Permit , CITY OF TIGARD MECHANICAL PERMIT
° ' � 1. = COMMUNITY DEVELOPMENT Permit #: MEC2012 -00229
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/09/2012
Parcel: 2S102CB03301
Jurisdiction: Tigard
Site address: 9952 SW FREWING ST
Project: Darrow Subdivision: FREWING'S ORCHARD TRACTS Lot: 20
Project Description: Replace gas furnace and install A/C. Unit must meet 5' minimum rear and side yard setbacks.
Contractor: A TEMP HEATING & COOLING INC Owner: DARROW, DON S
16000 SE EVELYN ST 9952 SW FREWING ST
CLACKAMAS, OR 97015 -9519 TIGARD, OR 97223
PHONE: 503 - 650 -5014 PHONE:
FAX: 503 - 557 -2990
FEES
Specifics: Description Date. Amount
Air Conditioning 05/09/2012 . $46.75
Type of Use: SF Furnaces < 100K BTU 05/09/2012 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 05/09/2012 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $104.72
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: P ermittee Signature: a � N.� -P� G / �' � � 0 �
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.
•
MechanicalMechanical Permit AUUl1iCa � � " CEI\/EtJ � � r<, , : ( I ' , I i ,• , , ti t ' c l N t 1
City of Tigard MAY - 9 2012 Removed
>y: 9 '��/ P° ° / ' 1ecac�ia - oDaa� 9
13125 SW Hall Blvd", Tigard, OR 97223 P�Review
r 1'hu 503.718 : .2 Pou t: 503.598.1 4J OF T IGf��' D B abe B,. a>» EZC /a —47 6
i , i Inspection lino 639.4175 �/� i ! l�nte Beady/By: )veer: Bl See Page 2 rbr
hltanet: www.t and - ot.gov BUILDING 0!VsSiON ri° 1«hod: ramrmaton
-. _ _ " :alt`. : = us�:cz�E
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M echanical permit fees' aro based actin: value of the watt
❑ New construction Add /altexatiiOnfreplaCeMent performed. Indicate the value (rounded to the nearest dollar) of all
❑ 'D dine 0 Other meehhame el materials, equipmeat, labor. overhead,. and Proft
0 . v aw wM417fva. nRiQ • e Value. : tiR10 •
• KI 1- and 2-family dwelling 0 CommerCial/industi'ial 0 Accessory building For pedal isifurmatios nos elraclW*
❑ Multi - family o Master Milder a Other Aeon I Qty. ( Ea. I Total
JOB SITS I EVIA NAT1t1N • AND 1,OCATION Heofloalaaoling: r Li I r J
A ir conditioning
Job site address: s2 £ W 0 0 J t 1 (�aairw.. era. ��l r te) 1 46 . �
City/SmterZ.1P: 0.0
(2. [ q 22� r A\ rnaon 100. BTU Owls/rear) ' 91 f 141.43'
Sanc/bldg. /apt. W).: Proicut name: D ! Heal
a� ` t] 1/e�
(requite!' plan ahowimA ptacanow) 61.06
Cross street/directions W job sate: Duct warts 23.32
liydronio hot water system 23.32
Residential boiler (radiator or
bydronio) , 23.32
Unit heaters (thel-type, not electric),
in -wall in -duet, suspeade d. etc. _ 46.75
Subdivision: Lot no.: Mi./vent for ann of above I , 23.32
O 23.32
Tax map/parcel Ito.: Other lhel appliances:
. .. IdtaN �F .:1i1s4R>�': ' . . . . Wile; heater _
` ' Gas fireplace 33.39
4 1J VA ' U 6 A d r u .- (, r Flux vent for water heater or gas
fi e p 2332
y 1 ' c 1 n Lobs* (Ass) 23.32
Wood/pallet novo 33.39
Wood fireplace/insert • 23.32
[iatnny /liaerlfludveat 23.32
P. se a 0 .. . .
. 23.32
=UMW de7' .- . ? Other
d `: a+ Envlr+o,unental exhaust and veatilndott:
Address: '' 0' S of r'rew I A equip hood/°tlaer kitchen
equipment 33.39
City /State/ZIP: , d, / V �. C111;0 Clothes dryer exhaust 33.39
v Single -duct exhaust (bathroom;
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) , 2332 _
ri$' ' ; T ,. :t3 iT .. N. . csswlspace fans
.... , . : .. , . paid 23.32
Other. 2332
Busineasname: 11:1 ■,1' ,IC r!. .■ ..•.
Contact name: 16000 9$ Evelyn St. 51415 for Aim War, $4.03 for each addit
Address: ins, OR 97015 Furnace. etc. -
. ties heat bump . _ •
City/State/ZIP: walUstuyended/unit hesur
Phone: ( ) Fax:: 50g ) 6 5q- -^ 2-4 0 Water hearer
Fireplace
E -mail: (`o , , • . g u ' v i IPA Ranier
P B •
.. Barbecue _
• Clothes dryer (gas)
Business name: AjTEMP _t_ tl■ :.IS t!ele i,tc k.
Omer:
Address: 16000 SE Evelyn St. . . • ' . 'P *
Cluckames, OR 9 subtotal �'3.51r
City/State/ZIP: A4�..1 :1 " .,�—
F ax rr
Minimum Nara foe ( 590.00)
Phone: ( ) 0 D 3) 67 + —2 _ Plan review (25% o of permit tbe)
CCB lia : 'r I State surcharge (12% of permit fee)
/ TOTAL PERMIT FEE
1117
J This permit application mina tr a permit Is not obtained within 180 1
Authorized sign. • �� l days alter it bee been accepted as ventilate.
Print name:
r i V� • /� Date. 5 Au + Fee methodology set by Tri- County Building g Sonluc Board
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A-Templieating & Cooling, inc.
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F A-TEMP
HEATING & COOLING, INC.
16000 S.E. Evelyn Street (503) 650 -5014
Clackamas, Oregon 97015 FAX (503) 557 -2990
X TO: C L c FROM: R- a) e c-i- 6 A -- Ft" l e
r e � � 1 ATTN: ( �', l _ DATE:
PHONE: TIME;
T FAX: # OF PAGES:
R
URGENT
A Z. FOR REVIEW
N ❑ PLEASE REPLY
S $ 51 !L N , t rivk t or
NOTES: �� � • c � -- .
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