Permit CITY OF TIGARD MECHANICAL PERMIT
- • COMMUNITY DEVELOPMENT Permit #: MEC2011 -00379
•
TRiARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/18/2011
Parcel: 1S135DB06200
Jurisdiction: Tigard
Site address: 11290 SW 95TH AVE
Project: WALLACE Subdivision: O'NEEL ACRES Lot: 2
Project Description: Replacing gas furnace.
Contractor: OREGON AIRE INC Owner: WALLACE, ANDREW H & MARY R
7715 NE 33RD DR STE A 11290 SW 95TH AVE
PORTLAND, OR 97211 TIGARD, OR 97223
PHONE: 503 - 335 -2222 PHONE:
FAX: 503 - 335 -9977
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 08/18/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 08/18/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 08/18/2011 $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 503.232.198 00.332.2344.
Issued B Permi ee Signature: I
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 Application -
City of Tigard... Received
l Date/By: g ' /' - Perrnit No.: m I I — (10 3 7
3125 SW Hall 111vd , 'l i gard, (JR 97223 2 11 Plan Review
I ` Phone: 503.71 R 2439 Fax: 503.59 &.1960 n\ `( Datc/Ey: Other Permit:
T r t:. A R D Inspection Line: 503.(139.4175 P l GI ' , Rcady/By: - ioris El See Pate 2 for
Internet: www.tl and -Or. ov
g g �\ t-,t� t�!'S 9r tAl�otifcdJMedre,rl: r - � i - Supplemental Information
4 11 iI s` i —s—e
. , TYI C,.: WOCt; a�,t CO14I1�IER6; AL )f :' SCH,'DI'LE „t) G11V4a1 •
Mecitalucal permit fees# are based on the value of the work
❑ New construction ® Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ I)etT olition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
GA I O p C"OE 151 IiU I1
Value $ S4.600.00
.. aispiNT, I4"iQ�7� "iitN.wisYbt.E4sst'1iC.k
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Pa, Total
4I1i :1'ti; I VC 3 4T1bNN; AN C `A+11OIY ' ; ,' r 'Jesting/en. diton olin
Air cnnin8 :
Job site address; 11290 SW 95 AVE (requires site plan showing placement) 46.75
City/State/7.1P; TIGARD OR. 97223 Eumace 100,000 BTU (ducts/vents) 1 46,75 46.75
"..— Furnace 100,0001 BTU (ducts/v 54,91
Suite/bldg. /apt., no.: Project name: WALLACE ITcut pump
(requires site plan showing placement) 61_06
Cross streeUdirections to job site: Duct work 23.32
Hydronic hot water system " 23.32
--"- .. Residential boiler (radiator (1r
dronic) 23,32
"' Unit healers (fuel -type, not electric),
TN in -wall, in -duct, suspended, etc. 46.75 — _T,
Subdivision: T.ut. no. Flue/vent for any or above 23.32 „ _— ^
�.. Other: _ W 23.32
Tax map /parcel no,; f
DESCR1PTl'4j1%1 il r Xi ji Other fuel cc5, 23.32
Oth I appttliart
Water heater
.,.. .. . .. ................. .:.::: OLD ONE WIT H NEW ... .. ,,: ..,—
MOVE GAS FURNACE 4 l'LET AND REPLACE
GAS Gas fireplace 33.39
FURNACE Flue vent for water heater or gas r_.��,
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
-- Wood fireplace/insert � ^ 23.32
Chimney /liner /flue/vent 23.:32
®PROkE'RTli O FR : Q 'TENANT: , th
23.32
O
Name: ANDY WALLACE Environmental exhaust and ventilation:
�u Range hood/other kitchen
Address: 11290 SW 95 AVE equipment 33.39
City /State/ZIP: PORTI.AND OR. 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: 2 32
Fax ( ) toilet compartments, utility rooms) 3.
ho ti.
crawls ace fans
Al'1';, Ir tLk T ❑:01'i`ict, At''f `PE1iSOl' 23.32
Ir Attic/
UU1cr: 23.32
Business name; OREGON -AIRE INC. Fuel piping:
Contact name: RON STRONG $14.15 for first four; $4.03 for each additional
K „ Furnace, etc. F ,
Address: 7715 NE 33 DR. sun: A Gas heat pump �-
City/Stale /ZIP; PORTLAND OR. 97211 Wall /sus ended /unit heater
Water heater
Phone: (360) 423 -1966 Fax: : (360) 423 -1978 -,
_ Fireplace
E—mail: r¢tro
ng()oregon- aire.com Rage
eN:1 AC"TOI4 Barbecue
ar
. Clothes dryer (guy)
Business name: OREGON -AIRE INC, - --
__ Other:
Address: 7715 NE 33 DR. SUITE A °.` "' s,, ,, :
1! T)i,17`i[GALII~RM'ht Ha4...::` ...... ::. :.: ` ,.'::
Cfly /Butte /211: PORTLAND OR. 97211 Subtotal 46.75
_ Minimum permit fee ($90.00) 90.00
Phone; (360) 423 -1966 Fax; (360) 423 -1978 Plan review (25% it fe .
.... - •.- -, ( /o of permit fee)
('CB lie,; 64235 1 _ Stale surcharge (12% of permit tee) 10.80
-" - - `1T0 PERMIT FEE 100.80
This permit application expire.% if n permit is not obtained within ISO
Authorized signature; days after it has been accepted as complete.
• F v,eehpd y set by Tri- County Building Industry Service Ctourd
L Print name: RON STRONG Date: 8/18111
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