Permit CITY OF TIGARD MECHANICAL PERMIT
I II Permit #: MEC2013 -00278
� COMMUNITY DEVELOPMENT
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/28/2013
TIGARD Parcel: 2S104DC06600
Jurisdiction: Tigard
Site address: 13814 SW FERNRIDGE TER
Project: Miclau Subdivision: MORNINGSTAR Lot: 7
Project Description: Install new gas furnace
Contractor: OWNER Owner: MICLAU, ION & MARIA
13814 SW FERNRIDGE TER
TIGARD, OR 97223
PHONE:
PHONE: 503 - 524 -9347
FAX:
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 05/28/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 05/28/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/28/2013 $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 t. by calling 503.232.1987 or 1.800.332.2344.
Issued By: 10, l7.-e Permittee Signature: e/17 /52742/06./C./ /O
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.
May 23 13 11:31p ION MICLAU 5035249347 p.1
Mechanical Permit APPlicatiR EIVED /J� t G
City of Tigard Date/ 5 2 . 6 i b Permit No.: Ht6O,C�1 - C 2 7
. • 13125 SW Hall Blvd., Tigard OR 97223 . Plan Review
Phone: 503.718.2439 Fax Tigard, 2 8 2013 Pl Rev Other Penult
T 1 i.:.� :t.1) Inspection Line: 503 Date Ready /y: bait: i la See Page 2 for
Internet www.tigard- or.gov CITY OFTIGARD Nobfied&Method: Suppl ae.tat information
BUILDING DNISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special Information Arse checklist.
❑ Multi - family ❑ Master builder 0 Other: Description Qty. I Ea. I Total
Heating/cooling:
JOB SITE INFORMATION AND LOCATION Air conditioning p
Job site address: 13814 SW FERNRIDGE TER (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts'vents) 1 46.75 46.75
City / State/ZIP: TIGARD, OR 97223 _ Furnace 100,000+ BTU (ductsovents) 54.91 ,
Suite/bldg. /apt. no.: Project name: Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Ductwork , 23.32
_Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
' Unit heaters (fuel -type, not electric),
in -wall, in-duel, suspended, etc. 46.75
Subdivision, I Lot no.: Flue /vent for any of above . 2332
Other 23.32 _
Tax map/parcel no.: Other fuel appliaaces:
DESCRIPTION OF WORK Water heater 23.32
NEW GAS FURNACE Gas fireplace 3339
Flue vent for water heater or gas
fireplace 2332
Log lighter (gas) 23.32 _
Wood/pellet stove 33.39
Wood fireplansert _ 23.32
Chimney/liner /flue/vent 23.32
® PROPERTY OWNER ❑ TENANT Other: 23.32
Name: ION MICLAU Environmental exhaust and ventilation:
Address: 13814 SW FERNRIDGE TER Range hood/other kitchen
equipment 33.39
City/StateiZIP: TIGARD, OR 97223 Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms.
Phone: (503)524-9347 i Fax: ( ) toilet compartments, utility rooms) 23.32
CR APPLICANT ❑ CONTACT PERSON Attidcrawlspace fans 23.32 _
Other 23.32
Business name:
Fuel piping:
Contact name: ION MICLAU 514,15 for first four; $4.03 for each additional
Address: 13814 SW FERNRIDGE TER Furnace, etc.
Gas heat pump
City/StatefZlP: TIGARD, OR 97223 Wall /suspended/unit heater
Phone: (503) 524.9347 Fax: : ( ) Water heater
Fireplace ,
E -mail: aorthwestserviees( yahoo.com Range
- CONTRACTOR I Barbecue
Business name: NIA. Owner Clothes dryer (gas) ,
Other:
Address: (same as above) MECHANICAL PERMIT FEES*
City /State/ZIP: Subtotal
Minimum permit fee ($90.00) 90
Phone: ( ) Fax: ( ) Plan review (25 %ofpermit Lice)
CCB lie.: state surcharge (12 %ofpermit tee) 10.8
TOTAL PERMIT FEE 100.80 • I/ This permit application expires if a perm a not obtained within 18Y
Authorized signature: days after it lm heat accepted as complete. � �� J
Print name: ION MICLAU I Date: 5/23/2013 I • Fee methodology set by Tri County Building Indusay Scry cc Boards i/
lea rn
vildineterroOMEC- PrUpp.doc Ce/Ca t 440.4617r(I1/ObC( t'WEB) IIII��
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
13814 SW FERNRIDGE TER, TIGARD, OR,
97223
Residential - Mechanical
699 Mechanical final
05/31/2013 00:00
MEC2013-00278
PASS - No C of O
Electrical minor label number ELS 368077
Violation Summary:
Inspector Contractor