Permit CITY OF TIGARD MECHANICAL PERMIT
1111- COMMUNITY DEVELOPMENT Permit#: MEC2013-00452
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08!06/2013
Parcel: 2S103AB02800
Jurisdiction: Tigard
Site address: 12432 SW 114TH TER
Project: Farwell Subdivision: WALNUT GROVE Lot: 1
Project Description: Installation of gas furnace and NC.Placement of NC or heat pump units must comply with the manufacturer's
clearance requirements.
Contractor: WOLFER'S, INC Owner: FARWELL, CHRISTOPHER J
290 YOUNG ST FARWELL, CATHERINE A
WOODBURN, OR 97071 12432 SW 114TH TER
TIGARD, OR 97223
PHONE: 503-981-4511 PHONE: 503-891-9365
FAX: 503-981-0801
FEES
Specifics: Description Date Amount
Air Conditioning 08/06/2013 $46.75
Type of Use: SF Furnaces<100K BTU 08/06/2013 $46.75
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 08/06/2013 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
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: t 1111r / - Permittee Signature: /N /0L/L01_77pA/
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.
AUG/01/2013/THU 02:27 PM WOLFEAS HEATING FAX No, 5039810801 P, 001
Mechanical Permit A licati PEI i/ j t'Ult OFFICE USE ONIX
City of Tigard 1rp awed �:! PermitNq/.y� 3 _l .S
• ": 13125 SW hall Blvd.,Tigard,OR 97223 y y n '`
AUG 1 2013 013 . Plan Review OtherPennit
M Phone: 503.718.2439 Pax: 503.598.1960 A Date/By:
7-l��A R Inspection Line: 503.639.4175 • C11'1/OF TIGA RD Date Ready/By; 3 ' liil See Page 2 for
Internet www.tigard-or.go Notifed/Me hod: Supplemental Information
BUI � ► � 1
1 5 r y +1 d-'4A r�'f+K.-. 1; M t'^L",T)��.. 1 ir;', 1 q.-Ii' ,i 1,r �, r :rvc 7 t-- 149 I y� a:..4��.p,`!.�73 nh -J
1 {+,'"n 14,11,,,.74 321.1,iv.�7at.1 1.1.4..,•kv, -4:::;,4.,•,..,_...1.� 1; 1X0 �,1=�.....-_I .,L:.• tE�'171 � trlL ILSi�}+eer �'.� �Ir,IMir rl "n�falsF—.t.�fr.. '1':�
Mechanical permit fees*are based on 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 profit
'., +"�m.•F Value:
° i,g, \t5,W =r:6 C^ G a l apm fLk1 -gi.4-1 ,ti„ 1{r ilvirai W i dag 1 J bsr,:,.^ ,op
11 , n L S s
®1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building Forspecie1 rnform:dlon use checklist.
Ej Multi-family ❑Master builder '❑Other: -Description I Qty. I Be. I Total
w+s M, + 7: 7s,x: p ni}'r'� 1/ y '�•; 'la'�str.7. c1,.i`o-7�,.1 t Head,• coailn::
$":`, *� ��?fir ^�+- "L'aaV I:- '-`,'"•-''''''"-' � '''''"�fi3a.,0,'^ ,1: .rS t'''" dry
1 Air conditiordn: •• 46.75 EMU
Job site address: 4 j I tlz- -if.ri"A. - Furnace 100,000 BTU(ducts/vents) J 46:75 EIN
City/StateJZtP: "-1= 4a. a r C�1 7-3 tm
Flace 100 000+BTU ducts/vents) 54.91
•
61.06
Suite/bldg./apt.no.: Project name: .t Duct 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.in-duct,suspended,ete_ 46.75
Flue/vent for any_of above 23.32
Subdivision: • I Lot no:: Other. 23.32
Other het appliances:
Tax map/parcel no.:. . . Water heater 23.32
'w r 4 ,1;j5^t Y ti'l iT M, >,tirl e)140, i��,61)�+,V3l 3.`,44',1 eS`b rs g T......-,-,44,-...r...rt -, r_�:�1� { ,�:; } { Gal' .18CC/itlSet'[ 33.39
tw r,r.x 7d-Yy�,arr�r St's :511:..T.fe,c. '2 .9•h.1.-.,7.6,+.... .�^.��-CL...%-∎,-,Ki:t,L,1 711 1.-7, ,tr.,.,....7.`oa,..wn.,m:�
n FIt1[%wet f07 water heater Or gab
-_ S .Nrww(.e— f�� fir- lace 23.32
W Log lighter(gas) 23.32
Wood/pellet stove 3339
• Wood fireplace/tnsert 2332
• Chimney/liner/flue/vent 23.32
t^ a a v y n a. rw q! - Othcr. 2332
5 1g ,1.1 J 9 :d •el V1 .P�•�n�itti ,•I '1(+t .t, �.II rf i •F q (1C' ��""�..∎,,�' �,• .
i'4.7,;•:1:-..4';',: e. w ,4,.�..., '4,---''.a..44‘/. 214-'i .rya -• r_?-- ..;4,-f''"l. .... Environmental ex aunt and ventilatlon.
Name: .. t ,0! ,` Range hood/other kitchen
I` equipment 33.39
Address: _ - r • Clothes• er exhaust 33.39
City/State/ZIP: f Single-duct exhaust(bathrooms,
toilet come' cuts utili rooms 23.32
Phoue:-Sa )- { ~° , -:-- - •,;c/crawl 'ace-fan. • ' I= 2---�-
rr fr,ar+„rr17��Q Vi��} ��' 4•- 1�iw�'�'� �r'r-7,r �. c ��t '';
3 l'", '1'11 C �iV4'�1 i 171 [��""" r. `"+' 6:t t 1• i>;•+; .r
-=r''-1 c�SiJ; i,, �, b,•��.,!�4, ��•n. ,dt;C,F��':=,�1'Ei.1�3 ,^,.` t,�-ae. .,�'�.';,..li� Other: 2132
Fuel .1,i
Business name. k6j0 1 `Q„,✓,s e,4,Icm_ $14.15 for first font.$4.03 for each additional
Conflict name: —r_ rYL Fumac etc. IIIII
Gas heat.Ian'
Address: +, 0 t1. Wall/su .ended/uaitheater ____
City/State/ZIP: t,,vO• •_ 0 i 707/
Phone:65Q3 ) fr1 r i-j$7 Pax ($o ) ' • -a8? Sicill11111•11111111111111-
__-
Ren_c
P.matl t .1 . a.-,I GO Barbecue ___
I yy �m.: - uw
- w''Mtth n i?I P• (`I J:l4
4�
Clothes. • ." s Y 1 r imo 1 n S .. .• l�.r 9.�-:4 ,xv- _i�7 �c.�1.�1. - . Other
�s
Business name r r .. t 1_ c.."•;"4'-r' '�,+�m;;177 �,..�+,�.`�,.,�aVFfu: Cf1 .'1 . , `N�'
Address:
r r• is 'Subtotal � SO
City/State/ZIP: � • r, r 7/ Minimum permit fee(590.00)
p '~' _F7Q ! Plan review(25%of.ermit fee)
Phone:(4503 ) , I Li 51 Fax:(Jp7) , I ~--Q d 0 `State surcharge(12%of permit fee) I .LZ
CCB tic.: 19 1 I TOTAL?ERMIT TEE i 0W•7.1
This permit application expires Ma permit Is not obtained within 180
days after it has been accepted as complete.
Authorized signatur /1.,,; (S��. '' Fee methodology set by Tri-County Building Industry Service Board
Print name: 7 ,. 3•U er s 'Date: r/1 1/3
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