Permit CITY OF TIGARD MECHANICAL PERMIT
1111 f COMMUNITY DEVELOPMENT Permit #: MEC2011 -00195
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/04/2011
Parcel: 2S112BC09600
Jurisdiction: Tigard
Site address: 8085 SW VIOLA ST
Project: SUMMERS Subdivision: RAZE MEADOWS Lot: 19
Project Description: furnace replacement.
Contractor: A TEMP HEATING & COOLING INC Owner: SUMMERS, JAMES B & ALLISON I
16000 SE EVELYN ST 8085 SW VIOLA ST
CLACKAMAS, OR 97015 -9519 TIGARD, OR 97224
PHONE: 503 - 650 -5014 PHONE:
FAX: 503 - 557 -2990
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 05/04/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 05/04/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/04/2011 $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 503.232.198 • =!!.- .2344.
Issued By:� Permittee Signature: _ \
Call 503.63'.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.
05/03/2011 15:23 5035572990 A TEMP HEATING PAGE 02
Mechanical Permit Applicatil ;CEIVED • ro,: OF l-1(, i `i (,,1.1
City of Tigard Received 5
IN ' r 13125 SW Hall Blvd,. Tigard, OR 97223 MAY Plan R . ,•�� EZIEL
Phone: 503.639.4171 Fax: 503.595.1960 3 D ian Review
Inspection Lmc: 503.639.4175 Date /By:
R I) Dim EteadYLBY. El Sea Page 2 Ier
1 1 k :
Internet: www.tigard- er.gnv CITY OF TIGAR Notiticd/Mcthod. wpplemcntat Iniarmanon
BUILDING DIVISION
TYPE OF WORK COMMERCIAL, FEE• SCHEDULE - USE CHECKLIST
•
El New construction Additic,tt/sltera �, • r : t performed. Indicate the 111echasic+l permit fees* arc based de the value of the work
Wile (rounded to the nearest dotter) of all
El Dcmolitiot ❑ Other: mechanical materials,
equipmen la bor, overhead, an prgfit,
CATEGORY OF CONSTRUCTION Value: $
dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
7 - and 2-family ing ❑ Commercial/industrial [] Accessory building For special information use checklist.
❑ multi-famil 0 Master builder 0 Other: - Description 1 citx j rot I Total
-FOR SITE INFORMATION AND LOCATION Hcatiay,/cootlae
Snb sire address: JU � v
6 Sl , `! j 0 l U is air ilionidg Soil__ sit Ian. showing placement) 46.75
City(Staiu Q �'�L� Furnace 100 F17t1 d�,cral 46 -
1
Furnace 100,000+ BTU�uutdvcnrm) 54.9)
Suite/bldg. /apt. no.: I Project name: . &AY►'bh?,il1
Beat_ pump 61.06
Cross street/directions to job site_ Daet work 23.32
Id t' Idronic hot water system 23.32
� Residential boiler (radiator or
/ , I" ► I hydremic) 23.32
4) �(-1 5 - Unit heaters (fuel -type, not electric ),
Q , 1 vt 1 t�� in -wall, in -duct, suspended. etc. 46,75
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map/parcel no.: Other fuel appliances
-
DESCRIPTION OF WORK r Water heater 23.32
,� J!' /� -7� Gas fireplace 3339
R ply r) "?� 4 � OG4 .'rrr—Y ' . �, Flue vent for water heater or gas
1
fireplace 2332
. .og tig (gee) 23.32
Wood pellet stove 3339
Wood fireplace /insert 23.32
R OPERry OWN Er ❑ TENANT �"nUfeY /Iitttr Inane /vem 23.32
Other: 23.32 _
Name: r.� e..--_s._____ - i nvlr exhaust and ventilation
Addre 56 _,-�,� 1 ' (C c S.� eq r hood/other krtchcn
Ci ty r>/,Zi �'f W �'9�m�t 33.39
/Stat
1 Clothes dryer exhaust 3339
Phone: 02; ) _ I S" Fax: ( ) Singrc - duct exhaust (bathrooms.
toilet compartments. utility rooms) 23.32
Mg. FPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: __ T Other: 23.32
— Fuel piping
Contact name: ' 514.15 for Bret four, $4.03 for each additional
Address: Clackamas, OR 97015 Furnace, etc.
City/State/71P: 't• - t t One heat ptanp
Well/suapended/unit heater
Phone: ( ) Fax:: (CA .C. Water heater
E-mail: Fireplace ,.
. e
CONTRACTOR Barbecue " `-
Business name: ,_ r Clothes dryer (pis) ..
Address: 16000 SE Evelyn St. other:
MECHANICAL PERMIT FEES*
City/State/ZIP: Cdac:Ralnas, MINIS "-" -'_
— ?- 5014 subiotal
Phone: ( ) Fax: ( j�� ��� _ ��� Minimum permit fee (890.00) � p , a
/ �. y Plan review (25% of permit fee
CCR lie.: / , ' ( '
)
Stine surcharge V2%, of permit fee) /V, �41 elt, TOTAL PERMIT FEE / 5'v
Authorized • ' • nature: A, ' al" - IL { ) This permit spplleatten capirre W e permit la not obtained within MO
t..r deyn after it has been ecerptcd as compktr.
Print name' ' a S , or . - Date: ' �� • Fee methodology net by'rri.County Budding Industry Service Hearin
I :1511 ildng\Pecmid1MEC- .PotmilAPP -Cane I0/01 /as 440.4611r(IIr5121COAUWfiy)