Permit CITY OF TIGARD MECHANICAL PERMIT
� COMMUNITY DEVELOPMENT Permit #: MEC2011 -00534
Date Issued: 11/23/2011
TIGARD R D 13125 SW Hall Blvd., Tigard OR 97223 503.718 Parcel: 2S 23/201 8900
Jurisdiction: Tigard
Site address: 16145 SW 103RD AVE
Project: Reilly Subdivision: RIVERVIEW ESTATES Lot: 35
Project Description: Install gas furnace.
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: REILLY, AMY
1005 INDUSTRIAL PARKWAY 16145 SW 103RD AVE
NEWBERG, OR 97132 TIGARD, OR 97224
PHONE: 503 - 538 -1950 PHONE: 503 - 620 -9674
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 11/23/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 11/23/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/23/2011 $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 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: , 04/ /97 / e!}' -% /O/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.
11/23/2011 12:38 FAX 5035380165 Z002 /003
sicat permit
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C i t y of Tigard NO v 2 3 2011 a . ' • • 17=g7IMMSBN
13125 SW Nall Blvd., Tigesd, OR 47223 z • . Other env .
Phone: 5o3.i; .4171 Fmt 503.54 a OF TIGARD ° ma y ® see z for
Inspection Line: r w,w� g � BUILDING DIVISION w1 �� ammlemmuld hi '
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Mechanical permit ibis* are based on the value of the work
❑ New construction dditi�latneraaamhoplacetaem performed, indicate the value (rounded to the nearer dollar) of all
❑ Demolition ❑ Other mmxhanrcal ... ;u labor , , .. and
Value. $
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