Permit CITY OF TIGARD MECHANICAL PERMIT
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• COMMUNITY DEVELOPMENT Permit #: MEC2013 -00309
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/06/2013
Parcel: 25111 DC12500
Jurisdiction: Tigard
Site address: 15940 SW OAK MEADOW LN
Project: GOODELL Subdivision: SUMMERFIELD NO.11 Lot: 621
Project Description: Gas furnace and NC installation. Placement of A/C must comply with the manufacturer's clearance requirements.
Contractor: FOUR SEASONS HEATING & NC INC Owner: GOODELL, HARLAN & CLARA
1005 INDUSTRIAL PARKWAY 15940 SW OAK MEADOW LN
NEWBERG, OR 97132 TIGARD, OR 97224
PHONE: 503 - 538 -1950 PHONE: 503 -639 -2975
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Air Conditioning 06/06/2013 $46.75
Type of Use: SF Furnaces < 100K BTU 06/06/2013 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/06/2013 $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 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: „ S?..
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.
FROM Four Seasons Heating TO:5035681960 06/05/2013 15:15"12 #3751 P.003/003
Mechanical Permit Applies n D �1 ECEIvE® E! ICW . 131SW HallAl,'TiardOR 972 IIIII Phone: 501718.2439 Fax• 503.59R.19AQJ�JN 5 2013 Re Ihhcrl'cm.lt •
' Inspection Line: 503.6394175
Date/By
t I , , A I: I hate Ready /rly: /WM B See Pate 2 for
Internet. www.ulprd- or. guv
CITY OFTIGARD Noldied/Mdhod —,-- Sup Information
BUILDING DIVISION TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHFCKt.1ST
Mechanical permit key' are based tin the value of the work
❑ New construction ® Addition /alteration /replacement performed indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and pmtit
-- Value, S
(:ATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT /SYSTEMS FEES'
® I - and 2 - family dwelling ❑ Commercialfrndustrial ❑ Accessory building For sprdal Wornscrifon we e*eck1W,
❑ Multi- family ❑ Master builder ❑ Other: Description
Uty I _F_:__ 'total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air coonditioning I 46 75 41. 75
Job site address: 15940 SW Oak Meadow Lane Furnace 100,000 DM (ducts/vents) I 46.75 46 75
City /State/ZIP: Tigard, OR 97224 I 100,1100+ Hill (ducts/vcnrs) 54.91
Suite/bldgiapt. no.' Project name: Goodell I teal pump _- -- 61 06 - ,
—�, Duct work 21 32
Cross street/directions to job site: I lydrunic lot water system 23.32
- - -- -- - - Residential boiler (radiator ur
hydronic) 23 32
- I Init heaters (fuel -type, not cleans),
_......... _ -..
in-wall, in -duct, suspended. etc. _- __ _ _ 46.75 _ _ __
Flue/vent for any of above 23 32
Other: .
Subdivision: f Lot no.: - - ••
Other fuel appliances:
I ax map /parcel no.: Water healer 23.32
DESCRIPTION OF WORK Gas Fireplata/insert .13.39
Flue vent For water heater or gas
Install Gas Furnace & Air Conditioner ftreplaec 23.32
Log lighter (gas) - - - -- I_ ..__.L 23 32 1 ____ - .
- - - Woud/pcllet stove 33.39
__...-- •-- ____ -- Wood tireplaee/inscrt 23 32
Chimney/liner /flue /vent 23.32
® PROPERTY OWNER I ❑ TENANT Other — � _ - _ 23 32 -
Environmental exhaust and ventilation: ..y
Name: Skip & Clara Goodell Range hood/other kitchen
Address: 15940 SW Oak Meadow Lane
Clotho Cloth s d 33.39
_ C dryer exhautil 13.39
Single-duel exhaust (bathrooms.
City/State/ZIP: Tigard, OR 97224 !?1
- -.. toilet compartments. utility rooms) 23.32
Phone: (503)639 -2975 Fax: ( 1 Attie/erawispace Fan. 23.32
® APPLICANT ❑ CONTACT PERSON Other _ 23 32
Business name: - - Fuel piping: -- - - - - - - -- - -- -- - - - -- - - -- --
Four Seasons Heating S14.15 for find four; 54.03 kir each additional
Contact name, & Air Conditionlriy Inc -- - Furnace. etc
Address. 1005 IrlduSlrli i Pkwy Gas heat pump
Newberg, OR 07132 • - --- - — Wall/Au.pended/unu heater -
('ity /State/ZII': Water heater
Phone: (503) 538 - 1950 I F. (503) 538 1. treplace
- Range
E - mail: deborab (a)fourseasonshe►tair,com Barbecue _ _ ___
CONTRACTOR Clothes dryer (gas)
Business - - - e: Four Seasons Heating ( rifer
-- MECHANICAL PERMIT FEES'
es
Addrs: & Air CCondi oning. Gic —
- -
1005 Industrial Pkwy Subtotal 93.$0
Newber , OR 97132 City /State/ZIP: C _--- ___ - _ - --- Minimum permit fee ($90.00) -
Plan review (25% of permit tee)
Phone: (503) 538 -1950 Fax: (503) 538-0165 Mate surcharge (12% ut'permit fee) 11.22
CCA lac.: 97152 - TOTAI. PERMIT FEE 104.72
-- -- - -- This permit application expires if a permit is not obtained
-- - -- -- - --
-- p c p rm oo a aed within ItiO
� / ��� L ( � days after It has been accepted as complete
Aulhunccd signature: D -._- ___.--
, ': - • Ice mcyhodotoey set by In Budding Industry Service Board
Print name: Deborah Salo I i)atc: 6/5/I3
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