Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00438
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 08/01/2013
Parcel: 25111 DC 12200
Jurisdiction: Tigard
Site address: 15910 SW OAK MEADOW LN
Project: Brown Subdivision: SUMMERFIELD NO.11 Lot: 618
Project Description: Install gas furnace and NC. Placement of NC or heat pump units must comply with the manufacturer's clearance
requirements.
Contractor: WOLFER'S, INC Owner: BROWN, PATRICIA
290 YOUNG ST 15910 SW OAK MEADOW LN
WOODBURN, OR 97071 TIGARD, OR 97224
PHONE: 503 - 981 -4511 PHONE: 503 - 684 -0120
FAX: 503 - 981 -0801
FEES
Specifics: Description Date Amount
Air Conditioning 08/01/2013 $46.75
Type of Use: SF Furnaces < 100K BTU 08/01/2013 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 08/01/2013 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
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 0 C by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: e/V ,9 / C4-T/0 /\_/
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.
JUL /31 /2013 /WED 11:59 AM WOLFERS HEATING FAX No, 5039810801 P. 001
Mechanical Permit A„ppl>t 616 I Fo nr OH; r i F USE ONLY
hi
City of Tigard ei` ii, Permit No _ r
tY D ate/By: a0 .,,_. a1ree20�3 C
u : 13125 SW Hail Blvd:, Tigard, OR 97223 plan Review
• ' Phone: 503.7182439 Fax 503.598.194 UL L 2 ma other Petri[
Inspection Line: 503.639,•175 / rl cinit:�� Internet www.tigard- or.gov CITYOFT(GARD 'Notified/Method: r p mental Information
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Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition/alteration/replacement performed. Indicate the value (rounded to the nearest•dottar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
, tiY'uv kit h'+ E~ i�Lm1=-47...7,0w,77-70, A z - rs .+n� fk� u k e i r :s� +i Value: $
. ,= 2. k 3 _ +m p N j (41 ,d ii „ I. c, ezi '. r ,�V -; ,4z 1 ? y 1 AT 4 r , ' r4 "' '+ t 1 � j ..� ' ,,,,,, 4 i't ' iS r , .ci r n ` ,,,� 1. f r. . �, 2 ,?" r
,® 1- and 2-family dwelling ❑ Commercial/industrial -❑ Accessory building For special ir;Jor mation use checklist
O Multi- family ❑ Master builder ❑ Other Description 1 Qty. 1 Bar. I Total
X ry 753 R } p J'Jy :� t p_- y ,�'N. ..'" "r 7:1,-.c;41;4,407:.;4,..-.,:,..:::.,..:-,;:,,, TT� ' . . 1 ' m Healing/cooling:
4 u{ ,? *` ;4}4.1:2,,, , ;' .E2 , 1,,og„ ,,, � ..n ,,,, •••,,..
,tnr-+Lt.- Lut. " ,,,,
Air conditioning 1 46.75 y(,.75
Job site address: 15910 SW Oak Meadows Lane Furnace 100,000 BTU (ducts/vents) 1 46.75 4110.75"
City/State/ZIP:.Tigard, OR 97224 Furnace 100,000+ BTU (ducts/vents) 54.91 ,
Heat pump 61.06
Suite/bldgiapt.no.:' Project name:. Patricia Brown 2
pact work 23.32
Cross street/directions to job site: 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
Flue/vent for any of above .2332
-
•
Subdivision: I Lot no.:. . Other - 23.32
'Other fuel appliances:
Tax noap/parcel no.: • • Water heater 23.32
4 b ± T 2 toi t n a^ a1 r c r , car"` r �, r� i Mr Ga firePlacefrtrsert 33.39
..Lt , s Z � = fl �,�a a:zw... -A i� ; _�.... _ :.... h .. i r. < rr r? ?, ,, , 4_,. ,., ,;..i_l, s: Flue vent for water heater or gas
Install gas furnace and AC fireplace 2332
- Log lighter (gas) , 23.32
Wood/pellet stove 33.39
Wood firepla.ce/insert 23.32
Chimney/liner' /flue/vent 23.32
r M X dr .. ^max •Other. 23.32
h S � -t°r )) � lo `':4t •b' ZI" Y+ n� .r �� a u -,,, r X, �',1 y i �, , 7
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+.7'� >, .,r.. 1 ... . u' a. . ,'r, . �,:�.�rr�?1 * t�, ��± r , ,i ....» »v - . Environmental exhaust and ventilation:
Name: Patricia Brown Range hood/other kitchen
equipment . 3339
Address: 15910 SW Oak Meadows Lane Clothes dryer exhaust 3339
City/State/ZIP: Tigard, OR 97224 Single -duct exhaust (bathrooms, •
toilet compartments, utility rooms) 23.32
-- P1►oie: (503)684 =0120 . 1'ax: ( ) Athc/crawispace tans _ - 2332 -
re .;:t X?r�rw . L' M �* �iFr'3 ?1Jn J'�'tMyy�• . j yi�.d r"7f .7 , .4V . l
.. '", ri :1 ii :1161 t'+ i tt, . G , h - , : :.-'., .,`t^ i • �^J �, - . 5' .: . �Ir.„tia! ^. .a r > 1--,, Y ; :: ? Other. 2332
Business name:•Wolfers Heating Fuel phpht
$1
$14.15 for first four: $4.03 for each additional
Contact name: Teri Burns Furnace. etc. [
Address::290 Young St . . Gas heat pump
'Wall/suspended/unitheater
City/State/ZIP:'Woodbum, OR 97071 Water heater
Phone: (503) 981 -4511 1 Fax:.: (503) 981 -0801 Fireplace
Range
E-mail: trib@lewolfersheating.com Barbecue
�
':�. i:."*:,�,A.Nwtt: , :, .:Yf'- , iU'`...:J �.9 N�.i.�i,ih tTO), �. il' y .. : e ,.i., , ,:,,4,,-41..44,,,,,. .,.1 Clothes (gas)
- r q .N a_w,.3rx.. r1._ a�... .
.u. :L.",::_ i
Business name: Wolters Heating' i ,.
Address:290'Xoung'3t - gi .Z Subtotal
.76
City/State/ZIP:'Woodbum, OR 97071 Minimum permit fee ($90.00) 90.00
Phone: (503) 981 -4511 Fax: (503) 981 -0801 Plan review (25% of permit£ee)
• __._...... __ State surcharge (12% of permit fee) 1 I 7..
• This permit application expires if a permit is not obtained within 180
days after it has been accepted as' Complete.
Authorized signature, J • Pee methodology set byTri- County Building industry Service Board
Print name: Teri Burns Date: 07/31/13
__......__..__. /0 y 7.,---