Permit •
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00301
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/29/2011
Parcel: 1 S 125 DA00700
Jurisdiction: Tigard
Site address: 9240 SW 66TH AVE
Project: Ross Subdivision: JACKSON WOODS Lot: 6
Project Description: Replace furnace with new gas furnace and a/c unit. NC unit must meet 3' minimum side and rear yard setbacks.
Contractor: WOLFERS, INC Owner: ROSS, DOUGLAS LYNN
290 YOUNG ST 9240 SW 66TH
WOODBURN, OR 97071 TIGARD, OR 97223
PHONE: 503 -981 -4511 PHONE: 503 - 621 -6615
FAX: 503 - 981 -0801
FEES
Specifics: Description Date Amount
Air Conditioning 06/29/2011 $46.75
Type of Use: SF Furnaces < 100K BTU 06/29/2011 $46.75
Class of Work: ALT Type of Const: Fuel Piping 06/29/2011 $14.15
Occupancy Grp: 12% State Surcharge - Mechanical 06/29/2011 $12.92
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $120.57
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 B : ` 6 ` 4j i Permittee Signa 60(11a______---
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.
JUN /27/2011/MON 12:11 PM WOLFEAS HEATING FAX No. 5039810801 P, 001
Mechanical Permit Applica� / � ro � R OFFICE tier �,ntl.Y
City of Tigard Received e e A g1�7/ P bio -: �./ ;, "QQ
V 13125 SW Hall Blvd., Tigard, OR 97223 JUN 28 ZOII Date/By: / t
Phone: 503.639.4171 Fax: 503.598.1960 Plan Rcvicw
DstelBy: Other Permit:
TI G A x I r Inspection T i e: 503.639 Gr OF TIGARD Date Ready /By: mss: BI See Page Z for
Internet www.tigard- or.gov BUILDING DIVISION Notifiedmethod: . Supplemental Information
p � w yu�• r6�" ;, r ti' v .( x w bf .y pw:;ay 'S yr�� ' r ,t 'i J � upmw„v��w«,.��,w.,r r ,,,uiiuwuuuv, W��.,�,,�w,� w
Rig M'�§4 .ilia I V .. J .n. 1 it 1,o., J @ ..7 ,•�I'::,' � R IXY� �il '�( u� ,5t9 �1�1�4,:te' �L' PlitxtS:AS S • p, ,,, a u., - Ix t I wy�•• •r• w• s xwunn „wwmwwxw, x.w� ,vtxx H.yarcrvu anvxwuum r m y
ID New construction ® Add /alterat /replacement Mechanical permit fees" are based on the value of the work
performed. Indicate the value (rounded to Ibe nearest dollar) of all
El Demolition [ Other: mechanical materials, equipment, labor, overhead, and profit.
'&MitfOi liniNfifil value: $
® 1- and 2 -family dwelling [J Commercial /industrial D Accessory building a 9N•• • ? , r •w 'r� • ,. � � I
❑ Multi- family ❑Master builder 0 Other; Fors serail information use checklist.
�' $ Description Qty. Ea. Total
5t •••i f . "yn i 9'S ..r 1 .�iP'wt : " OAP.: A I .„ .a § N 1.I� ?y Y iR f l µ Heating/cooting ,
Job site address: 9240 SW 66`" Ave Air conditioning
{inquires site plan showing placement) 1 46.75 _ 46.75
City /State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts /vents) I 46.75 46.75
Furnace 100,0004 BTU (ducts /vents) 54.91
Suite/bldg./apt, no.: [Project name: Ross 55444 Heat pump 61.06
Cross street/dircctiona to job site: Duct work 23.32
Hydronie hot water svatena 23.32
Residential boiler (radiator or
hydrnnic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: I Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
m ^ r 1 } r l , : r ° ° , , r, �' i Water heater 23.32
r. ..k- • ,1 -',1 ,. ": . , fi r /x > "1� r.�n a6 ;.m,� ., • . 4 ■ ., � t. i
iwt ��Z�0 . } mo w ''a..m
Replacing existing furnace with new gas furnace and ale malt Gas fireplace _
Re 33.39
p g g g Flue vent for water heater or gas
fireplace 2332
- Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
,r,f yy�� �,p� �y{ Penal' .W . Chimney/liner/lluelvcnt 23.32
Sri ,':, �..c � , ;.Y riiwr '.1 . ' . ";:' !'Iw, e' . . 1 �", . "!�.'x' 7" V '" �G
Other: 23.32
Name: Doug Ross Environmental exhaust and ventilation
Address: 9240 SW 66'" Ave, Range hood/other kitchen
equipment _ 33.39
City/State/ZIP: Tigard, OR 97223 Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: (503)621 -6615 Fax: ( ) toilet compartments, utility rooms) 23.32
,r u br „'�����,a S w • to , , 5. �. *t MS e !r ,a t,1 e m t TM ■ , >P� r , Attic/crawispacafians 2332
Other; 2312
Business name: Wolfer's Heating Fuel piping
Contact name: Jennifer Winningham $1,4.15 for first four; $4.03 for each additional
Address: 290 Young St Furnace, etc. 1 14.15 14.15
Gas heat pump " -
City /State/ZIP: Woodburn, OR 97071 Wall/suspended/unit beater
Phone: (503) 981 -4511 Fax: : (503) 981 -0801 Water heater
Fireplace
.mail: Jennifer@wolfersheating.com Range
yy ur pan S l afi$i,S,�: t k:' t'1 ! r i lWFflt � o n. r 3fr 6..
uw1'" �a n "{! jil;'' t� L�i „ " w t ii " Y ° P g' tl i ' it r xd.�w
1 �r ",n,y.. „w• ny.wrr, ,n8 R.k9„ „tNnal.t.l • ll�d•pR, ",• R ,,,,• ,tC! !�" ••,
Barbecu
x • • w �„ ..a.. „ nr, yaw„
Clothes dryer (gas)
Business name: Wolfer's Heating Other.
Address: 290 Young St L Ipp'' r,1liiiin �' ,w'iiia L'�. 1 Y . r, x!°tr y;i.w i �tJ s
- 1.��',n�nlugr�4ml airy /ny "ka "•MTf:r Yri ..�iYiS�in�n °iu1nn�i����R�oiri
City /State/ZIP: Woodburn, OR 97071 Subtotal 107.65
Phone: (503) 981 -4511 Fax: (503) 981 -0801 Minimum permit fee ($90.00) 90.00
Plan review (25% of . ermit fee)
CCB lic.: 1911 State surcharge (12% of permit fee) 12.92
TOTAL PERMIT FEE 120.57 •
Authorized signature f L� j ; E a I l + This permit application expires If a permit is not obtained within 180
,,� days after it has been accepted as complete.
Print name: Jennifer Winningham Date: 06/24/2011 '" Fee methodology set by Tri- County Building Industry Service Board
I:\ Bulb,93\rermila \MEC- PermitApp.dac 10/01/09 440.4617T(11/02/COM'wEa)
CV .
° -A/C- HEAT PUMP—UNIT SITE PLAN -
„. .
FEET TO BACK OF. PROPS 7T LINE E
/-\
m •
0
L
',
x —
r-m-•
J 1c . G z M
w . - FEET TO FRONT PROPE I Y LINE - d
o f __ :::
! - . _ r .�..�.. _ •
_ i te O
. ADDRESS: _ a6D u) �3 kifl N-E `-- J! ( 01
C7
= I -
PLEASE.REFAX APPLICATION WITH.SITE PLAN -
•