor. overhead. and .. fa
CATEGORY OF COIYsCRUC ION
Value: 3 _ / T
❑ 1 -and 2- family dwelling ❑ Aceescory building ID �, � r '9�
Commetviallindustrial
eni I gavial 1,�orn,atiovr our ci►ecitRrr.
❑Multi -fe
Multi-family ❑ Master builder ❑ Other: pesctiption
f Qty. f La. Total
To
• • Jo) .91'17:. V) nitit ttoN:; . I:aGt'f1"(QN lfewliog/ovolin
Air conditioning
Job site address' I I 1 to . CAI . CA- .a Q Ile) ere- • (rmgdree ate ol*n Ahowisi :Reny
1 46.75
i �j Gt / �I Furnace I00,000BTU(daorivemir) 46.75
City /Stetel7(P:
( Cr) I/ • --( 1 22 .3 Furnace 100,000+ BTU (duets/vents) I 54,91
Suite/btdg./mpt. no.: l Project name: kit( 5 e ,_) Heat pump
trounce ce site Dian sbowinsplacenset0 61.06
Cro n street/directions to job cite: ,,...1 "} ` • C G, Duct work 23.32
Hydro,rs hot water system 2332
Residential boiler (radiator or
_kfttronic) _ 23.32 ,
Unit heaters (thekype, not electric).
In -woll, in-dens, suspended, etc, i 46.75
Subdivision: Lot na.: Flue/vent for any of above 23.32
Other 1 23.32
Tax map/parcel no.: Other fuel appliances:
DEll.iCRIPFION ' Of WORK . . Water heater 23.32
J ' P t' (C Po n A-4 C Z ^ fireplace/insert t nor to 33.39
a � Flue vent for omen healer or Des
gee 14c. e 4 / fireplace 23.32
'
J O r- ` Loa lighter (gas) 23.32
F- Wood/pellet stove 33.30
Wood firsplacerescrt 23.32
.id- P>itOPERYV•OW3tIIER I. • .3 MAW Chimney/liner/flue/vent 23.32
Name (_J J I a �/ (� S o 4J
Other. 23.32
A`!, • � � Farvironmenlal exhaust and ventilation:
Address: - 1 .7 S'. t.,--, C 6.4A-14 Range hood /other Idtdhen
equipment 33.39
City /Statc/Z3P: if i 2 ' L Clothes dryer chant 33.39
Sin te.ductexhaust (bathrooms,
Phone: ( S �3) �r ( - ) Lt - 0 2 2 Fan: ( ) toilet comp: mene utility rooms) 23.32
• $' r1:1cANir' . ' 0 CoNs.ET•P1IRso1 . .. Attieferawlspacc.fans 23.32
Business name: // era! ?c,„..) 0 „ C- _ F lt i . 23.32
ta 1r
I
Contact name: fV1 t (44,-,-/Ye: 514.13 for Scat Wgq $4.03 for each addition
Address: "2 6 9 T (. / 76 y. ' to Farnec,
*ete.
City/State/ZIP: [ - c -t ,- -r� ` 4,- 1. £ '7 ' Oachcatpnnr)
o �` 7 Z 3 wanrsa ptnaedMut heater
(�3) O -tp'e9 L Fax:: (� .l�•4 7(i- /0 V t Water heavy
•
E -mail: (+l'; Zoe/ wec` zoo__ 6-fro,' t , cay. -, Fitcplacc
• .• . ' :.'C rv'L� le:': . .. . Barbecue '
Businesaname: /4„ ,:.....e e- 4 Clothes dryer (aar)
Address: z lay r r . CA A ft" -
Other
C;tylStateam .Or c/ 0-- cf 7 2 ? e Subtotal
Phone: (Minimum �Y ( Fax: 76 !' / Minimum permit fee (590,00
/f� )
�' � Q O (5 ?) 6 , flan review (25"7• of permit flee)
CCB tic.: I 201 4 R (4 Slate aiuthar (124: of permit foe)
,/ / / TOTAL PERMIT Authorized signature: i.,a r Mi. pe. wN sppika nos empires if o nonntr Is not obtained within Wm
� If// /, day* sifter it au been accepted on eampld
Print name: pvi ( 1, g ` !r• (A4,- I S ( , f Dnte:/ ? -? 7- f 2 I • Fee toohndelogy so by Tti.C. aunty Building IndVrhr Sewn:e Head
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