Permit CITY OF TIGARD MECHANICAL PERMIT
11111 m COMMUNITY DEVELOPMENT Permit#: MEC2013 00518
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/11/2013
TI GAR Parcel: 1S126DC01002
Jurisdiction: Tigard
Site address: 9355 SW LEHMAN ST
Project: Anast Subdivision: LEHMANN ACRE TRACT Lot: 5
Project Description: Replace gas furnace
Contractor: FITZ ENTERPRISES INC Owner: ANAST,ANGELINE V
232 NE MIDDLEFIELD RD 9355 SW LEHMAN
PORTLAND, OR 97211-1238 PORTLAND, OR 97223
PHONE: 503-761-2270 PHONE:
FAX: 503-292-8237
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 09/11/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 09/11/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/11/2013 $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 B : / _/1,/, , _ ` Permittee Signet re: i. '`
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.
09/11/2013 12:21 FAX 21001/002
Mechanical Permit A• •ii tt.'r: , r(>►t 1)1 1'1(4 t "1'_(>\1.1
City of Tigard• 13125 SW Hal]Blvd.,Tigard,O �1t.
EIVED
:� Phone: 503.718.2439 Fax: 503.598.g ' 1 2013 Received
♦� �M ;Y
Plan Review
Date/By: pmfitvo,
-/IC /3- 60 1-/g
Other l it;
RD Inspection Line: 503.639.4175
Internet: www.tigard-or.gov Date ed/Met o or""+" S Page Supplemental
CITY OF TIGAR® Notified1Mc hod, Supplcmcntal Information
4 - ' 7t1-3'f .lL.•'• .;-T r �1r__ r t I ° ym� e r. r x-�k+ f'tei^5 kR( ii " �f
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Mechanical ptxmit Mess arc based on the value of the work
❑New construction " Addition/alteration/replacement
Demolition performed.Indicate the value(rounded to the newest dollar)of all
❑ ❑Other: mechanical materials,equipment,labor,overhead,and profit.
: cmfti: ...,
Value $'* r�•r, pit' ° �Nl •;fr {41 r 0 n f.� ate• fi mr
ti y,• L u3I.,&w v r �,Y,• a .w�rn:- u,._ :c , isQ I a...�u_;.:�a ,. '"7 Y
- ,, I f , "� i-4411,;'&1/7-k.!'",-,"1-,)"-. ,
,, , i i 4. 14
' 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For rpedalInformatton sue checklist.
❑Multi-family ❑Master builder ❑Other: Description I Qty, I Ea, I Total
,, �,..- i "Ci, d ' Y lv,A ° 7`_ma1 y_ .� ' ' x;
� " � Whn cooi :y d ' h TI : 1 4'. o b c4 i !
Au conditioning 46.75
/lob site address: q,'3vS SO '�� ( S-1. Furnace 100,000 BTU1dacuhents) / 46.75
City/State/ZIP: Vol kicAllki o , Furnace 100.000-e BTU(duatalvents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name; t)flct work 23.32
Cross street/directions to job site: Hydonic hot wager system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 9 46.75
Flue/vent for any of above 23.32
Other 23.32
_
Subdivision: I Lot no.: Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
:,' V � : `. !a , ' :o L t 33.39
. :1 t _ rt w * ” �'` " Flue vent for water
hearer or gas
�; n fireplace 23.32
- _ r� R1(� dC log lighter(gas) - 23.32
-
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: _ 23.32 M *. x : snw � yr' a sq u "w r�i
- . � •;.,,-__ -. i,: 1.-Ants, 0 . ° ::: 4
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 33.39
Clothes dryer exhaust 33.39
City/Statc/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) , 23.32
Phone:( ) Fax:( ) Allis/crawlspace fans 23.32
°7 { �'ry ry-Np� y gay F - r r ^�l
Other 23.32'
Business name: fuel piping:
$1415 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Gas heat pump
Address: Wall/suspended/unit heater ,
City/Stule/ZIP: water heater
Phone:( ) 1 Fax::( ) Fireplace
Range
E-mail: Barbecue
1r 1 B Vt , ud1 a d tizs:,.�sa°-. _ !i `` n Clothes dryer(gas)
Business name:Portland Green Heat Offer' - -
/%/fz, C`iJTP��/1r5f5 /,Jew ° ; i i :� : -:lt ;.
•Address:232 NE Middlefield Rd. Subtotal
(''ter/State/ZIP:Portland,OR 97211 . Minimum permit fcc($90.00) , 90.00
Plan review(25%of permit fee)
i-,le:(503)761-2270 Fax:(503)292-8237 Slate surcharge(12%of permit fee) 10.80
CCB 1ic,:33512 6'/Q// TOTAL PERMIT FEE 100.80
'Luis permit application expires if a permit to not obtained within 180
days after it has been accepted as complete.
Authorized signature: t t ry 4l �, • Fee methodology set by Tr;-County Building Industry Servioo Board kaly,40-4)
Print name: 1 4+1+1��{ 14 /) i Date:CO 4 L a�ji3_
r:1BuildiasTermhs1M t'e*rohApp_04011 . v KV1 440.4617T(2 L 2/C 7M/WEB)