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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2013 -00195 T t G ARID 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/10/2013 Parcel: 2S104BA03400 Jurisdiction: Tigard Site address: 12067 SW WESTBURY TER • Project: Lynch Subdivision: COTSWALD MEADOWS NO.3 Lot: 123 Project Description: (1) gas furnace replacement Contractor: COMFORT SOLUTIONS HEATING & COOLING Owner: LYNCH, DEBORAH PO BOX 1233 • 12067 SW WESTBURY TER CLACKAMAS, OR 97015 TIGARD, OR 97225 • PHONE: 503 - 698 -2665 PHONE: •FAX: 503-658-4011 • FEES Specifics: Description Date Amount Furnaces < 100K BTU 04/10/2013 $46.75 Type of Use: SF 12% State Surcharge - Mechanical " 04/10/2013 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - ,Mechanical 04/10/2013 $43.25 ' Occupancy Grp: Stories: Fuel • Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ✓ /kur Issued By: w( l� C.CLC Permittee Signature: ©M. 4-19%4C4 . t Dg- Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. Comfort Solutions Heating 5036584011 p.2 RECEIV Mechanical Permit Application FOR OFFICE I SE ONLI City of Tigard !' PR 1 0 201 • Re c t p ed / i� : • 13125 SW Hall Blvd , Tigard, OR 97223 Y I( i) 3 P- N-44669013 — pp( f( Phone: 503.7182439 Fax: 503.598.1960 Plan Rn iew InsInspection Line 503.639.4175 CITY OF TIG ' r �H10$S Other Permit: Internet: www.tigard -0r.gov BUILDING DNI ` ted/M R cnc�-d /B y ' a Pow 2 for , 1 ' 6 ., t Stitpp4astal Information TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USECJBCKLIST ❑ New' oonstntction ®Addition /aheration /replacement Mechanical permit fees* are based on the value of the work ❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all ; ❑ Other _ mechanical materials, equipment, labor, overhead, and profit _ j CATEGORY OF CONSTRUCTION Value $ ® Commercial/industrial 2- family dwelling ❑ Camercisl /industrial RESIDENTIAL EQUIPMENT /SYSTEMS REES* ❑ Accessory building For special informurlon we Medlin. ❑ Multi- family 0 Master builder ❑ Other: Description I f Qty. I Ea. Total I JOB SITE INFORMATION AND LOCATION Hatingkoalirag: Air conditioning Job site address: 12067 SW Westbury Terrace (requires site plan showing placement) - 46.75 City/State/ZIP: Tigard, OR 97123 Furnace 11)0.000 BTU(ducts/Mentg) 1 46.75 _ Furnace 100,000+ BTU (de,cta,'veatrs) 54.91 Suite/bldglapt. no.: Project name: J1699 -I ' Heat pump (requires site plan allowing placement) _ 61.06 _ _ Cross street/directions to job site: Duct work 23.32 Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) _23.32 Unit heaters (fuel -type, not electric) in -wall, in -duct, suspended, etc. 46.75 Subdivision: I Lot no.: Flue/vent for any of above 23.32 Other: 23.32 • Tax map /parcel no.: Other fuel appliance: DESCRIPTION OF WORK Water heater 2332 I Replace existing gas furnace Gas fireplace/ insert 3339 Flue vent for water heater or gas fireplace 23.32 — Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 0 PROPERTY OWNER I ❑ TENANT Chimney/Iiner /fue/vent 23.32 Name: Other: 23.32 Environmental exhaust and ventilation: Address: Range hood /other kitchen equipment 33.39 City / State/ZIP: Clothes dryer exhaust 33.39 Phone: ( ) Fax: ( ) Single -duct exhaust (bathrooms, ❑ APPLICANT toilet compartments, utility moms) 23.32 ❑ CONTACT PERSON AKic/crawlspace fans 23.32 Business name: Other. 2332 _ Contact name: Fuel piping: S14 - 15 for first four; $4.03 for each additional Address: Furnace, etc. I CityiState.IZIP: Gm heat pump WaI l: suspended/unit heater i t Phone: ( ) l Fax : ( ) Water heater 1 1 I E -mail: Fireplace Range CONTRACTOR Barbecue Business name: Comfort Solutions Clothes dryer(gas) Address: P.O. Box 1233 Other MECHANICAL PERMIT FEES' City /State/ZIP: Clackamas, OR 97015 Subtotal - Phone: (503) 698 -2665 1 Fax: (503) 6513 -401 I Minimum permit foe ($90.00) I n- Plan view (25% of permit fee) CCB lie,: 146470—, ( State surcharge (12% of permit fee) TOTAL PERMIT FEE J Authorized signature: This permit application expires Ira permit is not obtained within 180 days after it hag been accepted as complete. J Print name: Suaaa Stanley ate: 01.1/10/i 3 - 1 • Fee methodology set by TO-County Building Industry Service Board l\ Building %permitsOMEC- rrertApp.dac 03/07:12 44046177 (I t/o2,'COMWEB) 01/10/2013 11:0? Twice The Light Inc. (FRX)360 566 0186 P.001 /003 E. • r �1qq yy 1:. ! .'��tiRk ' 111t��i "di, ��alp V flv� � �t�i � k li11 1� 11:1; 1 11 . PQ BOX 65279 VANCOUVER :, WA 98665 ,► P (360) 573 -6101 kt F..1360) 566 - 0486 • FACSIMILE TRANSMITTAL SHEET • 1 U: FROM: —... . City of Tigard Rhonda. Roche], CCMP,ANY: DATE: 04/10/2013 FAX NUMBER: TOTAL NO. 01; PA(;i ;, INCT.T7DINI; COVtlt: 503.598.1960 3 including cover PI1oNr. NUMBER: SENDER'S REFISItUwc;1 , .. NUMBER RE, YOUR RP.FPR1NCE NUMBER • Paps Materials Handling Permit NOTES /COMMENTS: Rhonda Roche! Office Manager DIRECT: 360- 573 -6101 RhondaR(a)twjce.thclipht.com • •