Permit CITY OF TIGARD MECHANICAL PERMIT
I COMMUNITY DEVELOPMENT Permit #: MEC2012 -00262
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/21/2012
Parcel: 25111 CD07700
Jurisdiction: Tigard
Site address: 15775 SW SERENA CT
Project: Estes Subdivision: KERWOOD ESTATES Lot: 10
Project Description: Replace existing A/C Must meet 5 minimum side yard setback and approved rear yard setback
Contractor: WOLFER'S, INC Owner: ESTES, MATT
290 YOUNG ST 15775 SW SERENA CT
WOODBURN, OR 97071 TIGARD, OR 97224
PHONE: 503 -981 -4511 PHONE: 503 - 888 -1800
FAX: 503 - 981 -0801
FEES
Specifics: Description Date Amount
Air Conditioning 05/21/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 05/21/2012 $10.80
Class of Work: A I or k Type of Const: Minimum Fee Adjustment - Mechanical 05/21/2012 $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 callin 503.232.1987 or 1.800.332.2344. �,
Issued By: Permittee Signature: D'`.. A j� _' ' 77OAL
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.
MAY /18 /2012 /FRI 09:04 AM WOLFERS HEATING FAX No. 5039810801 P. 001 ee
Mechanical. Permit licatioREC 0 1.0K OFFICE USE ONLY /'D r
City of Tigard ad �9 ;; 7 , " Pe t14 yti�.6� -.io 1— D • - 110112-
41 ' 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
� '1 a Phone: 503.718.2439 Fax.: 503.598,1960 MAY 1 8 2012 DatcIBy. Other Permit
Inspection Line: 501639.4175 p ReadyBy. kris: El Sec Page 2 for
T1G/�IZL� Internet www.tigard-or.gov � CI ; c- pl
OF TIGA oti5ed/Method; w Supplemental Information
Mechanical permit fees' are based on the value of the work
❑ New construction . pl gAddition /alteration/repla0oment • ' performed. Indicate the value (rounded to the nearest dollar) of all
1:1 (? 1 Demolition ❑ Other: flo mechanical materials, equipment, labor, overhead, and profit.
_ - $
,471,,-..Z..,=, , , r '{ r,!� .. ,F6 All'4 - ,- �1� ''_,. :71f Ur4JFI fl ^�; -... "''�-a T w. . -.i.. -. ,,,,,., Sae, i 0 5 , ` —�:rr , °. -`^ d —,'
..- r �-r w.:�. -. r ,,, '�.,.: l e s.'3���Nf`, C 114 � - r��J.� jr
--�` - T�.,: - V,: : � . � ,. , .
:I 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. 1 Total
F ° -: :- c ' 1 n [ ei.7, e y . ° [ IT J u � c l ' Heating/cooling:
i - r .;,, ::; a2 . f ` ;:,-u '+- 7:-= -• - �'� c st1- �t _ ,,; Air conditioning 1
Job site address: /G-7 75 TIN ' A (yi_ (requires site plan showing placement) I 46.75
�( � G - _ e 7 9 Furnace 100,000 BTU (duerslwlc
�9 46.75
/f/
�
City/State/ZIP: Furnace 100,000 BTU (duce/vents) 54.91
Suite/bldgJapt. no.: f Project name: Heat pump
. (requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
— Hydronic hot water system 2332
. Residential boiler (radiator or
hydronio) 23.32
. Unit heaters (filet-type, not electric), .
' in -wall, induct, suspended, etc. 46.75
Subdivision — • I Lot no.: • Flue/vent for any 'of above 23.32
Other 1 2332 _
Tax map/parcel no.: • Other fuel appliances:
a ,,,_-, - l, ) C °4x tey , r- a--~ r„ Waterheater 2332 i
Oas fireplace insert 3339
Lt�/ / / / _ _ / -e / t` l e--" Flue vent for wager heater or gas
fireplace 2332
' Log lighter (gas) 2332
Wood/pellet stove _ 33.39
Wood fueplace/insert 23.32
----- ,_ •»-- -y-4 Clwnney/liner /flue/vent 2332
���..._ �. '"�a...��.. .._.,.....:. - 7 .. , ._, .-- ,�- -, °'. Other: 2332
Name: d s Range ha odlottrerXkitelren and ventilation:
Address. /�' � �, equipment 33.39
City /State/ZIP: 0 72 Clothes dryer exhaust 33.39
j� � Single -duct exhaust (bathrooms,
Phone: ( � /'C Z ) Fax: ( ) toilet compartments, utility looms) 2332
fir;• `- :J' ,-41.7. � i E a +k; % w2 ® a l b r1F o . .z.,:. ,r- Attic/txawlspacefare 2332 ,
Business name: �t w Other: 23.32
• •
V Q� -Ai/1 y Fuel piping:
Contact name: ( tsJ N `. $14.15 for first tbur $4.03 for each additional
Furnace, etc,
Address: Q / ∎ / iT> `—
Gas heat pump •
— CityLStatrrZIP' i i . 4 / WalUsu . nded/unitheater _—
Phone: ( '7j f — `4x7( , Fax: : (3) % - si t f / Water heater
Fireplace
E-mail: ' ,�i('/ ' I4/d J L' / / lJ Ida Range .
• .` v. ".4.y . ,jakz,i'I - G 1 . , - ,,„: a LA =..,,,♦�.. Barbecue
Business name Clothes dryer (gas)
Other: • 1 I
Address:' ^"l,Vl , (;�Cl'32S' 14AE E, t 4 'w °
City /State/ZIP: Subtotal
Minimum permit fee (590.00) t
Phone: ( ) IA l Fax: ( ) Plan review (25% of permit fee)
CCB lic.: 1 / / State surcharge(12%ofpermitfee) ODD'
TOTAL PERMIT FEE / • .- /
TLis permit application expires if o permit is not obtained within 180
Authorized "1.. store: days after it has been accepted as complete.
Print name: - =� ./ ¶ ea - Date: /, ' 1F' • Fee methodology set by Tri- Count/ Building Industry Service Board
MAY /18 /2012 /FRI 09:04 AM MOLFERS HEATING FAX No, 5039810801 P. 002
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