Permit CITY OF TIGARD MECHANICAL PERMIT
1111 o COM MUNITY DEVELOPMENT Pe rmit: MEC2013 -00348
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/25/2013
Parcel: 25111 AD 14500
Jurisdiction: Tigard
Site address: 14827 SW 91ST AVE
Project: Hatfield Subdivision: MALLARD LAKES Lot: 11
Project Description: Replace gas furnace.
Contractor: A TEMP HEATING & COOLING INC Owner: HATFIELD, BARRY
16000 SE EVELYN ST 14827 SW 91ST CT
CLACKAMAS, OR 97015 -9519 TIGARD, OR 97224
PHONE: 503 - 650 -5014 PHONE: 503 -348 -1432
FAX: 503 - 557 -2990
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 06/25/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 06/25/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 06/25/2013 $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: Permittee Signature: A/
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.
08/24/2013 11:38 5035572990 A TEMP HEATING PAGE 01
Mechanical Permit Aulpllca r,- E1 V ED FOP 01:1'1i I. I'SF: Or\ [
City of Tigard Received
• ZS 43 , - PermiLNr 6TO ,, .I
II 13125 SW Hall Blvd., Tigard, OR 97223 c� 4 .,
1' Phone: 503.718.2439 Fax: 503.598.1960 U N 2 / O � 3 Other PormiN
• • 1 i r . P, I; 11 Inspection T.me 503.639,4175 Date Ready/By. Wal 121 Sec page 2 for
Internet: www,ligard- or.gov CITY OFTIGARD NodE eirod. Supplemental tntoormntlen
_DIIII. INGDNISION -
° ; - At. '1131.� :�V111��1i ny f.1& �i[k1GIrA.J1• ; ., .
�'1iF�i;.C�F K<Yii1C r
Mechanical permit fees* are based on the value of the work
[7 New cons truction Addition /alteTatiott/replacentent � performed Indicate the value (rounded to the nearest dollar) of all
E] Demolition 0 Other: meolmmcal materials. a in labor overhead, and ofit
Value: $
.. , . -. ' 'CA`q Y O.F. COs. c attc rIoN , , - .
..... F)CSS" ; ,... .
Ell 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building Forspee►47 aar,wrrittn tsar ewer
❑ Multi- family ❑ Master builder ❑ Other: Deaaription _ Qty- MI Total
" ,Pcifft- BITt IIrT i MA'tION .A.NIi t1CbCk►2 tiki.; . , - ReatL�/cool n:
Air conditioning
Job site address: I 1 /Z " r S ( , t f l i s t • ' L� ve , (to9� fm site glen al ___n Ptaco .. nt) 46.75
Furnace 100.000 BTU (ducta/ven� I 46.75 '16,
City /511►tc /Zll': � j G r . a . ( 7 2 r? Furnace 100 +BTU (duetslvcnta) 54.91
Suitc/bldg. /np Pro ject name: t../ f Heat pump
-
r 2 (requires site pion show erg pi:Ammon() 61.06
Cross street /directions to job site: Duct work 23.32
Hydr'onic hot water system 23.32
Residential boiler (radiator or
hydroniu) 23,32
,--- link heaters (Iuel-type, not electric),
in -wall in -duct, suspended etc. _ 46.75
� Lot nn.:
Flue/vent for any of above 23.32
Subdivision:
I Other: - 23.32
Tax map /parcel no : Other Ind a a . offences:
i ,ESt"� i 'f iv 'tCAF'- *b Water heater 23.32
Y „ , I 33.39
C,as fireplace
�T rra k rr► , ie efei l Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
__" Wood fyreplaccrmsert 23.32
- , ,- ;:,trip ir:' r!ol ' . - eatitnoeyilil,er>tlndvent z3 332 ,
Cl'lvAlvx,"
I Other: 23.. 2
Name: qtr , f Enafronmentalexhaled and veattlaHtm:
Range hood/other kitchen
Address: ('-f R-2._ 7 5 t,,./ c (s# Ave, .� -. cadig -. , 33.39
City /State /Z[P: / V f 7) 2 C,' Clothes dryer exhaust , 33,39
q -! I ..- Single -duct exhaust (ballrooms,
Phonc, (6- 3 `, _ 141 F ax: ( ) toilet coin artmem t utiiity morns) , 23 32
I MititiOtil`t ` ,' l;r iii •iikitSbN Attic /crawlepacc lhtts 2332 . ,
Other: 23.32
Business name: - e t►C ._
Contact name: 26000 SE sr. $14.15 fur first (bur; $4.03 for each additional
R Furnace, etc
Address: 503450.5014 oas heat�ump
City /Stater /ZIP: r 65 4.— 2_41 � "� Wall /snapended/unitheater _
Fax: Phone' ( ) ( [ d
?3_) 6 5 _1`" �J 1 0 Water heater
� -
r F, 1 fir M Psrcplace
- mail:S t(Qrf a'r . .-
.. .� � - : ' Barbecue �.
Clothes dryer (gas)
Ruiincss name: Alma HEATING AND MOUND, INC other
Address 16000 SE Evelyn St MECUAN1CAL PERMIT ne.s. , '
a s
atutes, OR 970 5ahtotal
City /Stete/zm: ,:n -5014
�} 11 Minimum permit fee ($90.00) IQ, QQ
hone: ( ) Fax. (5 3) � — (,q (kg w Plan review (25% of permit fee)
CCl3 lie.: ( g State surcharge (12% ofpermit floc) 1 d, f
TOTAL PERMIT FEE /Oa t ro ,
l' lids permit applitalion txphcs If n permit is not obtained within LEO
Authorized signor ft• . � y days after It has been accepted ss complete.
. r I 4 r- f z. D 6 - V - — /3 e Fee methodology cot by Tri- County Building Industry Service fioerd
f Print name: ... of r ,l
M6w1dme\Permits \Met: xc ,w..,,,,., 140.46171' (I l /02/C0M/WER)