Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2013-00691
Date Issued: 11/14/2013
TIGAFRD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Parcel: 2S112BC05200
Jurisdiction: Tigard
Site address: 14920 SW 83RD AVE
Project: Friedman Subdivision: LA MANCHA ESTATES Lot: 5
Project Description: Install gas furnace.
Contractor: SUNSET HEATING&COOLING Owner: FRIEDMAN, MITCH DAVID
0607 SW IDAHO ST 14920 SW 83RD AVE
PORTLAND, OR 97239 TIGARD, OR 97224
PHONE: 503-234-0611 PHONE:
FAX: 503-234-0439
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 11/14/2013 $46.75
Type of Use: SF 12%State Surcharge-Mechanical 11/14/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 11/14/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: .f4; Permittee Signature: /17 ,42—/'/°f.::. 77,f/1
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
11/14/2013 09:47 5032340439
RECEIVED SUNSET HEATING PAGE 02/02
Mechanical Permit Application IIIIMIIIIEIEIMIIEEIIIIMIII
City of Tigard NOV 1 4 2013 Received
Datemy: Permit Nn r20/3 -,a 6-
li . 13 i25 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.7182439 Fax: 503.598.1960 other Permit:
lnspeution Line: 503.639.4175 CITY OF TIGARD Data/fly:
Aid,: , Pi See Page 2 for
T IG A RD Rendy/ny:
Internet: www.tigard-or.gov
BUILDING DIVII
JagonttflediMethod: 11 6,,,- suppic,....1 Information
. ,COstkERCIAL:SW SCHEDULE L usE cHECEDST
'' Mechanical permit fees*am based on the value of the work
0 New construction ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
El Demolition. Other mechanical materials c. i. ent.labor overhead,and 'Wit.
Voluc:$
CATEGORY OP 051004010 .: a1sotstrat:Eigrinsptr#/0YSTEMS.FROFis
-and 2-family dwelling U Commercial/industrial 0 Accessory building for special information use checklist.
0 Multi-family 0 Master builder 1:10ther Description Qty, WM Total
.,.-.."
.717:*.SIO'INFOR00101j.0. 10e*POt.41:„ :,..,„ , : - Heath].coolinit ...
Job site addresT '
,. tyl_p_.<2. .. r-62 . . ite.., '' ' Air conditirmin_ 46.75
Pomace 100 000 BTU duets/vents Mill 46.75
City/State/ZIP: - rtapiCti...09 01-1)9'(-1 Furnace 100.000+BTU dactsivente ME 54.91
Or12 61.06
Suite/h1dglapt.no.: Project name: f--/e fe-is/Li/9.A/ Duct work NMI
Cross street/directions to job site: A . 14 dronic hot water system 23.32
- — Residential boiler(radiator or
I (Ironic
Unit heaters heaters(fuel-type,not electric),
in-wall in-duct,so..ended,etc. 46.75
Flue/vent for an of above 23.32
Other: MI
Subdivision: L,otmo.:
Other Biel a'.names:
Tax map/parcel no.: Water heater 23.32
nEAcattrioN OirivOic, : , , ..,, , , GOA fi •laCIATISCri .11.1 33.39
- Flue vent for water heater or gas
1.a.-.6_&..tur_ALL_ lire.lam 23.32
Lo:li Atter Las 2332
Wood! Het stove III. 33.39
Wood Sim lace/insert 23.32
Chien /liner/flue/vent 23.32
Other: 23.32
0 PROPERTY.OWNER . 0 TPNiiNt , Environmental exhaust and ventilation:
Name: " ../e,/ C—LNt-747f frf ir-e...1-/ Range hood/other!Eitel=
/ t / e.ui,ment 33.39
Address: Clothes d or exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms. impli
_..... tact corn., nerds utilit rooms
Phone:( ) Fax:( ) Attie/crawls ace fhns 1111.11 23.32
0 APPLICANT ' ;: .112,,CO*1,000* : Other: MEM
Fuel i.1n.:
Business namc: $14.15 tbr first four 54.03 for each additional
Contact name: Furnace etc. II.
Gas heat.um
NM
Address: — Wall/sus.endcd/unit heater 1.1111.111—
City/Slate/ZIP: Water heater
Phone:( ) Fax::( ) 121=21. 11.1111
. Ran Lc IIIII
E-mail: Barbecue
' . . COSITRAiTote " , Clothes d er L as ME
Other: MINI•Business name: , _ ' ..,.- ''41 4-- I/ .. ..! C..-0611A-5- — , :::: :,':IltEORANICkE iikli*Fr-FEES ' '
Address: '.: 00 L ' T,4111.hd1=1_,..' i Subtotal
—_
City/State/ZIP: p_611 p ak. -oV..._ q,---ta- ') Minimum permit fee($90.00
/ Plan review 5%of permit fee)
Phone: 4 115 . q ... , ,i I Fax: ',4 , ..s" L.I- 63,qii State surcharge(12%of permit fee)
gr..i wan 1.7
i CCD lie.: 1 1 1 0&5.- • TOTAL PERMIT FEE IV,iizior
I — — — Tbio permit application expire;if a permit Is not obtain d within 150
days after It has been accepted as complete.
Authorized signature: Fcc methodology set by Tri-County Building Industry Service Board
Print name: sN , bate: 111/P-iiii,
1,■null4ineWerminaMEC.3'riemltApp_ 113,dne 440.461Tr 0 I IN/COM/WED)