Permit CITY OF TIGARD MECHANICAL PERMIT
I:. COMMUNITY DEVELOPMENT Permit #: MEC2012 -00361
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/19/2012
Parcel: 1 S134DA00302
Jurisdiction: Tigard
Site address: 11190 SW 106TH AVE •
Project: Venables Subdivision: NORTHERN PINE Lot: 13
Project Description: (1) Furnace and (1) Heat Pump Heat pump must be within 5' side yard setback and approved rear yard setback
"REPRINT 7/16/12 Project description addition"
Contractor: S & J HEATING & A/C INC Owner: VENABLES, JOHN
1004 NE 4TH AVE 7120 SW 60TH AVE
CANBY, OR 97013 7120 SW 60TH AVE
PORTLAND, OR 97219
PHONE: 503 - 651 -2702 PHONE: 503 - 246 -7544
FAX: 503 - 266 -2452 •
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 07/19/2012 $46.75
Type of Use: SF Heat Pump 07/19/2012 $61.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 07/19/2012 $12.94
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total . $120.75
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 Notifi . '. . 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 dire • uestions to • NC by calling 503.232.1987 or 1.800.332.2344.
Issue By: I / Permittee Sig i
Call 503.639.4175 by 7:00 a.m. for the next available inspe ion 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.
•
RECEIVED
M Perini r�� c 1 IC:L l SY . ONI.1
- ��'�012 FOR Of J
City of Tigard Date/By 7 / I, 1 ?i S permit lil;i i Ia'' .903G/
13125 SW Hall Blvd., 1anl5oPTIGARD Plan Review
m Phone: 503.7 18.243 �t l )are/Ry: Ocher Pennit:
I tion Line: 503. . VISION ) uric: El See Page 2 for
T I i,; A r, 1 � P� Date Ready/By: S
Internet: www.tigard -er.gov Notified/Method 1400 SupplemeatalInformation
- g r gi:. ! i -Xidi r ;� :..1. ; : ; ,f, c �r? t .'/- per : 7 . - - - yr = COMME*CIAL 'FBE• ...- . $'C:" .. .4101E+1E ... . • n Fkx ;'.Frrr,`�,:)f; ', . `, IE,. = r.;lr :.:�!'�,°.. . i',. :.f�' } ` 7 ; h ... ` •g � .�.e value . .
"" " ' "' '' Mechanical permit fees* are based on the ve of the work
❑ New construction ® Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor. overhead, and profit.
�.,) ii � ti s. ;hJy . , ,1r - r --.,, �r r : Value: $
y
Zi "N.Q t� /Cl•.:.Y •"r:4J ;aa':n . �:T..4,,x r r . <.., .,:_ -.-, .. ,.. • 82';S1L1 F1 ; ';
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special informMfon MSC chraliLY
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty' I Ea. Total
•.r%'' 2P kZ4 r" , . ; r .. r r. Heating/cooling:
1 "< , y ` . r._•. V .�,, ±i.'`F/"" •.. �N, :. : ■ir condit
Job site eddies. 11190 SW 106 AVENUE (requires site plan showi p lacement ) 46.75
Furnace 100 000 BTU (ducts/venm) t 46.75 4.44
City/ State/ZIP: TIGARD, OREGON 97223 _ Furnace 100,000+ BTU (ducts/vents) 54.91
Sttite/bldg. /apt no.: I Project name: VENABLES Heat pump
wires sire Ian shuwiu lacem ent 61.06 6)/101:
Crags street/directions to job site: N. Dakota Street • 23.32
Hydronic hot Waal' system 23.32
. . Residential boiler (radiator or
23.32
Unit heaters (fuel-type, not electric).
in-wall, in-duct, suspended, ete. 46.75
Plue/vent for any of above 23.32
Subdivision: Lot no.:
Oulei. 23.32
Tax map /parcel no.; Other fuel appliances:
��+�aw� q / a�
rts, ,yr � a!ra+ .ar , f3 : � .. .. . .'. 23.32
iv.�r 6J a f ii{?, �.1�Y i t ltii a'c% <l /i: `�' ... f'7-i . .., ..
, ;.' • 4.
Gas firgrtace/insert 33.39
DUCTLESS HEAT PU _ Flue vent for water heater or
fire lace 23.32
23.32.
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
r . . _ fi r. , + , u.�•.•� Chimncy/lincx /fluc/vcnt 23.32
r : :• ,;2 GY it i 'r Fm ' 4 , ,�� � t,- , r ?is` 4' , :1�.
,fir ,
�� ,1fi'.r) im/F ra�'a�%sr' . N :: � , .... Other: 23.32
Name: JACK VENABLES Environmental exhaust and ventilation:
Address; 7120 SW 60 AVENUE Range hood/other kitchen
equipment L 33.39
City / State/ZIP: PORTLAND, OR 97219 Clothes dryer exhaust 33.39
Single - duct exhaust (bathrooms,
Phone: (503)246 -7544 Fax: ( ) toilet compartments, utility rooms) 23.32
5.M: i : - ;.yu�=° Aliic/crawls ace fans 23.32
� � r . . u � . 6. n , ' l R� , o � : • �f w' `' y
y _,, • � 'A�1Er�,1.��r'
�� / � � y � . ..... ra> � §rs�'xlAHi: �,. • r : , : , i•r. �Yl ..t = -F ;pia... ..
Business name: S & J HEA'L'ING Other 23.32
Fuel piping:
Contact name: STEVE DAVIS $14.15 for first four, $4.03 for each additional
Address: 1004 NE 4 AVENUE : Furnace, etc.
Gas u�ump
Wall/suspended/unit City / State/ZIP: CANBY, OREGON 97013 heater
Water heater
Phone: (503) 263 -7773 I Fax: : (503 -) 266 -2452 Fireplace
E -mail: ADMINSJHEATING @CANBY.COM Range
..q t�f �rl q t a'a2m'T 'n, � y y '' l y �•. N • :i <
, ; � Barbecue ,�'C`
< , .+li / /4'ti,,.„ 3 ( f]st . �." t atafi �I 1 . • �J
{! p1° ''""'` ' clothes s dryer
Business name: S & J HEATING Other:
AddresS: 1004 NE 4 AVENUE i 40641 ` . :
Subtotal
City /State/ZIP: CANBY, OREGON 97013 -
Minimum permit fee ($90.00)
Phone: (503) 263 -7773 I Fax: (503 -) 266 -2452 _ Plan review (25% of permit fee)
/ CCB lic.: 96972 - State surcharge (12% of permit fee)
TOTAL PERMIT FEE /63.0-1 -
110) This permit application expires ire permit is not obtained within IBU
Authorized signs • , _, I i r ; 1 days after it has been accepted as complete.
1 ` f • Fee methodology set by Tri -County Building Industry Service Board
Print name: STEVE t AVIS Date: 07/11/12
l: \Buildin%WPerraits1MEC- Permitaaa.doe 03/07/12 440.4617't (11 /02/COM/WE3)
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