Permit CITY OF TIGARD MECHANICAL PERMIT
411 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00610
Date Issued: 12/29/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S112C605300
Jurisdiction: Tigard
Site address: 15345 SW 82ND PL
Project: RASMUSSEN Subdivision: ASHFORD OAKS NO.2 Lot: 67
Project Description: Gas furnace installation.
Contractor: COMFORT SOLUTIONS HEATING & COOLING Owner: RASMUSSEN, MATTHEW C
PO BOX 1233 RASMUSSEN, YVONNE
CLACKAMAS, OR 97015 15345 SW 82ND PL
PORTLAND, OR 97224
PHONE: 503 - 698 -2665 PHONE:
FAX: 503 - 658 -4011
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/29/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/29/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/29/2011 $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: 4 . Z iv7 ^
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.
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Mechanical Permit Application 1 i�0R s hhit L t`5[: ONIA. "
City of Tigard i J� ,
n 13125 SW Hall Blvd., Tigard, OR 97223 8 �� r� may. V " "` u��-�'
Plan Review
1 . ` . _
G i Phone: 503.7182439 Fax: 503.598.I9601 ./ p y; Other Fannie
I i A It 1) Inspection Line, 503.639.4175 1 . -ri- ix ri 4 11 Date Ready /By: ® See Page 2 for
Internet: www.tigard- or.gov • `,; , , p � IvotifiedIMethod; ' Supplemental Information
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. m c perm f ees' are b ased on t he va o the work
❑ New construction ►4 Addition/alteration/rep : r: pertiarmed_ Indicate the value (rounded to the nearest dollar) of all
❑ Derriolition • Other: mechanical materials, equipment, labor, overhead, and profit,
F 1zr e� rx ,JIr:T�etu , `�,iy�= y �, i or tl 'u . ''^,: :- .�trsr •� , f Value $
. r a . ,, q T. 1 r,, r i', i 1i` $k.", !T �.: :71t{ flS: A - 7 T r u�t�. �G^�{ P ,zi i G, 7(S${ , r+ : , ..p, t " T,'f, 7 {- r 7 4 '7'1
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a .._. S ". 4 .,.,, r'nr. ,�, . '�,.r �n
a, 1- and 2- family dwelling ❑ Commercial /industrial Q Accessory building For special information usecuecklis.
• Multi- family ❑ Master builder ❑ Other: Description I Qty. I )~a. • I Total
'>t ' ' T..zrmt z, i7utP1{101 ?f z�j n c N l Pfpvrz� 1 t Heating/cooIing: '
. , ,',,; : ,; ( ,a , , ', , , • ?I '1 :i s., } r w, , , fi.iq: lt�;a'., }ix,„ ;.;y " �l , l ^ y 11 4,, •: ; 1: ! itY! >U , I, „
t9 � � ' Air conditioning
•
I
Job site address: I 5 5 £.§.4) n c( t2 ce f r - nes , ni site , Ian ehowin- - laccmcne 46.75
` Furnace 100,000 BTU (duetylvents) 56.75
City / State/ZIP: , a' / - Furnace 100,000+ BTU (ducts/yens 54.91 '(,‘i i
Sulte/bldg./apt. no.: Project name: 14 85 -• 7 Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
drone) 23.32
Unit heaters (fuel -type, not electric),
• in -wall, in -duct, suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision; I Lot no.; Other 23.32
Tax map /parcel no.: ~n, £ Other fuel appliances:
i t s t ,,,, yYrry,iF si:T., li ;1, i iTIgl ,Ri -' r 9 71 y r zi# l i lt t9 �w'� tm' ;,ru 3 ".' } �' 1 23.32
Water heater
.: c > ; ,. .r . C ' ,,.li. { . ?_..,. ..,.....,. .. i.S ^ ' 1 l`13L' L1�rSsati�tii a a.!"t
Gas fireplace 33.39
_ r t \ / Flue vent for water heater or gas
fireplace 23.32 .
Log lighter (gas) - 23.32
Wood/pellet stove 33.39
•
Wood fireplace/insert 23.32
< z � , 4.' �{ �9�+1,i+Ifr14 Chimneylliner /Fue/vent ' 23.32
..a -7 r ,5 7, ;: 11 , �. f 1
� , i h it t (f N� f +J + .7� y 1 Frj: u,,;? �f'
S WL t 61L4 „
rno: \) ` ,c a ,� n Other: 23.32
Na
7►ianr , � r Environmental exhaust and ventilation:
Address: 395 t� lard 3 'place. Range hood /other kitchen
u equipment -
33.39
City/ State/ZIP: p m ; O R Ca 7 D 4 Clothes dryer exhaust 33.39
�g 1 r Single -duct exhaust (bathrooms, Pbione ljti, I / P l b Fax: ( ) toile et comparhnents, utility rooms) W 23.32
4 t } }Fu
r Y ; {: (^ r �i Gar a( 7 1 I1 t l N � F ., � lri n n i R iR1i " r ill .i r.
(( i�.,f rr (aiLYi, st tf1 Attic /craw[space fans 23.32
1.,. • ?r t, r.. , "•,, , , . :: ,.cr. ,t ..,t.:. + &i .s ,i},.. _;5 2, itu itl;An i i r e4ittl x „ , tZf iV, a , , ti a
Business name: Other: 23.32
Fuel piping: •
Contact name: S14_15 for first four; 54.03 for each additional
Address: Furnace, etc, I
- - - Gas heat urn
City /State/ZIP:
Wall/suspended/unit t •
Phone: ( ) 11' I Fax: : ( ) Water heater
•
E -mail: Fireplace
,, , 77-• 7.7,T!r^ -� . " T r r arc 1-M" „ , I ( ,, rr ,,,, i' 7 7. Range
t l „ ,w M u e; i4., r 1' f' c` i y� rt t �l1 y t^F E r�'' - > �1" T"S• , .
. '• -, .,....... ,.. ) .. wa, a,,�'t;,,.. r.4a11a.,1�:,+ ,h -, �, r�: ftls; ,9,i{rL,Lv;!�t� ,a,tiUltj�1'i�I` + "'.�Y Barbecue i .
//MM_ D $ I _ Clothes dryer (gas) an Other
,•e
Address: '] �r rc
,L
, ..,
City/ State/ZIP: / (► r � 5 I 0 - ' 7015 Subtotal > . Ci
1 • ; Minimum permit fee ($90.00) 10 , Lk)
phone: ( ) p , i F a x ( ) Plan review (25% of permit fee) ---
CCB 1ic.: ) L t (_47, ) /d--1-
O -- - / 3 > State surcharge (12" %e of permit fee) i r) „ kk() TOTAL PERMIT FEE I 1 f)t')
Authorized signature: / ! This permit application expires if a permit is not obta nod wittin 180
�1 ,../ jI / t ,i' days after it has been accepted as complete.
Print name: ' ` fAil Irk , - D; trr ct ` Fee methodology set by pi_County Building Igdusvy ScMcc Board
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