Permit 1, a CITY OF TIGARD MECHANICAL PERMIT
'
B- COMMUNITY DEVELOPMENT Permit #: MEC2013 00123
T f G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/06/2013
Parcel: 2S103AA00802
Jurisdiction: Tigard
Site address: 11015 SW ERROL ST
Project: Olson Subdivision: ECHO HEIGHTS Lot: 6
Project Description: (1) A/C installation Must maintain 5' side yard setback and approved rear yard setbacl
Contractor: FOUR SEASONS HEATING & A/C INC. Owner: OLSON, NANCY
1005 INDUSTRIAL PARKWAY 11015 SW ERROL ST
NEWBERG, OR 97132 TIGARD, OR 97223
PHONE: 503 - 538 -1950 PHONE: 503 - 332 -5303
FAX: 503 - 538 -0165
FEES
Specifics: Description Date Amount
Air Conditioning 03/06/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 03/06/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/06/2013 $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. 1.800.332.2344. /►
Issued By: C�� Permittee Signature: A CH11 Ok.
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.
03/05/2013 09:21 FAX 5035380165 Z003/004
Mecha Pe rlmit Ap •ticati _ COED l; ii: i i I 1 i r I l,, I "\ 1
City of Tigard / Rweiriy, 3 67 , l 3 s-( Permit No.; µe,G. ul 3 _poi
., 13125 SW Hall Blvd., Tigard, Oft 97223 MAR 5 2013 Plan Review other :
• �, phone: 503. 718.2439 Fax: 503. 596. 1960 DadBr:
Inspection Line: 503.639.4175 CITY OF TIGARD : Supplemental � be
www.ti8ard- or -gav
BUILDING DIVISION
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Mechanical permit fees* arc based on the value of the work
❑ New construction Addition/alterat ion /reptaccmeflt performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials. equipmen, labor, overhead, and profit.
Value: S
'w r ' -
RI 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special WNer er:ion ate checklist
O Multi - family CI Muster builder ❑ Other: Description .,_. 1 Qty. I Ea I Total
4
a» ,F , : w- r, y+r[� , I.: Heati�JeooIl :
{ ,; .'. ; a c 13� :, .... `` ' �c- . Air conditioning
Job site address: 1 1 01.6 S-J . ' E r fro 1 (Si e_j (iequires ane plan showing placement) j 46,75 405
Furnace 100,000 BTU (ducts/vents) 46.75
City /State/ZIP: . a+. 0 ' GI -1 _ - Pomace 100.0001 BT hi /wncs) 54.91
Suite/bldg./apt no.: Project name: (requires showing placement) 61.06 ,_ ,
Cross street/directions to job site: . Duct work 23.32 _
Hvdronie hot water system 23
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel-type, not electric),
in -wall, in -duct, suspended. etc. 46.75
Flue/vent for any of above 23.32
Subdivision: L ot no.: I Other ...... f 23- 32
Tax map/parcel no.: Other fad appliances:
� '¢ '.A .n.. : . +1u r; :',. : 1, ,p + .. :!7.., Water heater 23,32
, G lacescrt 33.39
, etSTJa- A 1 e > orsiil La c Flue vent for water heater or pa
fireplace 23.32
lighter) 2332
Wood. ellet stove 33.39
Wood fireplace/insert 2332
*. , wow; Chinmeyflirtar/flttt/vent 23.32
Z,_:;°.+ %..... � , ...� � . : 4: t. . 4 �d :.Ai.,, .5,4•; -., ,'.0. * ,, r + p ! :. 1 . .. 23.32
y .,a :,r.'.gti, .- Other:
Name: t• a n el • Environmental exhaust and ventilation: -_
Range hood/otherkitchen
Addis:as: t 101 a • e,4.' equipment 33.39
City /State/ZIP 1\ 0 ( _ 0 11 a2 ?� - Clothe dn/er exh aust 33 -39
Singh -duct exhaust (bathrooms,
Pbmtoe: (5%3) 33a-S303 Fax ( ) toilet coi p nests, tail !y moms) 23.32
. ' :Y .. Attidcrawlspace fans . 23.32
- :�;.11�+oav 23,32
Business name: - Four Seasons Heating tamer:
Feel ,' . i
conk name:
8. Air Cond}tioning Inc 514.15 for that four, 54.03 for each addldoaal
t • r
Furnace, ate.
Address: LVewberg, OR 97132 -_,• - Oas heat puny
City/StatdZ1P: WO/suspended/unit heater
I Phone: ( .3) 53 - Iq
Fax :: (5b3) S 3 _ O ((o c _Fireplace
E-mail: i - - o y •. u.r • ,-' a ' e-- ° "el ••-
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our ease s - - eig Clothes d (Ras)
Business name: - Condt'tionif► - Other:
Address: 1005 industrial PI(w� - ifr'a F. 1 ;':'laii'. „�..a:
City/State/ZIP: Newberg, OR `n7lTIJ�L subtot
Minimum permit fee ($90.00) gn. Oa
Pte ( a3) s 31 , `q 9 ..../ Fax: (53) rj 3 $ - p RO c plan review (25% of permit Ike)
. CCB lie.: Gil 157- 31311' State s rcba ge (12% of permit fee) L , Pro
TOTAL PERMIT FEET $O
This permit application expirss if a permit is not obtained 180 Authored signature: j1 days after it has bee's accepted in complete.
F Print name Debora f - i', c ( 1c, ! 1 fie: 3.75-1 3 . Fee methodology act by Tri*�:onmy Building fndu�y Service Board
L daa03/07/1S. 440-461it(11 /02VOM/WEB)
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DATE: 3 - f . TIME: 9 2,a. ►rY
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ATTN:_akc j2a. ; P€ r r,r` i k
RE: Ati'C0--1 PQir v.,:4,, te..eeziej .
NUMBER OF PAGES (including cover): "1
FROM: Four Seasons Heating and Air Conditioning 0
1005 Industrial Pkwy
Newberg, OR 97132 rota:
Phone: 503-538-1950
Fag: 503- 538 -0165
CrCitIl We/ •
Sent By: 190 90 r a�
E- Mail: d;.r @fourseasonsheatair.cam