Permit v CITY OF TIGARD MECHANICAL PERMIT
1111 COMMUNITY DEVELOPMENT Permit#: MEC2013-00471
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/14/2013
Parcel: 2S104DA10100
Jurisdiction: Tigard
Site address: 13113 SW MERLIN PL
Project: Bukair Subdivision: QUAIL HOLLOW-WEST Lot: 87
Project Description: Installation of a/c unit. Placement of a/c unit must comply with manufacturers clearance requirements.
Contractor: FOUR SEASONS HEATING&A/C INC. Owner: BUKAIR, SHARON L D
1005 INDUSTRIAL PARKWAY 13113 SW MERLIN PL
NEWBERG, OR 97132 TIGARD, OR 97224
•
PHONE: 503-538-1950 PHONE: 503-521-8944
FAX: 503-538-0165
FEES
Specifics: Description Date Amount
Air Conditioning 08/14/2013 $46.75
Type of Use: SF 12%State Surcharge.-Mechanical 08/14/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/14/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct q -. ' • to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued : i / Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FROM:Four Seasons Heating TO:5035981960 08/12/2013 13:25:39 #8343 P.003/003
1
Mechanical Permit Applies (; 1 CE!VED it 1;I l I( I I .•3 I;,i ,
N...... City of Tigard AUG 1 2 2013 EMMA 1�-� P"milNu. )`lgc■a�/3-x04/7/
13125 SW liall Blvd.,Tigard,OR 97223 Plan Roviow
Phone: 503.7182439 Foot: 503.598. i ai&Hy: (tiler Permit:
I.i , mil Inspection Line: 503.639.4175 B 'p' TIGARD !)ate Ready/13y: tab. a Sec Page 2 for
Internet: www.tigard-or.gov UIL G DIVISION Notified/Method: - -
-
Supplemental Information
TYPE OF WORK K DIVISION
COMMERCIAL FM` SCHEDULE- USE arlECKLIST
—New construction �Addilion/alterati(trtlre laccmenl -. Machin pemnt fas•are basal on the value of the work
❑ P performed.Indicate oho value(rounded to the newest dollar)of all
❑Demolition ❑Other: mechanical materials,r uipment,labor.ovtncmad,an� dylmtit.........._
--. - -- Value:$
_ CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT/SYSTEMS EKES,
0 I-and 2-family dwelling ❑(:ommactaUindustr1al ❑Accessory building Far spedafrgjomI Jotusecheat& _
❑Multi-family ❑Master builder ❑Other: Description Qty. lia._..�. 'Total_
J013 SITE INFORMA'T'ION AND 1A(:ATION 11eAdltg/coding:
_.. -. --- ---- Air conditioning_ '4 'I
Job site adtlness: 7 ` 7 (� f �------
I J... 1 .2_ i- IrJ1 t i.e.r.....1.�v-1 Y `a Ct Furnace 100,000(MI((praai.veri ,. ........ 46.75
City/Shit/ZIP: 'it ci 0,v'c O R Ci ] _..— -. Fumaa 1 00.000+Hill(duus/vent.J_„ 54.91
L....: _.. _....:.... I icxtturttp. 61.06
Suite/bldg./apt-no.: - Project name:
— u..kCa 1.r... _,...., Ihtct worst -_.. ._._.,..:.,.....: ... . 23.31
Cross sweet/directions to job situ: I tydrunic hot water system 23.32
---• • _- --- ... . ....... -- kmidential boiler(radiator nr
hydroni) 2:1.32
Unit healers(fuel-type.not electric).
_... ....__. - -.... -.--- no-wall,in-duct.suspended.etc 46.75
• Flue/vent for anvil'above - 23.32
Other: 23.32
Subdivision: i IAN no.:
-...--- Other fuel appliances:
Tax map/parcel no.:
Water heater _ ...
