Permit n CITY OF TIGARD MECHANICAL PERMIT
14 2 : COMMUNITY DEVELOPMENT Permit #: MEC2013 00061
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/28/2013
Parcel: 2S 103DCO5600
Jurisdiction: Tigard
Site address: 13750 SW 115TH AVE
Project: Tamasaka Subdivision: VIEWMOUNT Lot: 44
Project Description: (1) gas furnace installation
Contractor: WOLFER'S, INC Owner: TAMASAKA, GARY & JEAN
290 YOUNG ST 13750 SW 115TH AVE
WOODBURN, OR 97071 TIGARD, OR 97223
PHONE: 503 - 981 -4511 PHONE:
FAX: 503 - 981 -0801
FEES •
Specifics: Description Date Amount
Furnaces < 100K BTU 01/28/2013 $46 :75
Type of Use: SF 12% State Surcharge - Mechanical 01/28/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/28/2013 $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.
Issued By: Child ( ermittee Signature: O /J /tPLGa / 0 ,I
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.
r.
JAN /25/2013/FRI 10:15 AM WOLFERS HEATING FAX No. 5039810801 P. 001
REC •
Mechanical Permit Application s o ft c1,�flCr usL uh�1,e'
City of Tigard Permi ( Tigard . JAN 2 8 211 stagy: (�-k vf-1 eLap(3 ' 00044
u 13125 SW Ha1I B1vd., Tigard, OR 97223
• Phone: 503.718.2439 Fax: 503398.1960 ^ TIG ��� Other Permit:
T I o; A tt 1 inspection Line: 503.639 CITY Ki i eady/By; Ed See Page 2 fo r .
Intarnet: www.tigard -or.gov BUILDING DIVIR'r s ems �0, Supplemental Information
4f , 1 .
�.,� .7"';'. ;ai N , ); 11 Z +..' 4 , •Y• . ^.� ,1 +Ft . — i' IIMi1 , wnf. ; '';`r..11; �.'q E ": VIA ''."-,1 - B :re d "'.ir .
l Y Itera tian/ 4 re lacement erformcd.11pe permit vale b r dad to the a of t he work
i
��.., = p t
❑ New cons truction IKAdditi p performed. dollar) of all
❑ Demolition ❑ = Other. , , mechanical material ■ ui men labor. overhee. and . ofit.
9n 1M Value:5
p � t ,�i�.(n Y" -'__�, F rY + 1 - 7l� ,, +H� j�.Ci W; W r 1r �X r' n1Y .., 0, 7� qra 1' ,, ` q" ur
if,7:�,,„•, `� n, r•u:.:.... __ � -.r l,r, TI . � . . ��Ht .S .„.. II Y % ,p.=711,017;117.
r i l l .- "^'t,:JC � is
IL 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special Infornmlion use checklist.
❑ Multi - family ❑ Master builder 0 Other: Deecri , tion Qty, Ea Total
m om*- 1y Rr j - y': . a i1 ' 0 ' k : r , ■ . .1 Head coolln :
i , C ' � 4: v __ ,1 Q . r r. � Ittig'iI Ni !`' p� S gt, !" �,�•,..-t': ', ,. 1 p ., --- Air conditioning
Job Site address: 13 '7 t5' 5 k...) l 15 '- a () re.uires site •len showin• .lacenient 46.75
Furnace 100,000 BTU (ducts/vents E, 46.75 I
City/State/ZIP: ' d — /?Q3 _ Furnace 100 000+ BTU (ductsivetas 54.91
Suite/bldg. /apt no.: I Project name: Heat pump
woes site .Ian showin, • Moment 61.05
Cross street/directions to job site: . Duct work III. 2332
H conic hot water stem 23.32 MOM
Residential boiler (radiator or
. h dronic - 23.32
Unit heaters (fuel-type, not electric), -
• -
in -wall, in-du a a - . - d , etc.
Subdivision: I Lot no,. Flue/vent for :. of above FM
Other. _FrN
Tax map/parcel no.: Other fuel a trances.
n 7,. z �. , r Imo+ Water hea MIMI
ttr �. -_,_ _�,qa.' -1' 3339
. e msert
, - Vv..4 441. ds.g. n40, • Flue vent for water heater or gas -
fire lace
Lo: 11 ;4 ter • ::. MIMI
Wood! diet stove In 33.39 ME
• Wood fire.lace /insert -- 23.32 MIMI
q yLy Rp, 1 - . ' admit /liner /flue/vent 2332
.' �.i (:a 7 i1,�, a ��•�,��iH��' ���(�';^'��I��:'y�G.,, � , ,• W 1 g . fib 4r.1. +� l Other. MIll 23.32
Name: r�,_ 4 •u, �� h. / Environmental exhaust and ventilation:
` : - Z'� ✓1 Range hood/other kitchen
Address
>.' 75 6 ) )S I'r� .ui, ant Ell 3339
City/State/ZIP: r " t _ a (j 9 -7.x,3 Clothes , exhaust Mill 33.39 Mil
Single -duct exhaust (bathrooms,
Phone ( ) Fax ( ) toilet com,artments utif rooms 23.32
fit-7-1 � 1; / 14 4{ 7, l ^° 1,� _ � e —g ""( . �r r Attic/crawls ace fans _MI
I r n' r, a:,, r'L ».., tt -ne x do :x ierM ^ [t fit, w 2332
Other,
Business name: � ��/ l� a r/ Fuel i in_:
Contact name: � CC1 '.' $14.15 for first four $4.03 for each additional
Furnace etc. Address: .i% : r — '
City/State/ZIP: M: U1Gr A r ' 0 '7Bn j Wallis ,ended/unitheater =
�
Phone: (' ) Q
�3 c fj) .. , . 1) Fax= : m3) q C I b (' n t Water heater
/� ��{ ,� !) j5 U •
&mad: I .tea. ' W 01-4 t' 1 S 1'.1C ahl'7.0 . Nrn ITIT
4- r s u .p t4:,, 15 e i e • ' o: i" mt'' p t 3 B ecu e
1 UJEI/'�►frtil� lfll ,
Clothes . _1111.11
Address: /ii r ,it) A / . V-. . f � . ate- : :0 .1 .' 'P3;01*. : hriit , :. ' ;:
' j i 101 /4 1 1 a Subtotal
Minimum ,ermitfee($90.00) M
Phone: es )3g1- " l�✓ 1 ! Fax: ( 5) • 6 181 - Q&. I Plan review (25% of pemiit free)
CCBlie.: _I 'j State surcharge (12% of permit fee) I $0
TOTAL PERMIT FEE / r�
This permit a pplimti4n expi If a permit is not obtained within 180
Authorized signature �S _ days otter it has bean accep ;ed .as complete