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Permit CITY OF TIGARD MECHANICAL PERMIT 2 ' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00128 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/29/2011 Parcel: 25111 CB01743 Jurisdiction: Tigard Site address: 10395 SW HOODVIEW DR Project: HUGEL Subdivision: HOOD VIEW NO. 2 Lot: 42 Project Description: Furnace replacement. Contractor: A TEMP HEATING & COOLING INC Owner: HUGEL, LIDUAN 16000 SE EVELYN ST 10395 SW HOODVIEW DR CLACKAMAS, OR 97015 -9519 TIGARD, OR 97224 PHONE: 503 - 650 -5014 PHONE: FAX: 503 - 557 -2990 FEES Specifics: Description Date Amount Furnaces < 100K BTU 03/29/2011 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 03/29/2011 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/29/2011 $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 1.800.332.2344. Issued By: , r 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. 03/28/2011 09:31 5035572990 A TEMP HEATING PAGE 02 Mechanical Permit Application 1•'(*. ()l I'l(I l 5t. ()• 1.1 City of Ti and Received . • 13125 SW Hall 13lvd., Tigard, OR 97223 I T tt 7 - v �ll Phone: 503.639.4171 Fax: 303.598.1960 Dote/By: 1 1 c: . .,: R1 -, Inapecy Line: 503.639.4175 Date Rendyfey: jam' 12I See Page 7 flrr Internet: www.tigard- or.gov Notitied/Method: 7 Suppkmentallnrarmatlon TYPE OF WORK COMMERCIAL FEE" SCHEDULE - USE CHECKLIST El New construction 0,, Addition/alters • /neplae - . t Mechanical permit fees* are bated on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all CI Demolition © Other: meehatieal materials, equipment, labor, overhead, and profit CATEGORY OF CONSTRUCTION Value: S RESIAENTJAI, EQUIPMENT / SYSTEMS FEES* a. 1- and 2- family dwelling 0 Colnmcrcial/induttrial [] Accessory building For afrecial information ire checklist. ❑ Multi - family [] Master builder © Other; Description ,, EA. Total JOB SITE INFORMATION AND LOCATION lleatht /eaulhtg Job site addross:/a � �1 f Air conditioning i y (requires site pinup showing placement) 46.75 City /State /ZIP: + t , 4 , II ♦ .. „ t<. Purnacc 100,0 BTU ( ducts /vcntt) I- 46,75 • Furnace 190,0001- (duct ivcna) 54.91 Suite/bldg. /apt. no.: Project name: „ • Heat pump 61,06_ Cross street/directions to - job site: Duct work 23.32 - Hydronic hot water system 23.32 Residential boiler (radiator or hydronto 23.32 Unit heaters (fuel -type, not electric). in-wall, in -duct, suspended, etc, 46.75 Subdivision: _.1 J I.ot me.: Flue/vent for any of about 23.32 Other: 23.32 Tax map /parcel no.: Other itscl appliances _ DESCRIPTION OF WORK Water heater 2132 - Craa fireplace 33.39 (� 1 4 Flue vent for water heater or gag r. ill. 0 \1_ . or I. h. i Lteplace 23.32 Log lighter (gas) 23.32 Wooesellet stove 33.39 -- Wood fireplace /insert 23.32 Chimney /liner /flue/vent 23.32 PR OWNER El TENANT Other: 23.32 Name: • 6 • .r _.- * , 'Environmental exhaust and ventilation Range hood/other kitchen Address: equipment 33.39 Citi /State /7.IP: : , ' C 41 d ,. t. ' Single duct exhausts.... 33.39 roams Phone: ( ) Fax: ( ) toilet c artments, utility roome) 23.32 iii PPLICANT Q CONTACT PERSON Attic/crawlspacc fats 2332 ' � Other: , 23.32 Business name: Fuel piping name: - - . AVER i r► t ' I t • IM1l ' C r I' 5 1.4.15 for Virg four 54.113 for each additional Address: Clackamas, OR ' Furnace., etc. 1 .11 1 Gas heat pump City/Slate/ZIP: WaJI /suepended/unit heater Phone: ( ) Fax: : ( ® 4• Water heater Fireplace E-mail; 9 /fr . _j A,. _cam._ Range `��� CONTRACTOR Barbecue Business name: Clothes dryer (garQ A TE1 P HFATTNCi ANTI ['CIMINO INC Other: Address; 16000 SE Evelyn St. MECHANICAL PERMIT FEES* City/State/ZIP: ' Suhtntal 4./.0-/S I 1 1 • • Minimum permit fee ($90.00) 9 f Phone: ( t ) Fax: ('� - Plan review (25% of permit fee) CC13 tic.: , I; 7' State surcharge (12 %ofpenuit fee) f D , tS0 TO PERMIT I "EE �[ Authorized nature: ( This penuit'application e:plrex ir e permit it ne ebtalned Within 160 ` days after It h#i be accepted as complete. Print name , ` n ,�,, .jam ;, � Date: 3 _'� �? * p, '! 1 * Pro methodology set by t'e;- County 13uilding Cedu+iry Se vice Board r : :Titi ete.,Pantlte'MEC- PeenaApp.doc 1 0101/0? T7L- 110.4611 71' (1 II /02 //C9 13)