Permit CITY OF TIGARD MECHANICAL PERMIT
e . COMMUNITY DEVELOPMENT Permit #: MEC2013 -00341
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/20/2013
Parcel: 2S103CD00600
Jurisdiction: Tigard
. Slte address: 11535 SW FAIRVIEW LN
Project: Oliveira Subdivision: HOLLYTREE Lot: 1
Project Description: Install gas furnace
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: OLIVEIRA, JOSEPH K AND
1005 INDUSTRIAL PARKWAY STEPHANIE F
NEWBERG, OR 97132 11535 SW FAIRVIEW LN
TIGARD, OR 97223
PHONE: 503 - 538 -1950
PHONE: 503 - 598 -0259
FAX: 503 - 538 -0165
• FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 06/20/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 06/20/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 06/20/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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 by calling 503.232.1987 or 1.800.332.2344.
Issued By: /( st / / Permittee Signature: /, L/ ( 9-T/eV
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:5035981960 06/19/2013 10:04:11 #4621 P.003/003
Mechanical Permit ApplicatiRECEIVE
D • . . •
1„,(01!i, 1 1 „i ,,,,,,,, .
City of Tigard Received •
Date By: ( / C f Pcnnit N°416,
14 .:--- 1 SW 1 lall'Hlvd. 'figanl, OR 97223 ,IUN 1 9 2 013 ' Plan 0 /
Review
Rhone: 503,718.2439 Fax: 503.598.1960 1)aie/liv, Other Pernik:
I , , , J , I , InSpection Line: 503.639.4175
CITY OFTIGARD ' otue kcudylilyT
tint' El See Pap 2 tor
Internet: www,tigard-or.gov
BUILDING DIVISION NotiliedNdhod:
-".'" Supplemental laturiasti
TYPE OF WORK (.!OMMERCIAL FEE* SCHEDULE - USE CHECKLIST
. _
' Pvieiiiiiical pcmtit fees* arc based on the value of the work
0 New construction A Addition/aeration/rem...nem pm Indicate the value (rounded to the nearest dollar) of all
El Donut i I ion 0 Other: mechanical material$9tuipment, labor, overh9H1, and profit_ ..
. Value; S
CATEGORY OF CONSTRUCTION ___..._ .. .
RESIDENTIAL iiciatuPmENT/ SYSTEMS FEES*
R I. and 2-family dwelling 0 Commercial/industrial 0 Accessory building Poe apedal Information sue elseeklIst.
El Multi-family 0 Master builder n Other: lkocription 1 Qty, T Ea.
......... _ , ..
JOB
SITE INFORMATION AND __ LOCATION Heating/coaling:
"' Air conditioning 46.75
Joh site address'. I \ t 7 5 .. . v t c. 0 t__ c:kot)
Furnace 100,0(X) liTt) (ductsivoiasL . ,A___ 46.75
_
CIty/StatellIP: - '1" - • , .
1..1 L e.dk o 0 7 , .. 9 1 7 3 _......., l'urnace I 0091 ,0 BTU (thietalvents) 54.91
61.06
Suite/bIdgJapt. Ito.: - I Project name0
' I
• 1,1V (-L. 31.6 Duet work - —
Cross street/directions to job site Ilydronie hot water mtm 23.32
. .. .. .
Residential butler (radiator or
tydronic) 23,32
. ..... . . ... .
Unit heaters (tacl-type, not eledri4
in-wall, in-duct, susptmded, du. 46.75
. - - - --„ - . --- . - - . . . _ - . _... ___... ____________________ ,., - ..._
Flue/vent (Or any of above 23.32
()Cher 23.32
. :
Subdivision: Lot no.:
, _______ ................... .......,_ ...._____ .... _ Other fuel applianeem:
Tax map/parcel no.: Water heater 23.32
.. .. .. . _.
