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Permit -r r CITY OF TIGARD MECHANICAL PERMIT 2 ', COMMUNITY DEVELOPMENT Permit #: MEC2012 -00244 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/15/2012 Parcel: 1S133DD08300 Jurisdiction: Tigard Site address: 11624 SW 128TH AVE Project: Locsin Subdivision:'ILLAGE AT SUMMER LAKE PARK NO. Lot: 120 Project Description: Gas Furnace & Air Conditioner Must meet 5' side yard and rear yard setback requirments Contractor: FOUR SEASONS HEATING & A/C INC. Owner: LOCSIN, SUSAN 1005 INDUSTRIAL PARKWAY 11624 SW 128TH AVE NEWBERG, OR 97132 TIGARD, OR 97223 PHONE: 503 - 538 -1950 PHONE: 503 - 880 -0145 FAX: 503 - 538 -0165 FEES Specifics: Description Date Amount Air Conditioning 05/15/2012 $46.75 Type of Use: SF Furnaces < 100K BTU 05/15/2012 $46.75 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 05/15/2012 $11.22 Occupancy Grp: Stories: , Fuel , Fuel Types: 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: Permittee Signature: bila AP Pt/ t A-i7 0i.i _____ _pii_jaiLacr____ 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. ,Q s Mechanical Pern'lt Applic tia� 1 EC ,..,,,,;‘, ..,,,,,,.. iii City of Tigard MAY 1 5 2012 eia 13125 SW Had Blvd, Tigard, OR 97223 Phone: 503.639.4171 hoc: 303.598.1960 Wier Pan ` • Inspection Lane: 503.639.4175 CITY OF TIGARD Dam aandetey . t Pagel i Imam= www.ti -o gov BUILDING DIVISION► �: `, . w TYPE •oF. WOia c • •': • . : : OObIIld t. PEW SCHEDULE.— GEEtHECiad.Wr • ❑ New construction Addltian/atitexeQsonheplao�t Mt 1 s an based on the value of the wept perfumed Indicate 03: value ( to the neatest dollar) of all © Demolition ;• R CATEGORY OF. Q)NS!RV('UN C . Yeh $ . azawarrnapioutrmarcr mamma m i._ and 2- family dwelling 0 Co industrial ❑ Accessory *niidi*+g For 4� � _ Mute- family 0 Maier builder 0 Otter: Description ! Qty. I Total SOB S1 E HFoRM& 9tt A that*. IlmtioeoO6e>e rob 102.."1 1 a% Nit - 46.73 ` Air oendifioning (tewitas yea alas showiest td>1) pr,Ottn y C2 ai - 1 � t) / 39 • Sn bldgJapt no.: , Pitied um= i ■ , 61.065 _ _ • dross streetidireedons to job see: Dust work- 23-32 Hydroeic hot water system 2332 • • Residential boiler (radiator or hyehonic) 2.332 . Unit beams ( t-type, not electric), • is -wail. iP a cm. 46.75 Plush= Sir any of above _ 23.32 Subdivision: - I Lot no.: 23.32 Tax m p arccl no.: Other fed apaih ens _ DBSCRI? WN. OP:.WORH .: Water heater _ 23.32 , CikS FvrA2 �. a3 39 Hue vet for water busier or gas iieepf 2332 ?. .1.01 Iighttr WS) 23.32 . Woodlpellea suave 33.39 , M r C. t i ene- Wood Emplace insert , 23.32 — — • PROPEliFTY. OWNER I � ' • U .� ($imneY/1 /1►ent . 23.32 p� Odle: 2332 Name: Environmental ezbaost and veodlatleo • _ Range hood /other kitchen Address: ( t Loa � p� kite___ a __ a tt , 3339 r) / �t +� Siege -da (badman,, , 3339 drier =host p O SO - 0 'r 5 F ax: ( ) r to c�pm Why looms)_ , 23.32 7:'APp,B ICANt ' - ' . .:. : CCiNtAit•PERS°N • � Atdcl , - , _2332 Attar 1 23-32 Business nein= Asti C o m a name: S14.1.5 F O U R S E A S O N S rites► 11NI i vial few mgr mar-, s4.S3 for eaeh additional AMU AIR UONDF IONIN(3 INC. . co. Addle= . Gas beer peep Cuy/State/JP 1005 INDUSTRIAL PKWY Wellkanoendminatit heaau , Phone: ( ) NEWBER(� ) - wane: heater tl1( i'39 E4neil - Rine . Busies name: — Clothes sites) Omar: nddtess: • mamma. »Mrt0211'. • . , � AND AIR GONOFFIONIN0, INC. Subtotal �mimntm permit fee (390.00) 4 11 3.50 ( ) 1005 I NDUSTRI4I,F CWY) Plan review t2.1%or l$a) ..iCB tic: 97/52 N z BFPO - 81139 State surcharge (12% of permit fie) 1 t - 22. A / TOTAL PERMIT FEE / 0 '7 L_ Authorized Ac :; ,, ,:,. A s p ( , ► I / i l l / . t It • is ned waft IBS Pt lai , 1.7t�[ /a / Dabs _ • Fee mdbodoloy au by T1i-CamRy Belding ley Swine Honed • :: r .• LiBmAraigensilubd3C-PermaAppAtet 10101109 410.4617T(11/02CO ) • . 1700 /ZOOS 59108CS80S XVJ OZ :60 ZIO3 /91./S0 05/15/2012 09:20 FAX 5035380165 Z003/004 • ..... . s4 ,,, c , vnovi . i.i.rm .---vtovqV . .. . . . . . • . . • • ..__. . . . . .. . . . . . . . . . . .. . . .. . . . .. . . .. .. .. . . .. . . . . ... . . . • l ', - 1 • • . • 2 _.. a . I _,..,...„.„,,rg....................›, a 1 . .. I. ....... ... .''.. ‘• • . P. 4 (it a. -,-; . ...... . . . (� 0 r . r; i o p • . • 10 II .. rz is• ,.. Ow . . .. (..? .. �, y rehA •uu eeuu IA ai1 ORAL 4R Oft VYa 17 O 1717lM • 1 ` , 1 �,1.Vk SA� T FOUR 9 , ' � SEASONS 4rq r0 , )\ FAX DATE L5 - t a TIME: 30 ! ' ATTN: RE: NUMBER OF PAGES (including cover): 3 FROM: Four Seasons Heating and Mr Conditioning 1005 Industrial Pkwy Newberg, OR 97132 � • 3- 5r8:i 195 �! Phone. 50 Fu: Sent By: s E -Mail: @foarsessonsbeatair.com 6 A VOO /LOOT 99LO8C9CO9 XVJ OZ GO ZLOZ /SL /So