Permit CITY OF TIGARD MECHANICAL PERMIT
• - COMMUNITY DEVELOPMENT Permit #: MEC2013 -00404
Date Issued: 07/18/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S 18/201 0700
Jurisdiction: Tigard
Site address: 15498 SW SUMMERVIEW DR
Project: Stefani Subdivision: ARLINGTON HEIGHTS NO.3 Lot: 95
Project Description: Install NC. Placement of NC or heat pump units must comply with the manufacturer's clearance requirements.
Contractor: WOODWARD HEATING INC Owner. STEFANI, SCOTT & TIFFANY
PO BOX 13610 15498 SW SUMMERVIEW DR
SALEM, OR 97309 TIGARD, OR 97224
PHONE: 503 -448 -4328 PHONE:
FAX: 503 - 448 -0038
FEES
Specifics: Description Date Amount
Air Conditioning 07/18/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/18/2013 $10.80
Class of Work: OTR Type of Const: • Minimum Fee Adjustment - Mechanical 07/18/2013 $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: ‘ , /t / 3 / G /C-9 -SON
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.
Mechanical Permit A lic.a i .
UP I ' E'(llt i)l la(I llhi•: ( >Nla
1 tom ..
- City of Tigard
13125 SW Hall Blvd., `d'igard, OR 97223 JUL 16 2013 /I a Permit N��1� ye
I Phone; 503.718.2439 Fax; 503.598.196U PILm Review other Permit:
'1' I t A l; Dute R 1 Inspection Line: 503.639.4I7S CITY OF TIGARD Du R.
ad Ju:ia see Pau 2 for
lntcmet: www.tigard- or.gov
BUILDING DIVISION ' ' Supplemental Information '
0 Mechanical permit fees" are based on the value of the work I .
New construction Ikt Addition /alteration/replacement performed, indicate the value (rounded to the nearest duller) of all
❑ Demolition ❑ Other; • mechanical materials, equipment, labor, overhead, and profit.
v? ,
[ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special intarmaz1on we checklist
—
❑ Multi family ❑ Master builder ❑ Other: Description ! Qty. E�I'ut
1 ,
Air conditioning 46.75
Job site address; ( • ( S u furnace 100,000 BTU (ducts /vans) 46,75 .
City /Slide/" /.I P: t �L Furnace 100,1100+ BTU (duets/wins) 54.91
Suite/bldg./apt. tn
ldg. /apt. no.: u Project name: , I•leat pump 61.06
S� E�gN DUCA work 23.32
Cross street/directions to job site: Hydronic hot water system 23,32
Residential boiler (radiator or
hydronic) 23,32
Unit heaters (fuel -type, not electric), .
in -wall, induct, suspended, etc. 46.75
_Flue/vent'tor any of above 23.32
Subdivision: 1 Lot no.: Other: 23,32
Other fuel appliances: , :
Tax map /parcel nu Water heater
w 23.32
i r ` ," ` Gas fir'epliIL Insert 33.39
Flue vent Iur water heater or gas
fireplace _ 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23,32
Chimney /liner /flue /vent 23.32
m {{ Other:_ 23,32 .
1 '1'2 - .---... .- ...- .. .._. _ _. .._. __- _ -. -_ • . ,::J Environmental exhaust and ventilation:
Name: 5Tt = -f N / Range hood/other kitchen
, 9 7t / E • Clo
equipment 33.3
Address: 5 9
Clothes dryer exhaust 33,39
City/Stale/21P: Single-duct exhaust (bathrooms.
toilet Lx mpiatments. utility rooms) 23.32
Phone: ( ) Fax: ( ) Attic/crawlspace fans 23.32
1
F I 4'. i J Other 23 32 „�_
Business name; 1 L � - - fuel pi ping;: — •
G.�
cr• • _i ,,Q L! l. C 514.15 for first four; 54.03 fur each additional ,
Contact name: Futnaee, ay.
Address: /9e, LS n X / „ ( i Gas heat pump
Wall/suspended/unit heater
City /State/ZIP: • .ch' I ` O g7161 Water heater
Phone: (5'd3 ) ( it /�- i - v I Fax: : (5,53 befit- ell-34) Fireplace -
&mail: Range
r-. n ., , Barbecue •
Art i : ±. �;
- Clothes dryer(gas)
Business name: Other:
Address:
Subtotal
City /State /ZIP: Minimum permit fee ($90.00) 9e) -
Plan review (25% of permit fee)
Phone: ( ) Fax: ( ) State surcharge (12% of permit fee) /0 ,..-P
CCB tic.: i _ 2 d ' 4 , 2 15 5 //t/ TOTAL FERNLEY FEE job 410.7 y,” / This permit application expirm itt a permit is not obtained within I8U
' days after it has been accepted us complete. i
Authorized signature: b Ice LnetlLOdulugry set by Tri County Building, inilusuy SaLVice t3u■rd
Print name: (,'s e,i (,..)1 7 on Date: 7i // q ,
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