.._ —
DESCRIPTION OF WORK Gas fireplace/insert 3339
— 1 Flue vent for water heater or gas
I V\ ( 171.k, ()ft (z__•(;.Ato — _ _ __________ .... fireplace 23.32
.!.:98 WIt (131) T3.32
- - • - Wood/pellet stove 33,39
Wlitid lireplacelinscn
._.... . ... . . , - - ---- 23.32
Chininey/liner/flue/vent 23.32
— 3
l'A PROPERTY OWNER Other 232 0 TENA
_. _... NT ---- - ------. Environmental exhaust nod venni,' tun: --
Nnme: 01.1V '1. , . Range hood/other kitchen
equipment 33.39
...__. ,
Addr°8; k\ ..S3c SA,...,`I ILA.A_ 4/ t ___________ _... Clothes &Vet exhnos1 33.39
_
Single-duet exhaust (bathrooms, --- --
City/State/ZIP: "V ., . ..
Icp.i..3 0c_ co ,)_..1.1
et isanparimcnts, utility roornsl 23.32
Phone: f 50'5 F--- ( ) toil Attic/craw_Lei tIceIttri.1_, , _ ________ _2332_
. -
fZi ' APPLICANT 0 CONTACT PERSON Other: 23.32
....... - -
- •-•-• - - - ' - Fuel piping:
Rosiness nante . . .. , __Four Seas_ons..Heating .._,.. .... _..... .........__ .,._ S14_15 for first fenvFA4, .03 or each additional
Cantata name: & Air Conditioning, Inc; Furnace, etc. - -
Addms•
.._. __ .
1(10',.) indritTr " ...-. . • ."- ' - lias heat p_p
..._.......: __ _ __*44 n R .211 a"L____ wail/suspended/unit 'hatter
City/Siam/ZIP: Water heater
............._ .... . . . .
I Fax: : ( 1 - - -ib3) S "Z,S - 6 lix,i,i- _Fireplace
Phone: ( 5(.13) S 3 q - iric 0 .
Ransil
F,-mail: c ii c .i. 2 ,,, eik i...., e c. u,- a o..„..,, y , I.Ae r" . CC, v \ Harbecue
_
CONTRACTOR Clothes dryer (gas)
Bus ier.
Business name: (M ,.........
_F_ait.c.Seaso . . MECHANIcAg. Flamm. FEES*
Adereas: 8 Air Conditioninsi, Inc_
1. 005 - fnciustrial Pkwy ............._.
....... . §ubtotat ..1 5
city/state/LIP: Minimum permit - fee . (S90.00)
.
Plan ieview (259 -- permit foe)
Phone:150'4 ) t; 'A ... ( c 0 ..._.... _..... .
State surcharge (12% of pennit lec)
. . .. ...... ... ...... . ..
MI1 lic.: i. 1 4,5 ^1 :1:Cii iiifif I (3 0
..._ .......
....------ --- - Tills permit gentlemen eater,* if a permit is not obtained within INO
Authorized signal ure: pst2A(..L1-1A64.1_,C)
0
day, after It has heen acsheptcd MI COMpkte.
• Feu melhod01010 sot by Tn47oonty Building Industry Sotyico llosrd
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I VluildiryerormitaNMEC l'onmiApf, 0.10111.doc 440 I Tr (111011COmiwius)
FROM Four Seasons Heating TO:5035981960 06/19/2013 10:03:54 #4621 P.001 /003
yA1�ES;01
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SEASONS 4 et
rig PP
FAX
DATE: (n '" f ` ■ 3 TIME: Cv uLt a
TO: City of Tigard
ATTN: Permits
RE: `/ f Please issue and fax copy of Permit as soon as possible.
NUMBER OF PAGES (including cover):
FROM: Four Seasons licatiug & Air Conditioning �/"'"
1005 Industrial Parkway
Newberg, OR 97132
Phone: 503-538-1950 , t de 6 L
I;ax: 503- 538 -01 ,t
r Ali
CDQ
Sent By: Deborah 6 mil*
E -Mail: deborah@fourseasonsbeatair.com