DESCRIPTION OF WORK Uas ftrepla insert --- 3339
- ... . .- Flue vent for water heater or gas
' --r7z}TL4kc _.. �-f-a1'��^�......., fireplace 23.32 IA4 lighter(gas) 23.32_
--- _..-_.... — _ -..._.....--..__...._.........� wtaxi//elletstove 33.39
_ Wood ftrcplace/msert - 23.32 .
Chimney/liner/flue/vent 23.32
.. - -.......-... Other. 23.32
pil PROPERTY OWNER ❑ TENANT ---
Environmental exhaust rod vendladon:
C Range hood/other kitchen
Y r S.1 U t v-
..
meat 33.39
AddrtNs: i 31 ‘3. S'te -'1 . .M ear l d.,.n P 1(�c.e _ Clothes dryercalmus! 73.:19
('it /StulelLlF: Single-dud exhaust(bathrooms,
y �i lAv -....-. .._� 1 .-'�`1 --._............_ toilet c anpartmtxas.utility roams 23.32
Phone:(t,70 3► i 4-i - g Fax:( ► Atti sinoylspace fans _____ T3.32 . _--
��yy APPLICANT ❑ CONTACT PERSON Odor
llusitiess name: -- ���:
ur-S,easonSli�t!ng .....-.__-_._.... X14.15 or Mot fourtS4.0.1 for each additional
Contact name: K Air Conditioning, Inc Furnace,de. .
Address.
1005 1ncTuStna RWy ties had puma!...-.---._-._ -_-----
--.---.-.. .....-— Nl-tefq,OR 97132 ............. —...... ...• Wall/suspended/tmit heater -
City/Stater/.I I': Water hatter
Phone:( ) 4- Fax::(�1. ) ` Fireplace�3 X345-1 1�J ..- 5�s=V.<<0� Range
1i-mail: kV Sc i $�e4-kivlr .. CO m t Itat'baYu
c(HVTRACI'OR Clothes dryerJga.9 --.,
liminess name: Four Seasons Heating (riper:
_.....-- -- _—._., MECHANICAL PERMIT FEES'
Added.,:
1K Air(,on(llttonihly, trlc __... �_..-
---_ 1005 In(11 ictrial,F,'kwy Subtotal —
City/Slate/%IP: Newberg.OR 97132 Minimum permit fix($90.00) `i.4, Go.
----. .....:.. w.. 3 - — Ply , .
r4 vtcw(2596 of permit Ice)
!'Itonc:( 'S) lS 3 t. (cl-p __. Fax:(r )5�S$ (C) I 41.57. . ..--._ - stet,surcharge(.12%of pcnmt fie) f 0• o
(14x1)lic.: (A-11Cj� 1'O'fAl.PM:RMI_I'FI F. ID.9.
..._....paw....
-..._ -- --.. ...._... --.--.............—_-....._._ tt� t apylkatlao eaplrea If a permit b ant obtained wlWin lie
�/�\ days after it has been accepted as complete.
Aotll(n/4:(I signature: .. �f . .') p- I un mathu�dugy yet by'1'rit'Iwnty Building[udu�ltry Service Itnprd
I. Print name: -Ekeiai f ... Stec-' 1-Date: -j.....`:t.3..... 1
I.VluddiwA rmts1MIIC I'mmuApp IIOI 11.doe 440-4(,ITT'(11417/(1)1WW La)
FROM:Four Seasons Heating TO:5035981960 08/12/2013 13:25:25 #8343 P.001/003
00E4477.
.
`c' 0" "fie` t
FOUR 1 0
FAX
DATE: CA - la - t ?, TIME: eM
TO: City of Tigard
ATTN: Permits
RE: Please issue and fax copy of Permit as soon as possible.
NUMBER OF PAGES (including cover): 3
FROM: Four Seasons Heating & Air Conditioning
1005 Industrial Parkway
Newberg, OR 97132
Phone: 503-538-1950
Fax: 503-538-11165
Sent By: Deborah
E-Mail: de borah @fourseasonsbcatair.com