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Permit CITY OF TIGARD MECHANICAL PERMIT `- COMMUNITY DEVELOPMENT Permit #: MEC2010 -00620 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/01/2010 Parcel: 2S103CA02400 Jurisdiction: Tigard Site address: 11900 SW JAMES CT Project: Schun Subdivision: TRAVPORT PARK Lot: 4 Project Description: Gas furnace replacement. Contractor: FOUR SEASONS HEATING & A/C INC. Owner: SCHUN, ELLEN G 1005 INDUSTRIAL PARKWAY 11900 SW JAMES ST NEWBERG, OR 97132 TIGARD, OR 97223 PHONE: 503 - 538 -1950 PHONE: FAX: 503 - 538 -0165 FEES Specifics: Description Date Amount Furnaces < 100K BTU 12/01/2010 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 12/01/2010 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/01/2010 $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 OUNC by calling 503.232.1987 or 1.800. . r / Issued B Permittee Signature: 1 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. 11/30/2010 13:30 FAX 5035380165 Z002 /003 Mechanical Permit Anplication 4r lt)Kt39''1IC! tsl ()Nis, City of Tigard (��j Q'� Doto!9y: �� Received Perron No .: ' �1 (. e.'.., • ■ 13125 SW Hail blvd., Tigard, OR 9722 C.J Q ' �+ Phone: 503.639.4171 Fax: 503.59B. �J Ott Permit Inspection Line: 503. 639.4175 O A � C, -. S5 See Page 2 Tor 1 .' t ' , Internet: www- tigard- or.gov � M Supplemental Information .. .. _ T i C h SOMME SOMME -7 ;c . . Mechanical permit fees"' arc based on the value of the work O ] New construction ►` Addi tio>terdtion/r ell erne nt performed_ Indicate the value (rounded to the nearest dollar) of all 0 Demolition ■ II er: mechanical material: e.ui.men Iabor overhead and .refit /1qq Value: $ ►; 1- and 2. tinily dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist. © Multi- family 0 Master builder 12 Other: Description 1 Qty. I Ea_ I Total / SITE k. x '4'4 a .. Heath • coati , • Alt' conditioning Job site address: 1. b. �.�ts �� •.uires site p>an uu:Placemunt) 46.75 Ciry /State/ZIP: eh �� ~ �` ` Furnace 100.000 BTU (ductsiventa) ( 46.75 mil � Furnace 100,000+ BTU (ducts/vents) 54.91 SuitdbldgJapk no.: ' reject name: A al Heat pump 61.06 Cross street /directions to job site: Duct work 23.32 Hydronic hot water system 2332 Residential boiler (radiator or NIIIIIMMIMMIMIlliiiiMill h tannic 2332 Unit heatcm (fuel -type. not electric), WWI in -wall. in-du sus. • .ed, etc, Fluetvent for any of above 23.32 Subdivision: Lot no.: Other: 23.32 Tax map/parcel no.: Other fuel appliances "' .' Qli[i' Water heater 23.32 Gas fireplace 33,39 • — • IIIIIIrll Flue vent for water heater or gas fir .lace 23.32 li_ ter _•. 23.32 III Wood/. -1let stove . ill 23.32 Wood theplace/inscrt 23.32 $ Chien /liner/flue/vent 2132 MEW 'PROPERTY owns "'! other• 2132 Environmental exhaust and ventilation ' � 1 • Range hood/other kitchen Address: • 0 .. a �l`„.� equipment 3339 City /State/ZIP' 4 a t ca Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: "-T) I * • ti ms toilet compartments, utility ty o ) 23.32 . 2 ',!' ' Attic/crawlspace fans 23.32 i rooms) El At'PT IC�►311'f - • Other. 3.32 r - Business name: Fad piping_ • C ontact name. O. #' - �7, �, +` 0 EAT I Nt� $14.15 for first four; S4.03 for each additional AND Iw���®® r+re� Fume etc. Address: /'rtal� AIR v 'v� ®WI oN l.l. _... �► Gas heat .urn. — — NM 1,1 I,. 1 h .7. • . Wall/sus. • ed/unit heater . . Water heat r 1.�� Phone: ( ) _ _ Fireplace E -mail: _ .. r N IMMI Barbecue �i n ► , ri'n - d l ► Clothes dryer (gas) ■ Business name: ^ , 9 1 _ . Iv , 9 a , .e Other: Address: MEC$AIs1iCA/.. PERMIT nisi :: ' • : . - - • ' • Subtotal MUM City/State/ZIP: • Minimum permit fee ($90.00) •Io .001 ;' , , + Plan review (25% of permit fee) CCB lie.: State surcharge (12% of permit fee) }i� '� TOTAL PERMIT FEE TNi 1 .l This permit application explrra If a permit Is not obtained within 1 1 / pr Authorized signat • m ', t! - * krA days after it has bees accepted as complete. • Print name: / Date: Fee methodology set by Iii County Building industry Scrviw Board r �I G a ( , IAluildiaalPeasaitcMBG -B'erwitApP.Qac 10/01109 4. .17r 0 02/C0/AVM