Permit u CITY OF TIGARD MECHANICAL PERMIT
•
; _ - a....- COMMUNITY DEVELOPMENT Permit #: MEC2013 -00109
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503 718 2439 Date Issued: 02/21/2013
Parcel: 1 S134ACO2651
Jurisdiction: Tigard
Site address: 11110 SW COTTONWOOD LN
Project: Schoppe Subdivision: ENGLEWOOD NO 3 Lot: 217
Project Description: Replace gas furnace
Contractor: A TEMP HEATING & COOLING INC Owner: SCHOPPE, ALLENE BONNIE
16000 SE EVELYN ST 11110 SW COTTONWOOD LN
CLACKAMAS, OR 97015 -9519 - PORTLAND, OR 97223
PHONE: 503 - 650 -5014 PHONE:
FAX: 503 - 557 -2990
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/21 /2013 $46 75
Type of Use: SF 12% State Surcharge - Mechanical 02/21/2013 $10 80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/21/2013 $43 25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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 • - ' C by calling 503 232 1987 or 1 800 332 2344.
Issued By: ∎ � ' Permittee Signatur ,�, ` �!' /� /GL�
. 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.
Mechanical Permit A licati CEIVED ‚• ) It 0,:, u I.: I s r: i i N 1.1
City of Tigard • MAnglirliVo ParnvtNo., Hi e., echo 4
lig 13125 SW Hall Blvd., Tigard, OR 97223 f Pion H°" 1° '" Other P"r°"9t
■ phone: $03- 718.2439 Fa>c 503.598.1960 g 2 1 2 0 1 3 Duffy: c �
1 1 , : is l: I ! Inspection Liao; 503. 639.4175 ltesdYYB1'• s I So o o y for
ra&rinaYlun o P„ 2
lutetium , � , � ,,,, tl,ard- ar.gov CITY OF TIGARD Data Lv f«
BUILDING DIVISION _ ♦t +yr , �:,� nm��.p�j� ���r
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`:.�M, ; ,. Mech p orn : of all
;: : e'•.�:. a ` performed Indicate the value (r'oundedto the nearest dollar)
❑ New cron AdditionJssttelaticn/teplacemcnt n,ecbameat =taints - Yu.. - . labor. try Mr-- ame fit. 0 Otter Value; $ f
El 1 - and 2-funnily dwelling ❑ ConmAnnal/indusizial 0 Accessory building Description QV, Taial
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lob site address. 1 : � 1 (Q W t't vL o e 7� n �/ Furnace 100 000 Ff11 doeta/vaatal EN 4615 'r1'o'
II. 23.32 �
City/State/ZIP: 1.1 Q Furnace 100.000+BTU duos/Vents MI 54.91
d 4 �1., 1 4 �` �' (i' B Beat Pump 61.06
Suite/bidgfapL no.: J Project name: 0 �o0 `.I 0 . • a4o • . •laao�tt
Criss street/directions street/directions m Duct wort: job site: H dr min hot water stow _
Residential boiler (radiator or REM
It dronic
Unit heaters (fuel -type, not elautYic), PSI
-- -� inwall, • 1 . • sus • ' d. etc. ���
Flue/vent for an of above
Subdivision: 2332
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Tax muP/Paruel Irgn
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33.39
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Name: _
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Business name: A1Eb I- • • 1 : .1b ! pis N. e . I. Other ;- MI IIIIIIIII
Address: 16000 SE Evelyn St. • ' IcA i T
City /State Fax: (5 )i, x '' 0 0 t +4
Minimum permit foe ($90.00) a Y 0
ZIP: t t -� .1 I Plan review (25 (25°000f Permit [lie) NM
Phone: ( ) State surcharge (12% of perm fee)
CCB bL TOTAL PERMIT FEE +L obtained + • Tbtr parmtt nppliCatlon of plis& if a permit u k
days after K Loa been accepted Authorized Sl e 1 J� + bee mtltllodalo�' sally •Iti-CO Y Burtdulg rndtn Y Saw= Bust
Print name: 0 0 1
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F A-TEMP
HEATING &COOLING, INC. saro
05014
' A 16000 S.E. Evelyn Street FAX (503) 65 (503) 557 - 5014
Clackamas, Oregon 97015
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DATE: 2 2_1 21 _
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