Permit CITY OF TIGARD MECHANICAL PERMIT
IIIII �t Permit #: MEC2013 -00432
4 CO MMUNITY DEVELOPMENT
Date Issued: 07/30/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 28109AA01900
Jurisdiction: Tigard
Site address: 14434 SW 130TH AVE
Project: Riodil Subdivision: WOODFORD ESTATES Lot: 7
Project Description: Replace existing gas furnace.
Contractor: A TEMP HEATING & COOLING INC Owner: RIODIL, KRIS A T & ADELBERT R
16000 SE EVELYN ST 14434 SW 130TH AVE
CLACKAMAS, OR 97015 -9519 TIGARD, OR 97224
PHONE: 503 - 650 -5014 PHONE:
FAX: 503 - 557 -2990
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 07/30/2013 $46.75
Type of Use: SF FlueNent For Any of Above 07/30/2013 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 07/30/2013 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 07/30/2013 $19.93
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: OA/ - /C 9 --T7oN
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.
07/29/2013 11:13 5035fIEEIVED A TEMP HEATING PAGE 01
Mechanical Permit ApnlicationjUL 29 2013 Fop 011.1( T. 1 ()N I .1
City of Tigard Received
Datemy: 7 30 /3 t Perm"Virra20/3
1, . 13125 SW Hall Blvd., Tigard, OR 974 ITY OF TIGARD
Plon Review
I Phone: 503.718-2439 Fax: 503.398 LONG DIVISION DgeBy Other Permit
/napection Line: 503.639,4175 Doto Rcedy03y: ..t T21 8 ----- ee Paae -
l for - ...,
Internet; www.tigard •Nalifienvfattrod: 4 upriemoocat Tatoentatian
. ... ---•••-•
''' . • .-• ,, : . • . - . • . .. .::',', , '... ,:. : • ' , '::-. hitt: titipsc . :• _ : .: • : :•• . ..• • ; : : ::L. :.• .;-::' :.::.:
0 New construction Addition/alteration/replacement performed. Indicate the value (rounded to the nearest. dollar) of all
mechanical materials, 9uipment, labor . overhead. and profit
0 Demolition El Other Value: 2 1 i . g
Ea 1- and 2-family dwelling D Cortunercial/indnstial ID Accessory building For specin;ilfarwertiorg mix cfrogrliirt
El Mai 0 Master builder 0 other: Description LQw. EL Toad
-.• . :;.'-';', . :.:'•: ; :: :.: ,; : .•‘70.0:: . tects#0 . 440 .47 0. 7 AW . i.:.i.S.A 71 *.i: ,: 1 -.. ;',. -• '.. .. -•:,:',•::.; .1.: g
Job site address: f./ & l 3 L/ s-, 130# A ve. • ,... mite . en sb - '. .: nnornarit 46.75
PUTIM 100,000 BTU (duos/venni) i 46.75 W.73
City/Stara/ZIP: 7 .." ok. 7 2 2 cf Ft.. )00,000, Er.ru (ducts/with) 54,91
____
Suiteibk1g,/apt. no.: 1 Project narim: R i od; i Beat pump
(rureinis sac pion showing piseemerie) -1 61.06
Cross street/directions to job site: Duct work _ 23.32
r' -.
. .._ .... _
Hydronic hot water system
23.32
Residcotial boiler (nalimor or
hydosnle) -- 23.32
Unit heaters (fiel-type, not electric),
in-wall, in-duct, suspended. etc. 46.75
Flue/vent for any of above I 23.32 23,37-
Subdivisi on: Lot no.:
Other: 23.32
Tax map/prucel no ! Other fad appliances:
:. .', ; 7 ',..:': lljitik •• - 21 --- ater ILI;atcc 23.32
.-/5-0 Gas fireplace
ap 144. l - a 6 " a As ri4 eg1.4_10 ; 4 41 ? I( 4 , 7 ‘ Flue vont for water heater or gaa
cif fit r si . fireplace 33.39
23.32
Lo li cjitml
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
'- .- .:1! 1 atinnt5ilimilluelvcilt 23.32
23.32
Name: V 2 i ,,,,, i 1 Enviroomentale_shattst and ventilation:
Aec / '1'43 Li S . 13 4v.f., Range hood/other kitchen
equipment 33,39
City/State/VI": -7 , C q 7 2 2 - 4( Clothes dryer exhaust 3339
Stogie-duct exhaust (bathrooms,
Phone: (3 ) CI 7 l e a Fax: ( ) toilet compartments, utility room.$) 23.32
•. •••:': ' , '...:;.• ;:::. -: . ... ::. .-:-. •,...::., ,, ..,: . a .. .o-gitgo,. , .::: : i.,........:.: Atdc/crswlsPace fans 23.32
Other 73.32
Business name:
- AmMP uaapiammegouNckeie _ Fuel Mariam
Contact name: 16000 SI3 Evelyn $ $14.1511w lust four; S4.03 tar each additional
Address; Ciaciaanas, OR REIS Furnace, etc.
.. : • • • - CTEL9 tica,
City/State/ZIP: Wall/snspcnderVunit heater
,
Phone: ( ) Fax: : (.5 ) 654.. 2A.10 Water heater •
Fireplace
E-TT11.5 .../..6)...e.74.4., c42.
Range
. . ... ..• ., . .• • : . . . _ . • • • • . . . Batbecua ...
, Clothes dryer (gas)
Business name: A-IEMPHEATI/sIUMILCCKILINCUMC Other:
Address: 16000 SE Evelya St. ..y•.: ., •.',..•• 1
City/Slate/ZIP: ' Subtotal 70, 07
I . :I il •
one; ( ) Fax (5 ) g ) 51-- _ v - mum permit fee ($90.00) J5 . 13
Plan review (25% of permit fee)
_
4 CB lie.: _ __State surcharge (12% of permit fee)
. ji:;4.
_ToTALpERrynoog t../
This peewit applkation ear fres ifs p.mit is nbt obtained within tan
Authorized sign dor otter it has berm accepted an complete.
Print name: 5.4. A r_ . .) 4. .. c 1.-
t :" H a I Date: 7- )3 1 . pee trietboMogy qe hy Tri-County Building Industry SCIvicc aoard
modusiskrenstowrec•Porrnivisimioe ammo 44-46171' (I I /07/CCOAAVE 8)