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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2011 -00016 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/12/2011 Parcel: 2S104CA11300 Jurisdiction: Tigard Site address: 13683 SW TAMAWAY LN Project: Holland Subdivision: HILLSHIRE Lot: 113 Project Description: Gas furnace replacement Contractor: A TEMP HEATING & COOLING INC Owner: HOLLAND, ELAINE 16000 SE EVELYN ST 13683 SW TAMAWAY LN CLACKAMAS, OR 97015 -9519 TIGARD, OR 97223 PHONE: 503 - 650 -5014 PHONE: 503 - 521 -1152 FAX: 503 - 557 -2990 FEES Specifics: Description Date Amount Furnaces < 100K BTU 01/12/2011 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 01/12/2011 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/12/2011 $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 1.800.33. Issued By: i Permittee Signature: 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 AADplicatl City t FoR C1t• FI r ( 5t: ()NI:) o1 Tigard Receiv6tl q m 4 13125 SA' 13a11 Blvd„ Tigard OR 97223 JAN 1 1 2011 Date /By: /I � & 7 '�'r- P e rmit No. G _r —ob , • Phone: 503.639.4171 Fax: 503.198.1960 Plan RerviaW Inspection Lure: 503.639.4175 Data)By: I r`` I ' CITY OF TIGARD Date Ruacty/By: Iffil Internet: ,vww:trgara- ar.gov BUILDING DIVISION IVotilletLivtc171ud: 2 5 See rnr I rev Ef Ir pp m ental L[rormatlun TYPE OF WORK COMMERCIAL FEE. SC17 :DIME - usE CTi:t'c;taisT ❑ New construction Addition/al'le - at' replact:t are t Ivleehanical permit fees" e based on the value of the work pct'fprn ed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition Cj Other: mechanical materials equipment, labor, overhead, and profit. CATEGORY OF CON STRUCHON Value: $ 'C1 1 - and 2-family dwelling ❑ Commercial/industrial D Accessory building RFSIDEN'eIAI. E / SY S'1'tMMS FEES* ❑ 14lultl- family ©IV Mister builder Other: Fur special information use checklAsl. Description Qty. Ea. JOB SITE INFORMATION AND LOCATION Heutht.. /coolin Job site address: ' a i / L Air . rss ON V al ir e Shp xltpWl t 7lacc[negt) IN/ PI City /State /ZIP: AP 1' 110, 1 A m l Pam= e F 100,000 BTU (eucto/vcnte) 46.75 j • • • f Project name: � Furnace 100,000+ BTU (duet 54.91 _ � ill /Iii r `�� Cleat pump fi1.06 Cross streevdircctions to job site: Duct work 23.32 HYdrunic hot water s 'step, 111.1ral hyd Residential boiler (radiator or �� hY�•dn1L Unit heaters (ft e, not Cl3otrie) PRI in -wall in-duct, sus. ended, etc. Subdivision: Fot no.: �� Flue/vent for any of above WEI 23,32 MI Tax map /parcel no.: Odtnrfud a . ∎ Ifunces DESCRIPTI a N OF WORK Water heater ;l " 23.32 • �'�� t ` Gas v e n t for 33.39 II L :, � � �� • ,. � Flue vent far water hcal:;r or gas /! / fireplace 23.32 ir.11t1♦ • Log lighter (gas) 23.32 II Wood/.ellet stove 33.39 Wood fire. laee /insert �_ 23.32 r r ' a ''''PY OWNER � Ctritrutey /liner /flurJvcnt . 23,32 I ®j " ta � ! Other: 23.32 Name: C. s' IIMIIMP P''.rtvlronuleutal exhaust and vrtttil,rtion Address' # ...�- Range hood/other kitchen • `...w -"It t�� .! 4 etui.tnent 33.39 C ry/5 ZIP: / Clothes dryer exhaust e r r Single-duct exhaust (bathrooms, Phone: 11 j 6 , S0, H ( ) - toilet compartments, utility rooms) 23.32 ,-s PPLICANT 0 CONTACT PERSON Attic /crawls 'ace fans 2332 . r Other: 23.32 Business name: T.YNC� NC Fuel pilrLt Contact name: _ ' 1600(1 Sr . vPjyn St $14.15 for :lest Four: $4 -03 for each additional _..... , Address: Clackamas, etc, MI Clackarrlas, OR 97015 �. JU3- 45(1-50.14 021.5 heat . um. City /Slate /ZIP. Wall /sus.endcd/unir heater WE Phone, ( ) Fax:: (..a Cit'l. Water beater Fire E-mail, .laee CO1V'1'12ACTOR Barbecue Business name: Clothes dryer ( ,as) MI it ,I.I ',l', :. ►' s as • •' h. a 1► Other: Address: 16000 SE :Evelyn St. vIECi<IAIv[C aL 1 FEES' City/State/Zit': IL1aS OR 71U1S Subtend - — 5 ( 1 3 - 650 - s014 1 - �- y — Minitnum perrltit fee (590,00) Phone: ( ) Fax; ( C. Plan review (25% of permit Lc) CC B Iic.: t ( �o ail i► �..?- (I mm State surcharge (1- ij, of permit fee) ' TOTAL PERMIT FEE , Y I I` (� j ✓ _ . - .,--7" "ion/ pernrit application .•e ire permit is not abttbr d wit m 18 AuillOriied nature: ��nn '" days alter it has been vicerplyd us complete. Print imam / Date: I 4 ' Fee methodology sat by'! ri- County Building indusuy Servie'o Board I: , 13 uikUu.g \Permiaf b C'•Yeanl[kpP.dee 10/01/09 'Ii - 4617T(1 /caco4t/WEEL Z 0 Jl7d 9NIlt73H dN L d 066ZL55EO ZE :TT TTOZ /OT /TO