Permit • CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 00065
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/03/2012
Parcel: 2S104DC00700
Jurisdiction: Tigard
Site address: 13652 SW BENCHVIEW PL
Project: BALDES Subdivision: BENCHVIEW ESTATES Lot: 7
Project Description: Furnace installation.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: BALDES, GARY C & MARY FRANCES
PO BOX 241 13652 SW BENCHVIEW PL
DUNDEE, OR 97115 TIGARD, OR 97223
PHONE: 503 - 691 -9699 PHONE: 503 - 430 -7887
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/03/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/03/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/03/2012 $43.25.
Occupancy Grp:
Stories:
Fuel
Fuel Types:
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:
- - 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.
02/02/2012 1 1 : 38 503 OREGON HEATING PAGE 01/02
,o'N.,
Mech anical , 4,,,,\,.,---;,,, FOR OFFICE USE ONLY
City of Tigard ___„, r- As >: %'`■\., Reteivcd 2ffinrill Puma No • ----
Date/By: /-141rAn , CC° 0
II 4 13125 SW Hail Blvd., Tigard, OR 97 . 2,23 .4 :\ •,, ‘N:A, Plan Review
1
1 Phone: 503.639.4171 Fax: 503. ....V''' / V Data/By : Other Permits
T I GARD Inspection Line: 5 03 . 6 39 ,4175 ,g.1.P- C,.. Date Ready/By; r Ell See Rsige 2 tor
Internet; www.tigard-or.gov .<(„ `. NotiliediMethod; Mr ; Snaptementai Information
6 N:
' * • • • ' .. • . .. OF WORK C:.) ..•. s .. , OOYME111 SCEDIJLE ..=
. • • • •
0 New construCtion RAddition/alteration/raernent Mechanical permit fees* are based on the value of the work
Wormed. Indicate the value (rounded to the neare,st dollar) of all
0 Demolition 0 Other: _mechanical materials, equipment, labor overhead, and profit
Value: $
'P k
.;.'!.‘ '.
r,2t 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For ,s7aecial information use checklist
0 mmil-family 0 Master builder 0 Other; DeScri *lion Q. Ea, Total
' ::`' .•:: ' :.. ..•;,':',:,,..:: ° JOB SITE ENIFOlikkelo.N Aii'D LOONTION 2 ; ', • ... :: : • Reath) cooliiIn _
. • Air conditioning
Job site address; /1652 ,s-ti 1, 6t .isa s h o win • . lace:mut 46.
Furnace 100.000 BTU (duets/vents) 1 46.75 4 /4, i+..C"
City/State/ZIP ri. . 0 ' 3 ,2 _ Furnace 100,000-+- BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Project name: ;'*, Wesf.. Heat pump 61.06
Cross street/directions to job site: Duct woric 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
23.37
h Unit he (fuel-t not el"tric).
in-wall, in-duct suspended. etc. 46.75
Flue/vent for any of above ,.. 2332
Subdivision'. , Lot no.:
. Other: 23.32
Tax map/parcel no.: Other fuel appliances . _
. , ,, , v..i11:7-t;,.".-.:;.".:-'•‘'...-7 . :. .• ;, • -; 4 ,..;'; ..:% r iaiiiicovi, i i; x i i i ic :._., : , , : :: : „, ,.„;,„:.(.:;,,;,-,,,,,,,,,,,..,.;,,..::.,.. ; , , ,„.., : -.g. ; W heater 2332
.rs .',... .:;:: .. ,": .:.....,‘;1. ''.,.... . . -. .. ,...: ",',..: ,.. • • ":,:-.!• •-"r.;:;. ''''', ` • .'''1 :' :" Gas . . a 33.39
. Flue vent for water heater or gss
fireplace 23.32
Lo:.1i: - as 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 2332 ,
. CbinineY/linertflueveni 23.32
: O MB 1 1111113a2 Other: 23.32
Name. ,—, r 4..., M &Aide 4 - Environmental exhaust and ventilation
Rare hood/other kitchen
Address; /1? C 6 4 dren c A..voi.... , I4 c-e c ui.ment 33.39
City/State/ZIP: . aft q 7.223, Clothes thlesth 33.39
Single Yerurt exhaust (bathrooms,
Phone: (ca 0 _ , 87_ toilet comparttnents, utilty rooms) 2332 ___
23.32 ..
' - Other: ... I 2332
Busiriess name: o ,,,, eo-h)., .. ,0( ,, C Fuel aid':
Contact name; Z G /4 . _ $14.15 for first four; S4.03 for each additional ..
Fuma • etc.
Address: /' 00 , iig Arve Gas heat .um. Mill
City/Stateall' 7 -zi ,,, o e.. • 0 , - WalliSte eadCdh in it healer MI _
Water heater
Phone: (.5 6 q I - 3 6 4 ' Fir. 4= ill.
E-mail: Ran:e MIMI
".',. :': ',',`.;... ,::: ; ' :: l'' . 1" ***';:' ' •: eOlCITRAtTOR ' , . • .,". 7 : z ': ' • ' Barbecue _____
, .. . • . . . . - . . Clothes dryer (Rag)
Business name: ...—Saistle ..• # bot,..e-- Other:
.. .
Address; ,"'-' ,..:•, : ..: 401;fll',REES* : ' ,• '," ' ..., ',
City/State/ZIP; — Subtotal lig .FS
Minimum perit fee ($90.00)
Phone ( ) Fax! ( ) Plan review (25% of permit fee)
CCB lie.: I 72 /,2 C State surcharge (12% of permit fee) /0- FO
OTAL i F/42cmp___
-. This permit application expires if a permit is sot obtained within 1$0
Authorized siOatilre: -.. ,.. .. ..." . - .. days after it has been accepted as complete.
..,.
-.---.. I .•"... r• ,, , , TWP• '7 4-, / day * I . Fee methodology set by Tri•Courdy Building industry Service Board