Permit ip ' CITY OF TIGARD ME CHANICAL PERMIT
' 13 ::'-_, COMMUNITY DEVELOPMEN Permit #: MEC2012 -00537
TIGARL7 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/17/2012
Parcel: 2S 103AD00802
Jurisdiction: Tigard
Site address: 11050 SW FONNER ST
Project: Bushell Subdivision: ECHO HEIGHTS Lot: 10
Project Description: Installation of gas furnace
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: BUSHELL, DIANE E
1005 INDUSTRIAL PARKWAY 11050 SW FONNER ST
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 - 538 -1950 PHONE: 503 - 624 -1403
FAX: 503 - 538 -0165
-
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 10/17/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 10/17/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 10/17/2012 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
•
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon '
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct • . - stions • • UNC by calling 503.232.1987 or 1.800.332.2344.
Issued c : , - / I Permittee SiodIW / l i ��� •
�� r�'�SILV!
Call 503.639.4175 by 7:00 a.m. for the next available ins.. ion date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
10/17/2012 12:12 FAX 5035380165 002/003
P 1 � e91 Permit An� 4
• /o . �•
ill
City of Tigard ' ��
Phu= 503 639 Tigard. p 503398.1% 17 2012 other ' ': s»> � sr 2.VT:1 ` d ° Nokifiordabst
Totem= www.tigard-or.gov 111tR
• TttPS OF woi ' 1Mechanieal permit flee are bated on die value of the vat*
❑ New construction t: , on
.., /alsea ttni �j value (Pounded to • the dollar) of an
Q Demolition Other: Varna: S
• 'cxricoK!.•0F CTS � _ gesincinfra.Rourbtrav 8Y3i! lsi ::.
.1- and 2- family dwelling 0 Commucial/lndastainl ❑ Accessory bu:id'irg i -• F° *wild oVbnnaBon use
' Description
1 builder CI Other: tt ( M Total
Q Matti 1Y JOB S ' . iit]CA'1'h(�HV ; He otl n
Job site atldiess i t c$S ( `. abe .. „ • . • :_ �. ^" 26.75
tr. ► ^ : F u rn a c e 1 t 1 1 . 1 d f �i an
SbdmlbldgJapt. . ` � ' - - i 61.06
•
Project
Duct weds 23 32
Cross s1atldirealaass to job slag 23.32
R eident el boils (radiator or � 1,1 �
Unit heaters ((tc1.tYD4 not electric). WM
io- ht , sows above d, ete __
flue/vent fir .•■■ of above � ®�
Subdivision: Lot no.; Other
Other Lad :,. • - 23.32
Tea mapfpaoel no.: I Water heats
D 'E1ODf tOiF: W011t;{C { Gas , , .. 33.39
G P ') 4 Flue vent tbr Water heater or gas IIII
M•32 OM
Wood &reolacdifsert =II 23.32 EMI
r.,.,, .. • Aj■ 2332
' i i • a tarouvr Other: 2332 • 1 Environmental admen and ventilation
Noma 1♦`(�(tQ.. C .- , — I Range hood/ot6a
Adding: %, U SUS - C - OrlY‘tx -' • ( .LL . . 33.39 Ell
' ,
e Z °I-11225 Clothes . lode= 33.39 NM
i, 12 single-duct exhaust (e
Phone: r� (� — t O Fax: ( ) toilet -• anal' • root
El. tatter On
Business name: -• _ _ - -.11,.. -- - _ II. Fad „ .
514.35 for fait four. $4.93 for each additional
Cttra■et nom* . • ... • . • r FtunaLe. etc
Address: - Gas had
w t - t E ) Water hater -
Phone: ( ) - ; g•, ..lace
Erik _
• En i
•
FO, SA . • ,
Clothes ,. -
Bush= name: - S c • Other
al
i' e - h a - ^ , ^ M Pi num permit &e (59000? NMI
i h1�i11VBER�'ir 014 $r13� Fay ( ) Pim review (2-5911 of • - •• - fee
•
CCB lie.: TOTAL rsimur � • . WAWA
17tie permit .pp ose= mph= ifKpreenis . • r�.�nr.11a '-`
Audiorkted ': - a +ilf� days sir it Da bay as sant a ea . .
rte' • -e,, Date: 0 II 12. * Fee mdbadaktey E Bl" s IliceiseY
• PeniffeantordeMEC.PermitAmnee 10/01P39 440 -4..7T ,err icosonti)
10/17/2012 12:12 FAX 5035380165 el001/003
2-
nli
<5
FAX
DATE: /12- v3 Pill
TO:
AWN: -1 i ) eiciA)4zk - ` : :
RE:
NUMBER OF PAGES (including cover):
FROM: Four Seasons Heating and Air Conditioning
1005 Industrial Pkwy
Newberg, OR 97132 N
y ti
Phone: 503-538-1950
Fax: 503538-0165
CP
Sent By: ra-41 n
E-Mail: CLiailLe.--@foursea
zA
A_ \\■.`r z
\\\ (