Permit •
• ;, CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00189
13125 SW Hall Blvd., Tigard OR 97223. 503.718.2439
Date Issued: 04/17/2012
TIG. . g Parcel: 2S103CC00900
Jurisdiction: Tigard
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Site address: 12045 SW ROSE VISTA DR
Project: Brumley Subdivision: COLONIAL VIEW Lot: 4
Project Description: Install •(2) gas furnaces and gas line from meter to both furnaces; install new exhaust venting out sidewall of
residence.
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Contractor: SKY HEATING & AIR CONDITIONING, INC Owner: BRUMLEY, JANINE K
1637 SE NEHALEM ST • 12045 SW ROSE VISTA DR
PORTLAND, OR 97202 TIGARD, OR 97223
PHONE: 503 - 235 -9083 PHONE: 503 - 706 -9357
FAX: 503 - 235 -0454
' FEES
Specifics: Description Date Amount
Furnaces < 100K"BTU 04/17/2012 593.50
Type of Use: SF Flue/Vent For Any of Above 04/17/2012 $46.64
Class of Work: ALT Type of Const: Fuel Piping 04/17/2012 $14.15
Occupancy Grp: 12% State Surcharge - Mechanical 04/17/2012 $18.51
Stories:
Fuel • •
Fuel Types: Natural Gas
Gas Pressure:
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Total $172.80 •
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: iC.057-77 /
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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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04/13/2012 15:19 5032350454 SKY HEATING AND AC PAGE 02/02
Mechanical Permit ApplicatioECEIVED ()I.; c l i ff i t 1 c s r u m ,
City of Tigard 7 S ;... Pamir 1Vo.
13125 SW Hall Blvd., Tigard, OR 97223 APR R 2012 pan Review ��'� as
Phone; 503.718.2439 Fax: 503.598.196Q Date/Br O her Permit
r i ); i, r -) Inspection Line: 503.639.4175 (( jj OF TIGARD vats Rarer, El see Page 2 for
Internet vrww.tigard- or.gov BUILDING DIVISION Ne ime NiCI Supplemental reformation
,TyMy� �qV}�jam
i►p Mechanical permit Bea` are based on the value of the work
❑ Ncw constriction ® Addition/alteration/replacement performed. indicate the value (rounded to the neatest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
:. CA��'VJR �"WPT( i'R li;
Value: $
IE 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For spedelb7fomnarkn rate diecklnd.
❑ Multi- family ❑ Master builder ❑ Other Description J Qty. 1 Ea. 1 Total
' ' : d 'E R AN* l ' .. ... ., Head atoll
. ,. , . - • • - . _, • - . . Air ocnditiommg
Job site address: 12045 SW ROSE VISTA DR. (ma= site plan showing plaoen mt) 46.75
Furnace 100.000 BTU (duets/writs) 2 46.75 93.50
City /State/ZIP: TiGARD, OR 97223 FUtaue 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt no.: I Project name: BRUMLEY Heat pump
ahc , . showin; . 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel-type, not electric).
in -wall in-ducy suspended. etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 2 23.32 46.64
.. Other: 1 23.32
Tax map/parcel no.: Other Biel appliances: .
r,.': ; (ft WO* . • ' :, g .. Water heater 2332 4
INSTALL TWO GAS FURNACES. INSTALL GAS LiNE FROM METER TO BOTH Gas Flue vent for water v for wate aK7 33.39
heats eR gets
FURNACES. INSTALL NEW EXHAUST VENTING OUT SiDEWALL OF HOUSE. fireplace 23.32
Los lighter (Ras) _ 2332
Wood/pellet stove 3339
Wood fireplace/Wert 2332
{ Chimneyfinerflue/vent 2332
2332
Name: JANiNE BROMLEY Environmental exhaled and ventilation:
r Addreme 12045 SW ROSE VISTA .DR Range hood/either kitchen
lo t hes 33.39
City/State/ZIP: TiGARD, OR 97223 Clothes , � exhaust 33.39
Phone: (503)706 -9i7 Fax; ( ) Sin ��� ,
toilet compartments, utility moms) _ 23.32 • • 11141 !'PLIC YT ` . • ' 13. C irrAtr Metal/ • .. fans 23.32
Business name: SKY HEATING & A/C, INC. Other: 23.32
Feel prprnsp
Contact name: TAMI HAGEMAN _ S14.15 ibr first four, 54.03 for each additional
Address: 1635 SE NEBALEM ST. Furnacketc. , 2 14.15
Gas heat pump
City/State/ZIP: PORTLAND, OR 97202 WaJsuspendedhmit heater
Phone: (503) 2354083 I Far:: (503) 235 -0454 Water treater
E -mail: TAMI(a3SKYHEATING.COM Fireplace
Riinge „,
:. C�lc1IReA�.'II .. Barbecue
Business name: SKY HEATING & A/C, INC. Clothes dryer (Pas)
Other.
Address: 1635 SE NEHALEMST.
City /State/ZIP: PORTLAND, OR 97202 Subtotal 154.29
• : (503) 235-9083 (503) 235-0454 _ Mntimttm permit fee (x90.00) 61 CCB lie.: 5(1244 Plan review (25 % of permit . fee)
.�. State surcharge (12%ofpermit fee) 18.51 /
TOTAL PERMIT FEE 172.80
Authorized signature: a h / This permit applieatlen expires if* permit Is not obtained within Ian
drga after it has been accepted at coraptete.
Print name: TAM' HAGEMAN ( Date: 4/13112 • Fes methodology sat by 7ti -Co®ty Bmlding Tndueay Service Board
1: maiidnthPerrsenrtEr- PermiVl9e.dos 03/07/12 44046171 (I1R2/COM/WEtl)