Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00318
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/18/2012
Parcel: 1S125DD06200
Jurisdiction: Tigard
Site address: 6655 SW VENTURA DR
Project: Privitera Subdivision:VASHINGTON SQUARE ESTATES NO. Lot: 70
Project Description: Install furnace and NC
Contractor: WOLFER'S, INC Owner: PRIVITERA, PAUL
290 YOUNG ST 6655 SW VENTURA DR
WOODBURN, OR 97071 TIGARD, OR 97223
PHONE: 503 -981 -4511 PHONE: 503 - 297 -4169
FAX: 503 - 981 -0801
FEES
Specifics: Description Date Amount
Air Conditioning 06/18/2012 $46.75
Type of Use: SF Furnaces < 100K BTU 06118/2012 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/18/2012 $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. /1 /� �7
Issued By: JI7 / /J 1 7o Permittee Signature: 7)� APPu c% r► r [ O 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.
JUN /18/2012/MON 01:10 PM WOLFERS HEATING FAX No, 5039810801 P.001
Mechanical Permit Application FOR OFFICE USE ONE)
City of Tigard CEi D D'''ar' .1 - Permit No.: — 3(
13I25 SW Hall Blvd., , Tigard. OR 97BE Plan Review
e Phone: 503.7182439 Fax: 503.598.1960 pate/ay: ruler Permit
1 ' i c A u I . ) Inspection Line: 503.639.4175 JUN 1 8 2012 Date Ready/By: l0 See Page 2 for
Internet www.tigard or.gov Notified/Method: ■u Supplemental Information
M � •f.ti7 '.rt 1 01 _1.`` �L.. f.. - �..1•.... � ,.. M;. r it fie o . _ ��r - ,�..
`;. G 'w cY ; tii�• i e :� a �i_
. .," ,,., � ' ""�' �;; + - "�"-"�``_ "' Mechanical permit • are don the value of the work
❑ New construction " e I! Addition/alteration/replacement • performed. Indicate the value (rounded to the nearest dollar) of all
Q Demolition Other: mechanical materials, equipment, labor, overhead, and profit
�w, I...�.���.;��' °�°�'�"""}' •� tl' , � : '; Value: .�,. $ ..,A.• .
lu ..- r.;h.,,'t" w4a+•+. '
. :.Jw+ � �� 4 � t -.I lh -, L :7,4"
.na a , l iL':.
. . - and 2- family dwelling 0 Commercial/industrial ❑ Accessory building For special infornnafion use checklist
■ Multi- family ❑ Master builder ❑ Other. Description I Qty. I Be. I Total
w a i d o L t T o " ''l �} n'c�r r h — Y z �^ " � µ .- F, la eatiaz /coolie);:
.; 7. " . .,.. y T ' !`-; t ,.,• 7.1 • � ;_ .. ,,,„ -.,, •. "a A i r cond
Job site address: 1 r , (requires site plan showing placement) 1 46.75
Furnace 100,000 BTU (ducts/vents) ` 46.75
City/State/DP: IOW( I / 1 12..3 . . Fumat a 100,0004- BTU (ducts/vents) 54.91 _
Suite/bldgJapt, no.: I 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
• hydronic) 23.32
Unit heaters Mel-type, not electric),
• • in -wall, in -duct. suspended, etc. 46.75
Subdivision: Lot no.: Flut/vent for any of above • 23.32
Other, 1 23.32
Tax map /parcel no.: Other fuel appliances:
-' yir�•,,,�.'-:±2,4E- , col! J G i 'to 4! aLLr 1-�= .Z�.1.:•C-- rrnnlv4e..r.r •
0/Ify /T /f / I, „�L ./ - L, / A t . Flu vent for water heater or gas 3139
fireplace 23.32 . ,
Log lighter (tics) 23.32
Wood/pellet stove 3339
+y t
Wood fireplace/insert • 23.32
iu t _ Chimney/liner/flue/vent 23.32
F('"`. l -+ r.�r cS 23.
,I ft a,n. 7:11 :=[' i � -ac-N`,.`1 -2 ....,:. :: .'� ;r.
Wi.r.. l' Other 32
Name: d / Environmental exhaust and ventilation:
Address: ' • Range hood/other kitchen
J „% AL' It �J equipment 33.39
City/State/ZIP: � e Clothes dryer exhaust - _ 33.39
' �� Single -duct exhaust (bathrooms,
Phone: 0 :in ,� Fax: ( ) toilet compartments. utility rooms) 23.32
w�l' x: • ` e7�`tr "`ii �' ^El" '. nr i!' 3r-i w �•:� A ttidcrawlspacefans 2132 •
" ""`' �� / / Other. 2332
Business name: A LJ.NL _ ' i/ / l Fuel rp
INP : g •
Contact namr , - � 4 -
:'. T h`E $14.15 for first four; 54.03 for each additional
Furnace, etc.
• ' • ' ✓ 10 4 di _L a • Gas heat pump
r /.tate2IP: / 174 / x zit 7/ Wall/suspended/unit heater
( Phone; al jr) q, /- n n F ax:: ( 3 ��3I , a • I Water heater
Fir face
E-mail: r/ T'" , Bantle
, d-i L /
" ' r - 4t :: ---''' Y'' 0 .ti. w . � = '''."' i' -+ n, . '''' ^:r Clothes d
Business name: • , a Ir � w � 7� Clothes d ryer (gas)
Address: - - ,. P ,E mta. ..
Subtotal
City/State/ZIP: Minimum permit fee ($90.00) q
Phone: ( ) Far.: Plan review (25% of penult fee)
CB lic.: /1�` t� State surcharge (12% of permit fee) / i • 27.-
!. TOTAL PERMIT FEE /0 / • `T
This permit application expires If a permit Is not obtained within I80
Authorized signature: d ays attar it has been accepted as complete.
• Fee methodology set by Tri -County Building Industry Service Board
ate D ate: ■ Gila M
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• . ADDRESS: - 1 . 14 ' i 41. / l4J: C q7 -
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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
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ATTN: e r MI` DATE: 0 I "
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