Permit CITY OF TIGARD MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT Permit #: MEC2012 -00530
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/15/2012
Parcel: 1 S125DB06100
Jurisdiction: Tigard
Site address: 7100 SW SHADY LN
Project: Reid Subdivision: SHADY DELL NO.2 Lot: 34
Project Description: (1) gas furnace installation
Contractor: WOLFER'S, INC Owner: REID, RAY
290 YOUNG ST TRUSTEES
WOODBURN, OR 97071 7100 SW SHADY LN
PORTLAND, OR 97223
PHONE: 503 - 981 -4511 PHONE: 503 - 224 -4291
FAX: 503 - 981 -0801
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 10/15/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 10/15/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 10/15/2012 $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.
Issued By: L141-at Permittee Signature: O t j /�/� /"''uE H ,An
Call 503.639.4175 by 7:00 a.m. for the next available inspection date. n�
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 /15/2012/MON 11:04 AM WOLFERS HEATING FAX No. 5039810801 P•.0011
Mechanical Permit Apple � 0 ,� . FOR OFFICE USE ONLY EI V ED . Renewed Pon* N o.
City of Tigard Deceived /D I 5'1 1,)- S'1 jt,1e-C40/ g- OOS 30
74 4 13125 SW Hall Blvd., Tigard, OR 97223 PIS Review
a Phone: 503.7182439 Fax: 503.598.1960 C T 1.5 2012 Date/By: Other Permit:
TIGARu Inspection Line: 503.639.4175 DateReady/By: hair lit See Page 2 for
Internet www.tigard- or.gov • /1 T /f Notlfied/Mcthod: ' If 4, Supplemental information
�r- o Ramp � ) 'i4 ,, - iii r ( .,. r § . 1 7 ff l e4 � . ► i °, ', l k T, t S x . E v i p. i !7' ' " s '" p A --- k� iis� �GlF `i D,.... - .. , -.,., � v) ISSR ,fi
ia �ur ^ 'h^ - "t' r'° Mechanical permit fees are base on the value of the work
❑ NeW construction !r Addition/alteration/replacement • performed, Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment overhead, as �roflt
_ Value: $
r V w ar w .j ' . e, �l ° - ,�
A.,._ ? wwi � .r > j r t _ o f ... �t d u c t .r: g _.._ g al
4���:,v � ��..� _ _ . a .._.._. .. a - rte• - .....J�� �1Q�'`a��....t ..'..��'� •
/G• 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building . For speclalInformation use checklist.
A • Multi- famil ❑ Master builder 11 Other. Description I Qty, Ea_ I Total •
t aW r. g p i ". n a t o hzib. 1".. a �� Heating/cooling:
2:.xx.:^ `� _ .e . ' .�,... ... t^ a Air conditioning
Job site address: 4.0 ma y, / � L ( uirea site lax sh lacement 46.7
Furnace 100,000 BTU (docts/vents) ( 46.75
CityiState/ZIPP: , ��. ... Furnace 100,000+ BTU (ductaNcnts) 54.91 '
Suite/bldg./apt. no.: Project name: Heat pump
(requires siteylan showing placement) 61.06'
Cross street/directions to job site: . Duct work _ _ 2332 _ '
. livdronic hot water system 23.32
. Residential boiler (radiator or.
• hydronic) - 23.32 •
- _ Unit heaters (fuel-type, not electric),
• _ in -wall in duct, suspended, ate. 46.75
Lot no.: Fltie/vent for al of above 23.32
Subdivision: Other- - . 23.32 _
Tax map /parcel no.: Other fuel appliances: '
"i i ' 1 1;,, =*• t a' °
- i� a '' n lt-2 wl..;,,, "' ,:,. Water heater 23.32
i0. 1 .. (� . ., c� • °� Gas fireplace/insert 3339
Flue vent for water heater or gas
fire_ 2332
if / ' _ Lo 33.39
Wood fireplacefiinsen 2332
,+} ii" ` Y W Chimney/liner/flue/vent 23.32
•,...-:-',„1,,,... �. / �, ) 3w- leis . r - .7.! «, :;+ , .. ° a a h em , 23.32
Name: Environmental exhaust and ventilation:
- ,41 ,,,/ � Rane hood/other kitchen
Address: rf ,� equipment 3339
City/State/ZIP: ! / / /�L�I�I / —Mil Clothes dryer exhaust 3339
Single -duct exhaust (bathrooms, •
Phone j.1 Fax ( ) toilet compartments, utility rooms) 2332
7''''''''t4'47.17 " t m 1 �qq�� H, � � M ` ":4; ttic/crawlS ce fans �t &' lee t� 'tHiri• „ • ti ,'a?i� �u'��a �r � ' � :�, C� � f 2332 -
9 1... h4TAhYW. rim
p Other: 23.32
j /rG ' 4 • Fuel piping: '
Contact name: v l SI c, $14.15 for first four, $4.03 for caret additional
Address' / G 't- - Furnace, etc.
de, J Gas heat pump
City /State/ZIP: i " +, i ^ o A ' ' I /6 - 7 WalUsuspended/unit heater
Phone: (SO) " 1 " C
g - ' , II Fax: : (3) S j _ • a) Water heater • •
Fireplace
E-mail: • Range
-� �_ ` ` .� � v � r ,'"� •' ,w .. "' ' .' "� � ::‘..7,47.4%,;,-7:5z 1�1
te.0- _ a o
^ ",r lr : ' 7 ' � 1 : . - r,:� Barbecue
I I Clothes dryer (gas)
1 ■� deli♦ othe
Address: /� I ti / � ,01, !�'IDC3M0fA> 137gi aural '^ ^, *
City /State/ZIP: ' ' ! 4 ! I I)1 Cli1) Subtotal 49
Minimum permit fee ($90.00)
Phone: (rip)) )Q I . 4611 I I Fax: (I CM - OgO I — Plan review (25% of permit fee)
CCB lic.: 4 ( l �' State surcharge (12% of permit fee) .
TOTAL pe is not ray •
1 W This permit application expires Ir a permit is not t obtained within 180
Authorized signature: days niter it has been accepted as complete
Print name: t i I rf) G��'— . 7: pate: /a . f6 17'....- • Fee methodology set by Td- County Building Industry Service Board