Permit CITY OF TIGARD MECHANICAL PERMIT
I COMMUNITY DEVELOPMENT Permit#: MEC2012 -00671
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/18/2012
Parcel: 2S 103BB 10300
Jurisdiction: Tigard
Site address: 12140 SW KATHERINE ST
Project: Rabau, Wolf Subdivision: YE -OLDE WINDMILL Lot: 23
Project Description: Installation of furnace and heat pump. Placement of heat pump unit must maintain 5' minimum side and approved
rear yard setbacks.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: RABAU, MARLA S &
19300 SW 118TH AVE WOLF, KEITH S
TUALATIN, OR 97062 12140 SW KATHERINE ST
TIGARD, OR 97223
PHONE: 503 - 691 -9699 PHONE:
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/18/2012 $46.75
Type of Use: SF Heat Pump 12/18/2012 $61.06
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/18/2012 $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 Notificati. • - - 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 qu- tions to OUNC calling 503.232.1987 or 1.800.332.2344.
Issued B • /4 Permittee Sign- / ' z»
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.
12/17/2012 15:43 503 - 691 -8556 OREGON HEATING PAGE 01/03
1
M ec han ical Permi A lice \I EU FoROF USE ONLY
City of Tigard
Received 6.Z / / .:-.0, per
No.: / f E ekla, eve,/
NI 13125 SW Hall Blvd., Tigard, OR 9722 1 7 2012 Plan Review Ma Pesntir. f�! �Za .00 7-/
Phone: 503.639.4171 Fax: 503.598.19 DEC Date/t3y:
inspection Line: 503. 639.4175 D ate Ready/By: heir ig See Page 2 fur
/ t ; 'd - .!1 lx S lnformatioa
Internet. www,tigard-or.gov C ITY Q� �� Nom:
LP 4 a1V,!S c ot d E. scfn s ti. "" ' " .- - ' c
Mec hanical perrtnit fees• are based on the value of the work
El Now construction AddiYion/alte tionlleplaeement performed. I the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit
DemolitiOn 0 Other: ; .. value: $
CATEGORY PE ,P. tUC X4N , c t - I RESIDENTIAL 1;QIJIII�I N 1 SYSTEMS FE .
t"1- and 2- family dwellirng ❑ Commercial/irustrial 0 Accessory building For special information use checklist.
[] Multi-family El Master builder El hex
Description Qty Ea. Total
dt)B SITE :INIPORMIR A LOCATION Air coolie conditioning n_ � �
• I, Air
d
Job site address: 12 Ill o Shy te•uvEa site . win
04;i0 : ent
ducts/vents —
ePi �f' F urnace 100.000 BTU ucts/v 1111 City/5tate/Z1P: p 9 . 0 . t'.� : 1 54.91
Suite/bldg. /apt. no -: Project name: W6 ip • • IF' 61,06 G • 06
Duct work
Cross street/directions to job site: H drottic hot waters tern �
Residential boiler (radiator or 2332
Uni hearers Unit heaters (fttel-type, not electric),
in-wall in- duct,: -. - etc. 4615
Flue/vent for . of above ��
Subdivision: 1 Lot no.: Other:
Tax map /parcel no.: other fuel a • liences
. water heater 2332
b $! 1tI .. .. F . ,.. 33
�yO�C ` ; . ,.; ; .:•.,.w a Gas fireplace
a i s for water heater or gas
�Ilr urhnkc,e. a »d . freFlue .lacevent 2332
Log d ststove � �
Wood/ . ellove
23.32
___....---,— 10 Chimney/liner/floe/vent 2332 MEI
i:..!•,! , 23.32
,, �ROPEILTY,O�'irNElt :..- 'I' >yN�1,1! l' I' . i' ot MEI
Narrie E nvironatcntal exhanat and ventilation e i Range hood/other kitchen
Address: /2 0 S W ! . t, . � f •meat 3339 _
Clothes dryer exhaust Ciry /StateJZ7P: / r q O / � q .� Fax; ( ) 4y Single - duct exhaust (bathrooms, 2 �
J toilet compartments, utili rooms
i
Phone: (5'07) $03- 2 c ' , ' .,COCA ,.., .;:: Attic%rawlspace fans �M�
cX PER.SUhi
. . .•..
' � o PLIce r A , , Other: 2332
Business name: Or,, / l- Fuel • i • - .:
S14_15 for first four; $4.03 for each additional
Contact name: la o G.., : . - Lo. Furnace, etc. IIII
Address: f Qroa Sho //gtt 4e Gas beat .ua ME
City /State/Z1P: r o� Wall/s . ended/unit heater
Ra (�, ' 9 �' water heater mil
Phone: (SG! ) Ili i - 4 y9 I fax; • ( ) Fireplace
E-mail: arbecuc 111.111M..1111 R
/ Clotfies dr (gas) mom
.,._..____.:_..___::„
Business name: or e 0, Aleafi3,o 1'' 4" C- Other
- % MCAT
. ,, XERMI1.FEES
Address: / /fee
Subtotal /0 7.8 l
City /State/ZIP: Teal, , 4 , 0 R / CKi• Minimum permit fee ($90.00) ..
I
Phone; 03 Q I.- Q� Fax: ( Pay. review (25% of permit fee) /
State surcharge (12% of permit fee) / 2 .9
CCB lie.: i 7.2 / .26 TOTAL PERMIT FEE t z a.
This permit application expiree ups t as compute. witbin 180 1 ,
Authorized signature:
_ days after it hai p O4,
• Fee methodology set by m-Cnty 13uilarig bldg Service Hoard
Print name' - „ ` GA.1 1, Date: q 12
12/17/2012 15:43 503- 691 -8556 OREGON HEATING PAGE 03/03
-1212 -0015
First Floor
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Line Set Thou Attic FirSt FtOOr
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Garage
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Job #: Oregon Healing Scale: 1/8" = 1'0" ng & A/C P 2
Performed for: Right -suM R
Keith Wolf & Made fiehad 19300 SW 116th Ave 6,0.108 RSR39325
12140 SW Katherine St i Tualatin, OR 97082 2012.Oe0, 13 11:05:38
Tigard, OR 97223 Phone: 503-891 -9699 Fax: 503- 8914556 11otosbslFotderRedlreatonsltmc ...
Phone: 503-579-1979 ,