Permit •
CITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00229
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/26/2009
RD
. Parcel: 2S102DB02400
Jurisdiction: Tigard
Site address: 13588 SW CHELSEA LP
Subdivision: Lot: 0
Project: Brumbaugh
Project Description: Install a/c
Owner: FEES
BRUMBAUGH, KAREN J Description Date Amount
285 N LOTUS BEACH DR Air Conditioning or Heat Pump 05/26/2009 $14.00
PORTLAND, OR 97217 12% State Surcharge - Mechanical 05/26/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 05/26/2009 $58.50
Contractor:
FOUR SEASONS HEATING & A/C INC.
1005 INDUSTRIAL PARKWAY
NEWBERG, OR 97132
PHONE: 503 - 538 -1950
FAX: 503- 538 -0165
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue
Total $81.20
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 Ceht r. Thos rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You -may obtain a copy of the rules
, —
lss ed By: ) ,e it, ,,,.. Permittee Signdture: = �' _e.r 1 ��� _J
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Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
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Mechanical Per Ap iicat E -. ` I ,►► :, O [ i l ( 11 ti i 1 l
City of Tigard Sir) 9 `"4.9 V Permitro.: lig e;leo7 ee % . •
` Phone: 03.639.4171 Tigard,
Fax: 503. 9s 6 MAY 2 0 2009 0 Date./13y: Renew.' Other Permit:
i ,, - Inspection Line: 503.639.4175 CITY OF TIGARD DateReadYMY: 1o;r:
Internet: www.tigard -or.gov
BUILDING DR/1M', Noalied/Methad: c
..r`Yp ..',e .:. a'1 i, G`JW' SCBEEDLLE -
: U mown
. c Mechanical permit fees* are based on the value of the work
❑ New construction Addition/slteratidn/replacemral[ performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, e. at. ment. labor. overhe*• and • *fit
� 'HAL / ` ,t .,y,'r:•
- and 2 thmily dwelling 0 Commercial /industrial 0 Accessory building / For special information use checklist- .• NM
0 Multi-family 0 Master builder ❑ O ther: Description Qty. Total,
JO SITE, ATFON e4A1Dr E ;,. . • ,. .i, '•' i�ea8 • , _
� -r 1 r condition • heat pump •
Job site address: a ti J - � ' tam s si - . 'T .swim_ . cement gm 14.00 I 1E4
City /State/ZIP: • f �i V C) i' Furnace 100.000 BTU duersNents Mill 14.00
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Furnace 100.000+ BTU (ducts/voles 17.90 —
Suite/bldg. /apt. no.: Project name: 14.00
Cross street/directions to job site: Du ark 10
14 dronic ' s stem 14.00 _!
Residential boiler - . . 1 . . . . . . 1 1 1 1 1 1 1 1
h . rnic 14.00
Unit heaters (fuel-type, not electric), -
in -wall in -duct, s . - . ded, etc, 14.00
Flue/vent for : of above 1=1 6.80 MIN
Subdivision: Lot no.:
Other NM 10.00
Tax map /parcel no.: [lances
' )�I :, :
.: o>+l . 4 . . . ' 10.00
MEM cr u a
W tlter hooter 1 n 00
. 0... ilt ► r Flue vent for water heater or gas MI
.lace 10.00
Lo:li. ter 10.00
Wood/. -ltet stove NM 10.00 IIIIIII
Wood fire.lacc/insert 10.00
Chinni /liner/flue/vent 10.00
MEW FT4OREWEY ' ; v Other: 10,00 NM
/ ' Environmental exhaust and ventilation
,i_ ••._ - Als ` •JU.. A •• ' Range hood/other kitchen
Address: ' $ ` • � 1 1111/7 7 A , I e l • .ui.Malt IIII 10.00 Mill
Clothes . erexhaust 10.00
Phone: (- i ) . • • • fans ill rooms 1000
- ace s
sirs e-auct cxtiaust (bathrooms,
toilet morn. me, Will 6 SO
: fl- ` APl`IilCM'a , . ' -; • .> .. - ` . � ... .....
Other: Mill 10.00 OMR
Business name: . _ a ■ r ' I t:
Contact name: AND AIR CONDITIONING, INC, $5.40 for first four; S1.00 for dd�
al , t 1 _
ids= dress: . + _
Wall/sus. • • dhmit heater �— _ ater heater Phone: ) Water _1MI�
1:ErMEN111111=01.1111 Mill
�' Barbecue � NM
t;oNilf4ACi; "`' Clothes d ��
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POUR SEASONS FL1 A Other M ME
. :L�JL NKAL � : *�; .
Address: � I. �! r:. y :: - .�,1, - .
City/State/ZIP: NEWBERG OR 97132 Subtotal
p / Minimum permit fix (572.50)
Phone: (6�,1 2.-- (' 575 Fax: ( ) "8 `0 { e. S Plan review (25% of permit tbe)
State surcharge (12% of • • • t fee)'
TOTAL. PERMIT FEE _„9
t „
This permit .Pt�lka after if a ponies is o obtained Toddy 11111
Authorized si;ina 1 1. - ' - ' l l ( S J , days after 1t t has has been accepted as complete.
Dam: LEI V • Fee method ildin Bored
ology set by Tri- County Bug ladustry service Sd
print game: i \ ., 1f�� ilk ,. '
1 I: ToildthlPe.eth1MEGrMrmhApp.dec 01/19/07 440.4siTf IIO2/CAMIWEB)
1700/€00 VI XV.d g4 :01 600Z/OZ/S0
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1005 INDUSTRIAL Miff
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\ , FOUR SEASONS HEATING
AND AIR CONDITIONING, INC.
NEWBERG, OR 97132
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