Permit n CITY OF TIGARD MECHANICAL PERMIT
• ''1 2 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00143
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/16/2012
Parcel: 1 S133CA11600
Jurisdiction: Tigard
Site address: 10943 SW SAGE TER
Project: Olson Subdivision: VILLAGE AT SUMMER CREEK Lot: 39
Project Description: Installation of NC. Unit must meet 5' minimum rear and side yard setbacks.
Contractor: MUEHE QUALITY HEATING INC Owner: OLSON, TASHA L
7301 SW KABLE LN #500 10943 SW SAGE TER
PORTLAND, OR 97224 • TIGARD, OR 97223
•
PHONE: 503 - 598 -0966 PHONE: 971- 678 -0305
FAX: 503 -598 -8498
FEES
Specifics: Description Date Amount
Air Conditioning 03/16/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 03/16/2012 $10.80
Class of Work: OTR Type of Const: Minimum Fee Adjustment - Mechanical 03/16/2012 $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: Pennines Si Gv e "/ ° ,0L, e 7 70 ,
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.
•
Mar 16 12 08:47a Mliehe Quality Heating 503 - 598 -8498 p.2
Mechanical Permit Applicatio
FUR of 1 k 1, i 1. <).1.1
City of Tigard �0� Retxive •
13125 SW Hall Blvd., 'VP; D /4, � . • .r Paint No E C� iQ
d, Tigard, OR r,, CO �02 t7�
" C Phone: 503.718.2439 Fax: 503.59:J ; O, % 'Q�`
�Q` C '`� �� Rey. Permit
R D Inspection Line: 503.639.4175 ® P 2 for '
Internet: vrww.tigerd- or.gov r ` . \ r .c;, Notified/Method: Suppiemeatal Information
TYPE OF WORK $ \)`"
COA11bIERC1A1. FEE* SCHEDULE — USE CHECKLIST ,
Mechanical lit mss' are based on the value of the work
New construction
❑ ® Ad dition/ alteration /replacement performed Indite the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other. mechanical materials. equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1- and 2-family dwelling ❑ Commercial/industrial ❑ Accessory building For spedai
lo+rdualist.
❑ Multi- family ❑ Master builder
❑ Other: Description 1 Qty. I Fa I Total
- JOB SITE INFORMATION AND LOCATION Heatisyfcooling:
Air conditioning
Job site address: 10943 SW Sage Terrace (requires site plan showing placement) 1 46.75 46.75
City /State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (dnets/..tata) 46.75
Furnace 100,000+ BTU (duuvvems) 54.91
Sttite/bldglapt. no.: I Project name: Sommer Creek Heat pump
(requires site plan showing placemem) 61.06
Cross street/directions to job site: SW Sebolls Ferry Road and SW 135 Ave Duct work 2.3.32
Hydronic hot water system 2332
Residential boiler (radiator or
hydronic) 2332
Unit heaters (fuel-type, not electric),
i in-wall, in -duct, suspended, etc. 46.75
Subdivision: Summer Creek Lot no.: 39 Flut/ver►t foram of above 23.32
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 2332
Addition of air conditioning to existing system. Gas fireplace/insert 3339
Flue vent for water heater or gas
fireplace 23.32
Logjighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 2332
® PROPERTY OWNER ! ❑ 'TENANT Chimney/liner/the/mu 2332
Other 23.32
Name: Tasha Olson Environmental exhaust and ventilation:
Address: Same as above Range hood/other kitchen
equipment 3339
City /State/ZIP: Clothes dryer exhaust 33.39
Phone: (971 78 -0305 Fax: ( ) Single-duet exhaust (bathrooms,
later oonrparoneo►v, utility rooms) 23.32
® APPLICANT ® CONTACT PERSON Atticicrawlspace fans 23.32
Business name: Muehe Quality Heating, Inc 23.32
Fuel piping:
Contact name: Kyle Birman 514.15 for first four; $4.03 for each additional
Address: 7301 SW Kahle Lane, Suite 500 Furnace.
Gas heat pump
i City/State/ZIP: Portland, OR 97224
Wall/suspended/unit heater
Phone: (503) 598 -0966 l Fax: : (503) 598 -8498 Water heater
Fireplace
E -mail: MQHKYLE®1]% EGRA.NET Range •
CONTRACTOR Barbecue
Business name: Muehe Quality Heating, Inc. Clothes dryer (gas)
Other.
Address: Same as above MECIIANICAL PERMIT FED
City /State/LIP: Subtotal 46.75
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) 43.25
Plan review (25% of permit fee)
�(/�CCB liar 58096 State Surcharge (12% of permit fee) 10.80 /
��� TOTAL PERMIT FEE 100.80 ✓
Authorized signature: This permit application expires if a permit fs not obtained within 180
days •
Kyle Birman • Fee methodology is has been accepted as complete.
Print name: K
Y J Dat e: 3/16/2012 ogy set by TriCounry Balding Industry Service Board
t'BeadkePertessNEC -Permit App doe 03,071: 440461 TT(1 I/OIJCOM'WEB)
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