Permit CITY OF TIGARD MECHANICAL PERMIT
NS . COMMUNITY DEVELOPMENT Permit#: MEC2013-00628
Date Issued: 10/21/2013
T[GA.RD 13125 SW Hall Blvd,Tigard OR 97223 503 718.2439 Parcel: 2S102D601900
Jurisdiction: Tigard
Site address: 13245 SW BURNHAM CT
Project: LEWIS Subdivision: BURNHAM PARK Lot: 13,PT 8
Project Description: Gas furnace installation.
Contractor: WOLFER'S, INC Owner: LEWIS, EVAN W&KAREN E
290 YOUNG ST 13245 SW BURNHAM CT
WOODBURN, OR 97071 TIGARD,OR 97223
PHONE' 503-981-4511 PHONE:
FAX 503-981-0801
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 10/21/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 10/21/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment Mechanical 10/21/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types
Gas Pressure.
Total $100 80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090 You may obtain a copy of the rules
or direct questions to OUNC by calling 503 232.1987 or 1.81
Issued By: ittee Signature:
ip
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
OCT/19/2013/SAT 10: 10 A1{ V1OLFERS HEATING FAX No, 5039810801 P. 001
Mechanical Permit Any artGEIVED FOR OFFICE tier ONIN...
City Of Tigard
eed i
13125 SW Hall Blvd.,Tigard,OR,9p4,3 Plan Review ��- ��' f• �•
' •"' Phone: 503.718.2439 Fax: 503_95.,lA6C 1 2013 Date/By: Other Pernut
1'I r;A H:i., Inspection Line: 503.639.4175 pate Ready/BY: ET Sea Page 2 for .
Internet www.tigard-or.goV CITY OF TiGARD Notified/Metbod: jr Supplemental information
% f$ Y ib e Fi a ` G, r v i 1 yc$ry 4 2. '{ '-~0...,..Y.1.....1746
J'1 o"V 1..'4 't
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Me chanical
permit fees*are based on the value of the work
D New construction p Addition/alteration/r'eplacement performed indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit
} Value:$
fff�,� ,1,1•4 Y-,=1/ � :,,,Q -4,- .a Lµy � .Iz-ip . 1 = cL 1 g Np• g .0 S u
is 1-and.2-family dwelling -❑Commercial/industrial ❑Accessory building For special Informailon ass checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. I Ea. Total
l y aim Q„ .R' (.,tti 1, ijt ! Ya,_! t Heating/couling:
' `-� e ���k�t at'/.."°1 �ti'..°''';'f-- ,i a� t¢ ^l r K b
Air conditioning 46.75
Job site address: 13.2 4.1 S-- S T u t w Lea 0., C'.OQ t 1 Furnace 100,000 BTU(duots/vents) j 46.75 4f(•75
City/State/ZIP: T „ t! el a s- 41) lac 3 Furnace 100.000+BTU(dacts/vents) . 54.91
Suite/bIdg./apt.no.: Project name: � A . Law s Heat pump 61;06 `
�.l
17uct work 23 32
-
Cross street/directions to job site: H dronic hot water system 2332
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 23.32
Subdivision: Lot no.; Other: 23.32 •
)
Other fuel appliances:
• Tax map/parcel no.: Water beater - 23.32
' "� ' fa aM u�i c fire lr 33.39
„,14,T.o ,T w C. s t1111� � :. r :-. 14P r u ventforwater heater or gas
-1hS` ‘,4.11
_ GJ h._5 F V f M.A.CO fireplace 23.32
�/ Log lighter(gas) I 23.32- -
' Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
'7407:k4° Y Other 23.32
t on 'I� '''l.'l '. -4.� t �� i.. 1uw: � .�li".'�iT u .
Environmentsl exhaust and venrilarion:
Name: E%n, % 4- A.(e,v'` 1-G✓V t .S Range hood/other kitchen
equipment 33.39
Address: 13 2 H S 5 W Ti V r K CO J r 4.. Clothes dryer exhaust 33.39
City/State/ZIP:-rt, Q a Single-duct exhaust(bathrooms,,
toilet compartments,utility rooms) 23.32
Phone:(6Q ) L W-4- (a a Fax ( ) Attic/crawlspace fans 23.32 ,
.'m4,d,;1M ,,� .• A.6- i F"* ' c 1 1 'r,, ',br a t lr'rcc.J ,� ':.s` .4.J Other: 2332
Fuel piping:
Business name: Lk) ��d. `r ® $14.15 for first four;$4.03 for each additional
Contact name:1-.e r,: Chown e.g.t tu t/ Furnace,etc.
Address: 0 �C v Gas heat pump
' 4
. . Wall/suspended/unit heater
City/State/ZIP: t JQdd k)Jrn G Cj 70 7 I G,,, • Water heater _
Phone:(6O ) Gi�"'J - (�✓C�7 f Fex: ( )/lv i -0 D f// Fireplace
P Range
E-mail: - •
. •
Barbecue
...1's'aigr.ti•A ttlM,l e,' . f .fi . x:'1. r.,;!,
n ¢,. ":411:,:;.,", ,Clothes dryer(gas)
Ot her
herBusiness name: D leirS l_Y Fe .•!-t t �. � gal.., 3'.!,, - ; - �„
4k! g�Mr-g.g
Address: a� �vN„, 6 4
-Subtotal
�1 aoel-�7v frL a �Q.�! Minimum permit fee(S90.00) '1 Q
City/State/ZIP: -- plan review(25%of permit fee)
Phone:($p�,) e .j- (i 11 [Fax;(Sal) 4l:/ ...D$-d/ State surcharge(12%of permit fee) /0 4-0
CO3 lic.: r 9 `r _ TOTAL PERMIT FEE i 6 0•$C)
This permit application expires if a permit Is not obtained within 160
days after it has been accepted as complete.
Authorized sigaatur /•--r L f__ , Fee methodology set by Tn-County Building Industry Sernco)3oard
Print name: `reir. va„4.e..1IGtr Date: IV/al/Z.00