Permit r CITY OF TIGARD MECHANICAL PERMIT
.
I: COMMUNITY DEVELOPMENT Permit #: MEC2013 00022
t Date Issued: 01/14/2013
TibARO' 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Parcel: 2S114BA09600
Jurisdiction: Tigard
Site address: 16465 SW MEADOWOOD WAY
Project: Bowen Subdivision: COPPER CREEK STAGE 2 Lot: 49
Project Description: (1) furnace and thermostat installation
Contractor: OREGON HEATING & AIR CONDITIONING Owner: BOWEN, MARK A & DENISE B
19300 SW 118TH AVE 10510 SW HOODVIEW DR
TUALATIN, OR 97062 TIGARD, OR 97224
PHONE: 503 - 691 -9699 PHONE: 503 - 819 -4471
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 01/14/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 01/14/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/14/2013 $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.
a
Issued By: .I � 4 / - . 1 / : !, Permittee Signature: r -PPL/C � Dld
/ (;/ ,(fi/� 111 VVV
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.
01/11/2013 15:36 503-691-8556 OREGON HEATING PAGE 01/02
Mechanical Permit ApplicatichxRECEIVE 11 101, ,iFFICE USE ONLY •
Received
City of Tigard JAN 1 4 2013 DateBY: i 1 i 1 7 5.-r Pertilit N i t 'lee•JO/ 3 - 00C
- 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Other Permit
' 2 " Phone: 503.639.4171 Fax: 503.598,1960
: C1TYOFTIGARD Dat6i td r eg y
nate : kor ,... Ri Sea P2ge 2 for
frt3,“ . :I) Inspection 1-411e: 503.639.4175
Internet: www.tigard-or,gov : BUILDING DIVISIO 14°t`64eth°d: Oa soppiemesosi Warmation
fr.
. . . :TYPE OF 1%!Ot4c.. : ••. : .•'''--:: : !.- : • - SPEW 0* Cl*C4
Mechanical permit fees* are based 011 the value of the work
0 New construction DirAdditiontaltirationfreplacement performed Indicate the value (rounded to the nearest dollar) of all
D Demolition 0 Other ! mechanical materials. eu:pment, labor, overhead. and profit
eAtiootilt:'betiekii*delikii •.„ ..• Value: $
' '' " ': ::.. * 1 ;:•:'
1 2'1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special try'annaticm we checklist.
0 Multi-family 0 Master builder 0 Other: Desaiption Qty. Es. Total
!'..'.` ' :'• '; ' ' ...kit srrt:iNvoitiatitkii.004jioK :. , Head , : cook. L
Air conditioning
Job site address: I) LA 0 5 ..\,NI NI-feat \NOod Wftv (reczires site plan showing placeeneot) 46.75
City/State/ZIP: — r - i c)(i 02 .., q71:2_4- Furnace 100 000 BTU ductslventt) IIMI 46.75
- . Furnace 100,000t BTU (dzets/venis) 54.91
Suiteibldgfapt. no.: Project name` 11 2 1 .: 0 h, -. n Heat. , =11 61.06 M
Cross street/directions to job site: Duct work 23.32
:
Hycironic hot water system 2332
Residential boiler (radiator or
•
• h dronic 23.32
___... • Unit heaters (fol-type, not electric),
inJwall, in-ducsuspended, etc. 46.75
: •
Flue/vent for any of above 23.32
Subdivision: Lotoo.!
: Other
Tax map/parcel no.: : Other fad appliances
".•.. :,.::.,.,-, ; : ' • • ' : .: .! ... : : i REsRipiloy,17:6i;iyegit;-;',"',;,';'.,..:1./.ZZ-71.-4.:;:)::7•j& Water heater 23.32
-, Gas fireplace 33.39
(fl o iial &) at \ - II . Flue vett Or water heater or gas
fire 1.12CC ' 2332
'
- Log lighter (Ps) 2332
• Wood/ . ellet stave 11.111 33.39
Wood fireplacermscrt 23.32
23.32
PROPERTY OWNER NT ,, - , 7.' • '''' 4: ,-!. --:. 23.32
Name: i c)ft r... 't M CM V.... BO V \l' n Environmental exhaust and ventilation
Itange1100d/other ttitchen
Address: 1 LO +:40.0.6Si t VV Dr. e. i .ment 33.39
City/State/UP: -- c'eva,t pg. Al224 Clothes dryer exhaust 33.39
Singlo-duct eichanst (bathrooms,
.
Phone: (C/3) 'cs i Gi —, i-4 L 1 i 1 i : Fax ( ) toilet compartments, utility rooms) 23.32
23.32
•,'-: ii.• ..' :. :::HO.APIPCANT • . ::.'i'4: --. •• 0. COTACir; IT TSP9 i 1 ' -..:
` Other: 23.32
Business name: C) btaa.i.ev Fuel piping
Contact name: 2' G-Q, /bye^. /,6:;,, $14.15 for first four; $4.03 for each additional
Furnace etc.
Address: if3' 00 .56/ /8 ... /fc-t :. — Gas heat pump .. -.
City/State/ZIP: .
: r ok 9 7426.2 WalVsnspendedhasit heater
Phone: (5a3' )6 • / _ gc.) ; Fax : ( ) Water heider
Fireplace
E-mail; ' Range
0iO40V'.::;....L:-:.::;;:!:'::T..,: :::::.:.., ::. r' '..7;: ." :::. 7 . B
Clothes dryer (gas)
Business name . . ,,, iteith : Other:
Address: Woo ji. afti "liee : ,....: ,....100:14*C P0 #*0
^ • - ' . ..,. ,.
Subtotal
City/State/ZIP: re, , og 9 11 • Minimum permit fee ($40.00)
Phone: (Pr ) CA? f- 46.n Fax: ( ) Plan review (25% of permit fee)
CCB lie.: 1.72 / 26 • State surcharge (1rh of permit fee)
___.7.. TOTAL PERMIT rn poiyois
, . : This permit ipplication expires if a permit is not obtained within 180
Authorized signature: elsys alter it has been accepted as complete.
11.4.0. 1 i ir i i * Fee methodology set by Tri-Coimty Building bidnetry Service Board