Permit •
• CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00355
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/11 /2012
Parcel: 2S102BB00806
Jurisdiction: Tigard
Site address: 12490 SW BROOKSIDE AVE
Project: Linkhart Subdivision: BROOKSIDE PARK Lot: 6
Project Description: (1) Gas furnace
Contractor: FOUR SEASONS HEATING & NC INC. Owner: LINKHART, FRED
1005 INDUSTRIAL PARKWAY 12490 SW BROOKSIDE AVE
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 - 538 -1950 PHONE: 503 - 559 -5515
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 07/11/2012 $46.75
Type of Use: SF • 12% State Surcharge - Mechanical 07/11/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 07/11/2012 $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 calling 503.232.1987 or 1.800.332.2344. `` p `
Issued By: � J Permittee Signature: 0� '' A"!'�1L4 cON' . •
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.
•
07/11/2012 14:18 FAX 5035380165 fj002/003
Mechanical Per it A um ••
C'� . 1 -. 3
City of Tigard ,., 7 1 1 Z ti( � ''1� � Oa
13125 SW hail13lvd.. Tim Oil 07��UL 1 1 2012 1 Plm. Review
1 5 Floc 503.598.1 Dma+By. gee _
1pypetrtiortl.mo: 503.639A175 CiTYOF ( o s°°
Internet: .tww.titerd -or.gw
RUILD!NG DIVtS1QR1 * WEBS= - r
•
( Me meal permit fees* are based on the value thin, work
0 New construction E tlon/teP I performed. endue the value (rounded to the nearest dollar) of aA
I:1 D�arnolitioa Outer. ` mechanical materiaia, equipment, labor, overiseed._and ta'c&
• Value: $
CATEGORY `O!. 11D1 EQUIPMENT / SS{3 1Y1SF11g8!
•4 1- and 2- milt' dwelling 0 Commercial/industrial 0 Accessory buiidir.g For special information use otieeld ice.
• Multi -family 0 Master builder ❑ Off. _ Descripdon 1 Qty. I Ea. I Tots)
JOB SITE H4FOum? AND LOC4Th)N H ea>>aP 1 co
Job
site 1 aq O W 43 .. , 7 - • /
. /" - — J (m np ) 46.75
��( ("1"57._. r� n Fumeca 140,000 Bit/ (deott/vaam) 1 46.75
` 1 °`'�` Furnace 100,0004- BTU (a lvaaa) 54.91
Sttir ldgiapt. no.: 1 Phojeet nu_ te L' __Lii ee Heat pump_ 61.06
Crouse s t/dardOns to job site: - Duct work j 23.32
_Wvm hot wales sYdept 23.32 _
Residential boiler (radiator or
hydec ic) 23.32
- Unit l (fuel type, nat electric),
' is -wan, in >s dad, etc. 46.75
• _ Flue/vent for any of above 2332
Subdivision: —1 L o: no.: _ 23.32 Other.
Other fuel applEeaeea
Tax aoapdpael no.: Water heater 21.32
D "t$Qlli .., . Oat fireplace W 33.39
Fbie vent for water heater or gas
fireplace 23.32
2332
33.39
Wood faapleoe!msert 2332 • M ?332
PR OWNER '...: :. C•.. Other .. 23.32
`+ r ll � Faviroomzetal exhaust and ventilation
Address: Q., d YOC) - • . F'CV L n � 3339
Clothes dryer tit J
Ciao - 1 -1 1 • e r r� �n -- Single-duo exheutt (bathrooms, 33.39
Phone: (563 5 - • S51 Few( ) ^ toilet c000mparmt4 , utilityrocas) 23.32 ,
Anic/crawlsvaoe fens 233"2
:: A ppJ, ... . ; :.. ; 1pQFlrrrAk'1 OV 23-32
• -• • • ' Other
Bua name: t 0 . a , Poet violas
- • t . . - $14.15 for Drat bun $403 fir each additional
COMA name Fes, etc.
Adt)tt ' ♦ • C. • _ Gas host pump
Clry 1005 INDUS - ►l • Walitsuapendad/UOtbeatar
! ( ) .a,- RQ•112) Water
i -_
• s-rnai1: ROW -
Cledtes dryer col_
Business name: Omer:
Address. . i, . �. - sir • ` t • , MECHANICAL FERSO '!+>6 .
ttty/stafearn: 1005 INDUSTRIAL PKWY Subtotal
Mmiatmse pemtit fr!e ($90.00)
' ( ) ■ 'a r 1 :. : • ' fil1G2 ) Flan review C25% of permit fee)
'state (12% of pull fee)
"CM 1)0 . 'r TOTAL. PI M T FEE 0 . Sr
This permit application mires tea permit is not olmtiped within 180
0 ; ` J days aBw it tses boa a nta as eomptees
Authorized is a . _ - /► . Dare: RIM= • Fee msttodelogya11t by Tn.COInity 9 IIdUI ladmrry 9er%
grows
07/11/2012 14:17 FAX 5035380165 1 001/003
v
OUR 10
7 i
/yC ra.Cnt
FAX
DATE: : ..� 1,1 t a : :35 PIVI
TO:
ATTN: Te A
RE:
NUMBER OF PAGES (including cover):
FROM Four Seasons Heating and Air Conditioning
1005 Industrial Pkwy
Newberg, OR 97132
Phone: 503-538-1950 i `
Fax: 503 -538 -0165
c
Sent By: . .O"4". e. ''
E -Mail: 64 1el
@fourseasonsheatair.com n
om
.yi1