Permit p CITY OF TIGARD MECHANICAL PERMIT
`` • 2 COMMUNITY DEVELOPMENT Permit #: MEC2012 00532
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/16/2012
Parcel: 2510 4C B00800
Jurisdiction: Tigard
Site address: 13311 SW ASCENSION DR
Project: Kuhn Subdivision: HILLSHIRE WOODS Lot: 24
Project Description: (1) duct work add 2 zone system w /zone dampers
Contractor: WOLFER'S, INC Owner: KUHN, DALE A
290 YOUNG ST 13311 SW ASCENSION DR
WOODBURN, OR 97071 PORTLAND, OR 97223
PHONE: 503 -981 -4511 PHONE: 503 - 579 -0848
FAX: 503 - 981 -0801
FEES
Specifics: Description Date Amount
Duct Work 10/16/2012 $23.32
Type of Use: SF 12% State Surcharge - Mechanical 10/16/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 10/16/2012 $66.68
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: O t./ ""� Perm ittee Signature: 010 A PPGiC 4 - 6 o ki
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.
OCT /16 /2012 /TUE 08:36 AM MOLFEAS HEATING FAX No, 5039810801 P.001
Permit Application Pelrm>< nP lication RECEIV
City of Tigard OCT 16 2012 Received l 1 (4 l a- x Perarit °.:,u�;�,a_ vo5�
7 4 " 13125 SW HaII Blvd., Tigard, OR 97223 � p Review • a Phone: 503.718.2439 Fax: 503 - 598.1960 MM t rlgy ; Other Permit:
T I G ARIA Inspection Line: 503.639.4175 N T o Ready/B • rte: RI See Page 2 for
Internet www.tigard- or.gov BUIL {1S�fiedimeha: ( Supplemental Information •
t�V v1.1 ...„' +x �- &:' �IpF}#. 'FJ.Lc1L�E BR( K{Iti a
" r,� � J I permit fees based on the "� gill. ...�"�.��'�#i"y' ., ...... . . : ,
�� � - Mechanics p i fees* bas a value of the work
o 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
Value: $
iiiO x' r 'LAr ;" ,,za: :sirs x „ . - • tr, . � S h��� i , m,. " --. � . ...,- __ • " " - ^".. fi . -.. .e.. - : ,. :.:,...w.
"d,. , m r.IN 1 ',m -• a' I r �-.�- _ JAL „ .�., Sibs • •,,. KEIV / .. toe d - --Ili
x• ii
x, x�i�ry r ,. '� .�' - � - • _
.. ... .�.. � . i.P x �, ., ,. x, �'i "� -., + E���Q�'',.. .' � ... a � ` w � ! t
I- and 2- family dwelling 0 Commercial/industrial [f Accessory building For special informafttur use checklist.
Multi - family ❑ Master builder 0 Other: Description I Qty. I Ea. I Total
K " -u-... • r- ' ../ i Wr -
, w F l ,, Heating l cooling:
*" £" °Srwoz�o�i'gl1%a�o;oauo . w
1 ' ;�_. :- 1 •�;,-,• - Air conditioning
Job site address:. /33 /I $ `CC.6h c/4 .4 - .12121ILS site plan al:owing placement) 46.75 .
Furnace 100,000 BTU (duets/was) 46.75
City/State/ZIP: / Z il/ 11 / ‘' I Furnace 100,000+ BTU (ducts/vents) . 54,91
Suite/bldg./apt no.: Project name: Heat pump •
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 1 23.32 - ;r5'"* .9
Hydronic hot water system 2332
Residential boiler (radiator or
hydronic) 23.32
. Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 44.75
Subdivision: I Lot no.: Flue/vent for any of above 2332
Other: 23.32
Tax map /parcel no.; Other fuel appliances:
R�. o . w-" zr Water heater 2332
*s{ xrr1 °. � "a , x } , r x w ... Gas fireplace/insert 33.39
��J)' W (�f! Flue vent for water heater or gas ,
• fireplace 2332
-- / :i.L. �i - Log lighter (gas) 23.32
• Wood/pellet stove 33.39
,t Wood fireplace/insert 2332
it 1 . � " rt : Chimney/liner/flue/vent 2332 •
Other 23.32
Name: lr/1l `l M/ , — Environmental exhaust and ventilation:
0 j ` � �� j �� . � Range hood/other kitchen _
Address: 1 / /ji1 �[i , equipment 3339
r
City/State/ZIP: . / „ , ‘, AIM ) 7 ! Clothes drier exhaust 3339
�� � Single-duct
compartments, exhaust (bathrooms, utility rooms)
Phone: t� /irrif Fax: ( ) toilet compattmettts, utility ro 23.32
..� :1 J°" 1 y. a p w a.; . ari "( ' ' '�•h w t: - .W 4.1: al 4 y�rJ Attickrawlspace fans 2332
. t t'k+` .1'riut. ..r. u' Other: 2332
Business name: D iis __ _Aiing__ Fuel piping: _
Contact name: lc .91 (9 $14.15 for first four, $4.03 for each additional
Address: rr11 I , ^ ` �' Furnace, etc.
U tr Gas heat pump _
City /State/ZIP: 1 ii � � j_ tf q 'Q - 7 j Wall/suspended/unit heater
Phone: (SS) Gig) 4s I I Fax:: ( j) q t5 I - O RD I Water heater •
•
S lC(�- 'O IT ail 110 birn
Fireplace
ce
E -mail: Y _
'w►u s a
. x 1s�5 x , tz 7 acy r -a 6tR ...1...m � "ti' %,,,
.,,w" r 4 ' ng p
Evy B ar be cue (gas)
Business name: 6 J 1 t 114.:( I Clothes dryer 1 9 -..,W
Address: J • Ad A rsr` „�, ryi ! 47nx: - .: 1►�U, > w -rte;
City /State/ZIP: . ix / gra x , , Subtotal
,I � Minimum permit fee ($90.00) q
Phone: ( gg f . l4t I, Fax: (OM) qe) - pogo I - Plan review (25% of permit fee)
CCB lic.: 4 I , . State surcharge (12% of permit fee) g /LW
D
0 _ �" TOTAL PERMI PEE
� 1� This permit application expires if a permit is not obtained within 16n
Authorized sigma - days after it has bean accepted as complete.
Print name:
- (e, ( " - - Date: n •'IMis • Fee methodology set by Tri-County Building Industry Service Board