Permit n CITY OF TIGARD MECHANICAL PERMIT
°� ! g COMMUNITY DEVELOPMENT Permit#: MEC2013 00507
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/10/2013
Parcel: 2S 114BCO2400
Jurisdiction: Tigard
Site address: 10251 SW RIVERWOOD LN
Project: Nyhus Subdivision: RIVERVIEW ESTATES NO.2 Lot: 61
Project Description: Replace gas furnace
Contractor: A TEMP HEATING &COOLING INC Owner: NYHUS, KATHARINE
16000 SE EVELYN ST 10251 SW RIVERWOOD LN
CLACKAMAS, OR 97015-9519 TIGARD, OR 97224
PHONE: 503-650-5014 PHONE: 503-639-3993
FAX: 503-557-2990
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 09/10/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 09/10/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/10/2013 $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: ,47.441 „ Q ,, Permittee Signature: 6-��
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.
09/05/2013 09:23 5035572990 A TEMP HEATING PAGE 01
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Mechanical Permit Annli ti-iii:1 - Ely ED „iv: 0,.,.., i: , : (,,,, v
City of Tigard Raceived 9 /04:10:7ffi Pc-itN-:N6d,goa-ao6-o2
pe/13y:
,711 q 13125 SW Hall Illvd,Ti gard,OR ' . . Piga Review
. Phone: 503.718.2439 Fax: 503.598.193Ep 5 2.013 Date/By: Other Pent
Inspectio Date Ready/13y:
n Line: 503.639.4175 has: Ea See Page 2 for
1 it;M:p
Into-ad: wwse.tigatd-or,g0v
CITYOF TIGARD Nottfied/Method; Supplcuicetai wormatten
.-,,-tgirs,-----;d4tMitsl.G:DIVISION ' :' ''..efiVIRItR:.,-..04:1TW'AMEATA*:4,gig:•cVA4tF;',:.,-,-,...:
"..'1.':' -- - '' ', " ' ''''' .. '' - '' :. : '' :r ::: °- Mechanical permit fees*are based on the value of the work
0 New construction ai Additicm/altcrationfreplacement performed.Indicate the value(rounded m the nearest dollar)of all
0 Demolition 0 Other: mechanical materiels.equipment,labor overhead and profrt.
Vl_____._....._......______pe2L!I _
.:::: .:..-,•'..,: :': 7 .7:; 7:- -7 r77 -P,071471-:',iir'''mpriliwr101■T: ,:•:..i..",•: ' • •::; :::: ,,,:••••:' :::--.7=.*t.itopor,1-,040t#0$10: 00.MEP^::•,.:::.'••r
.. , „,. ...„. , ,
El
1-and 2-family dwelling 0 Commercial/irtdustrial 0 Accessory building Far special W.:emotion age checklist
0 Multi-family Ej Mash=builder 0 Otber: Description r Qty. I E I Total
•j:::,. • ... ;': :'i'... :,.7 .:...too SITE TclEtERE■akt/i7f4r:AMY LOrliTrOt!.:H'...- 1.:-• ',::-..-`. .v.- , Air eonditi -
(te,ydre%aim Ow ahowing plowmen* 46.75
Job site address: /02 i c 14.) ji.,'v•le .'■A' 1, .
Furnace 100,000 BTU(duds/vents) I 46.75
City/Statc/ZTP: -7-; .. 0 / . C122 2-q Furnace 100,000+BTU(ducts/vents) 54.91.
Suite/bldg./apt.no.: Project name: A/ II Heat pump
(requires site elan shooting procemen* 6 t.06
Cross sheet/directions to_job site: Duet work 23.32 ...
:Hydronic hot water system 23.32
Residential boiler(radiator or
hydrottic) 23.32 -■
— Unit heatera(feel-type,not electric),
M-watkin-duct suspended,etc. 46.75
Flue/vent for any of above 23.32
_
Subdivision; Lot no.:
Other: 23.32
Tax map/parcel no.: Other Ind appliances:
. 2332
7::...: *kit004#.1**;..0,*!e*K:''.-:,-::,-'.: :•. .':"''':-1--...;:'-"r .-,::.. ., via.tel.heater • '
kol" .cet_c FM r 11. LA,/'T / e -PluerventlrePlaforce water heater or gas
/77"....." fireplace 23.32
— ...„,
0.--ei$ rk r el , • Log lighter(gas) 23_32
Wood/pellet stove 33.39
Wood fireplacennert 23.32
23.32
10:001.5 ,:i.!::::'1F:111:: '1'-.. .?,' :.11t1F,401,'1. 17..: ..7•. ' other 23.32
....
Name: kg 714 a r-;In e.._ Itly in 01 S Environinental exhaust and verdilatton:
Range hood/other kitchen
Address: id 2,5-1 ..c .,/ e;,,ek,,,c),ta /..., . 3339
equipment
.
City/State/in': ; 22 Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms.
Phone:(5-03)t‘ i -?1 q 3 FEL.c( ) toilet compartments,utility rooms) 23.32
ZAPEtiCkiNiT::':''':.'''':.''.:'.:::,- .: •::.::.7:';':._ 0sifOtrAltOrit ?:! :... 7..:. AfficicrawisPact Ins 23.32
.......:—.--.-------.-....,—...,-....--..... Other:
23.32
Business name: 44112dEREATINGMID-CGOLINCVNe Fuel piping:
Contact name: 26000 SE Evelyn St 514.15 for first four;$4.03 for each additional
Address: caftan:4 OR 97015 Furnace,etc. I
--,
i f. ...": "':•• Gas heat tamm ,
City/State/ZIP: Wall/suspended/unit heater
Phone:( ) Fax::so3 ) 554- 2Ai 0 Water heater
Fireplace
E-mail; (4 a .4. ,-, , ..,- „, ., r, •A . ”PI.. Range
. , . .
Clothes dryer(gas)
Business name: A-TEMP HEATING AND COOLING,INC other: ,
Is‘)I Addras9: 16000 SE Eeveltly-9n St - ''
City/Stain/ZIP: eackanw7015 114EcitAikiKAVP.EWTs..u:lPSEoO_caL'.:.., Ae.L'a.• :'r: .
Minimum permit fee(S90.00) 1-13 g 2.f.
Phone:( ) Fax:6 D Z)G5+ —1.4-4.0 Plan review(25%of permit fee)
CC13 tic.: 4.I? ..5 State surcharge(12%of permit fce) (s)so
TOTAL PERMIT FEE I aro
. _ ,,ir..,.,,,,, 0,41r---t- This penult oppIleffitleo expires If it permit Is not obtained within ISO
Authorized signature:... vise don after It hoe been accepted ii%complete.
Print namv. .5.". .44,/,„1 *1•-- OCY4 11:ee - Date: qs--s--13 . fee methodology set by Tri-Connes Building Industry Service Boat91(....-
TABuildineTerreilLAMEC-PerleiLAee.doc 09/09/10 440-doi tr(I 1/011C0MAVE8)
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