Permit t � CITY OF TIGARD MECHANICAL PERMIT
'I COMMUNITY DEVELOPMENT Permit #: MEC2012 -00391
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/25/2012
Parcel: 2S104AB03100
Jurisdiction: Tigard
Site address: 13283 SW SCOTTS BRIDGE DR
Project: Kias Subdivision: MORNING HILL NO.3 Lot: 64
Project Description: Install gas furnace.
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: KLAS, ROBERT
1005 INDUSTRIAL PARKWAY 13283 SW SCOTTSBRIDGE DR
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 - 538 -1950 PHONE: 503 - 570 -7160
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 07/25/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 07/25/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 07/25/2012 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas .
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.
Issued By: Permittee Signature: �� ff�,D� �— /^-
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��I ��� JJJ,,,/// 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.
07/25/2012 09:23 FAX 5035380165 e1002/003
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Slec haiiical Permit AppItation i,),; (,; 114 r I :-■ i 1 )\I
sl aty of Tigard a.....i.d
DgeB 7 A-5AM= Pamit M it / e2 — 4t1 ■
13125 SW Hall Blvd., Tiprd. OR XBECEIVED ,.....
Photo 503.639.4171 Fa= 543392.1960. 4ill.1111111 Other Pets .: ,
Inspection Line: 503.639A175
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ht nterne www.tigarcher_gov Nonfieditletbak
NEVEIMMIMMIIIMrg - 44 tallitili Cli . . *****1 1 ::
. 4 .41-!1 . ' r) 1 h'l I 1 hieduatiad permit Des* are based' on the value of the work
0 New construction iltA„ „%,. ,14.9 :-.,.t..„
performed. Indicate the value (goaded to the nearest dollar) of all
0 Demolition 1:1&.- numbankal mth* equipmem, labor, ovethead, and profit
'. f ti*O.Oitt.404 :'': ! - : . :. ' Value: S
. ICI*424iiiialtQl0141/Pre(0 '..
tkand 2-thmily dweifing 0 Comm:mild/industrial 0 AccanCey building
RP special WormatIon use daddies.
0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
Job site address: I bag?) 5 ( Z 56:y6S tololcbe., Trial Air condition' ins
Gamins site she showing Discosom 46.7
City/StatarZIP: 11 c7g en 223 Femme 100,000 BTU (deettiveres) i 46.7.1.1
S
- Furnace 100.0001- 13TU (thesehotto 54.91
Suite/bld./apt. no.: 1 Project no= le. t ik5 Heat path 61.06
-
Cruse arect/directioas to job site: • Duo work 23_32
Hydronic hot water mum M.32
Rondonia) boiler (ldie= Or
hd1011iC) 2332
Unit heelers (el-type not electric),
in-wall. in-duct, Mended. etc. 46.75
Fludvent for say of above 4.32
. 1
Subdivision: I Let no.:
- . Other 2332
Tax map/parcel no.: Other fuel apPlImaccs
Dikealit***, " : : ''.;- • Wear heater 23-32
Gm fin:place 33..39
e 'Forna_CPC0 Fine vent for vele: heeler or gas
fireplace 23.32
Lon lienwbals) 23.32
Woodffieliet stove 33.39
• Woad fireptecrAnsot 23.32 ,
Chimoty/lieedfineivent 23.32
' OWNOIC:1:::';;;1;',...,.:. 7 " f': ' : -'::'''':'.::' - 00110010.4 i Cebts: _..... 2332
Nam= Eavissaments1 alma and ventilation
AddTess: 1 ,_ I 5 -' ti tWZMITAral.....A.1 Range hoodlother ldtchen
equipment 3339
City/State/2SP. 1 e. , I '11 Clothes dryer exhaust 3339
i 1 (ND 1221111.1=1111111 aula ShIgit.d o sc orat:ertments edinust . (bad ' utulls' utflta roans) 23-32
.: ..meizilAtiO PERSPN Atficicrawispace fine 23.32
Otbsa: 2332 "
Business =lc: Fuel
Contact name: FOUR SEASONS HEATINS SUM for firm burl 64.03 far eaci adtBdanal
Furnace. etc.
Adthenic ' *IL. 11:11,1•,, , , _. ,._. Gas hanomp
CIII/Staterin: WeWsuspendedhodt heater ...■
1 ' 0 - ' 5 .; - " y , , ' „ Water honer
ex: :
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BOWL= name: Other: I
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Address: INC. :
citylstileizip, —TON INDUSTRIAL PKWY Subtotal
— Minimum pamit fee (S90.00) .,
. Photo ( ) N i: ER c thi.6.-_.„- — Van review (2.5% of /tomb fee) -
7 L1121DifTALM111111.1111.1111.111.1111111111 SI= sardine (12% of permit the)
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07/25/2012 09:23 FAX 5035380165 Z001/003
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DATE: -7 ^ . ... � ._ - A � �
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ATTN: �exrn..1 - 6
RE:
NUMBER OF PAGES (including cover): 3,
FROM: Four Seasogs Heating and Air Conditioning
1005 Industrial Pkwy
Newberg, OR 97132 .1
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Phone: 503438 -1950 `�
Fax: 503 -538 -0165 —�
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E -Mail: @fourseasonsheatair.com J
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