Permit CITY OF TIGARD , # x MECHANICAL PERMIT
fril 0, COMMUNITY DEVELOPMENT f Permit#: MEC2015-00806
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/01/2015
1, _,;,,,, Parcel: 2S111CD07500
Jurisdiction: Tigard
Site address: 15745 SW SERENA CT
Project: emmett Subdivision: KERWOOD ESTATES Lot: 12
Project Description: installation of gas furnace and water heater. 12/2/15,REPRINTED permit to add gas piping for furnace&water
heater.
Contractor: SUNSET HEATING&COOLING Owner: EMMETT TRUST
0607 SW IDAHO ST 12086 SW 131ST AVE
PORTLAND, OR 97239 TIGARD, OR 97224
PHONE: 503-234-0611 PHONE:
FAX: 503-234-0439
FEES
Specifics: Description Date Amount
Water Heater 12/01/2015 $23.32
Type of Use: SF Fuel Piping 12/01/2015 $14.15
Class of Work: ADD Type of Const: Misc Administration Fee 12/02/2015 $45.00
Occupancy Grp: Furnaces< 100K BTU 12/01/2015 $46.75
Stories: Minimum Fee Adjustment-Mechanical 12/01/2015 $5.78
12%State Surcharge-Mechanical 12/01/2015 $10.80
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $145.80
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. YouNcnay obtain a copy of the rules
or direct questions NC by calling 503.232.1987 or 1.800.332.2344.
Issued B : Permittee Signature: e
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.
12/02/2015 13:23 5032340439 SUNSET HEATING PAGE 01/02
•
Mechanical Permit Application FOR OFFICE I_sv.ON
FFLY
City of Tigard
Received• /oQ && /C CLIO Permit No.:MEapp/5,-age*,
• 13125 SW I-Iall Blvd.,Tigard,OR 97223 Plan Review Other Permit:
I: Phone: 503,718 2439 Fax: 503.598.1960 Daten3y:
Inspection Line: 503.639.4175 Date Iteadwl3y: Juris: lip See Page 2 for
TIGAKU Internet: www.tigard-Or.gov Notified/Method: Supplemental Information
t, -� r> sc t1" 7� in'. j t y t Y - 'tutt 474,, '` ,4, 1?k, i? •• u.g. �-_ i•si"�SF✓. iR',a•2(•". t :41t,;„,
� �- -'•Lt-'-a ' 1 " -• ."�. Mechanical permit fees',are based on the value of the work
❑New construction Addition/alteration/replacement performed-indicate the value(rounded to the nearest dollar)of all
El Demolition ❑Other: •
mechanical materials,equipment,labor2 overhead,and profit.
Value:S
Ty ,Ir �'yr'"'�'A�-.-' qkI rf"j�. r�� .wir `r`,Wi 's g err Ai •; ,.M,a 1, 1 nar x-r-;-t n-aJ�":.�r $. 71•:,•ar- ,,,v7,-..1y,
,r' -" } � ���.4.;�c..�`-�..:�k��s� �-`'�e'�'��`�iifR ^°?���-'=� t^mow. ?,�`�e4.t.l�c+.��,E 2 ,�k�a :.��'i ..e�--,a,���-1� t
"N,I-and 2-family dwelling ❑Commercial/industrial ❑Accessorybuilding For specirrlInformation use eheckllsL
❑Multi-family ❑Master builder ❑Other: Description 1 Qty. I La I Total
:>w '0 n tih °"t t 61: ri,20 d 4) t emm ,, ' 1a"r Heapog/coot ,.
i. t•„ " ; 3� M ig 4 -n iztu1 tae ...e ,,';r.,i-dI a a r -,,: c: """ s, G' Air conditioning 46.75
Job site address: e �/�.Q_ di . Furnace 100,000 BTU(ducts/veots) 96.75 (
City/State/ZIP: Furnace 100,000+BTU(duets/vents) 54.91
-
- - _ Fleatpump 61.06
Suite/bldg./apt.no.: Project name: _Ductwork 23.32
Cross street/directions to job site: Hydronic hot water system 23.32
' Residential boiler(radiator or
• hydronic) 23.32
Unit heaters(fuel-type,not electric), •
. in-wall in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
I Other; 23.32
Subdivision: Lot no.: .
Other fuel appllancest
Tax map/parcel no.: Water heater 23.32 7
4::'" � � ��. ;, ..14,,,,t.1-...,,,,,,,.7-r.,,,, �`' � ""�"f� r - Gas fireplace/insert 33.39
� ,? . ;. M .e,} s, a .,re ,u `dl r ;'2,-.-- Flue vent for water heater or gas
o�/J—"DO9. 23.32
D t^o/j�7 / N�- r fire
Log lighter(gas) 23.32
. _- Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent _23.32
• _ _ p�� 23.32
s7v - u.• jr
t
^*t4:15:,�$` 4: s,:3g4P'. , h:me C ;i `'`".r .-'r"`t b ,," ,'" • Environmental exhaust and ventilation:
9t8''Jaw 5y at', a , ASL ?' rdtxi� ~+ �.1�+.
Name: Range hood/other kitchen
equipment 33.39
•
Address: Clothes dryer exhaust 33.39
City/State/ZIP: - Single-duct exhaust(bathrooms,
compartments,utility Mins) 23.32
Phone:( ) Fax:( ) Att
toilet
fhns 23.32 1_
! ara r 't Other: 23.32
r: a1 «' � � � i r : �
Business name:G�1_3(sC--)..()_.„-\- \-.V2�.� e 111`g to CLO c( A,Mink 510.15 for first four:$4.03 for each additional
Contact name: �A0.� • Furnace,etc. i
Gas heat.um.
Address; ' C - f/qI / �. Wall/sus.ended/unit heater
City/State/ZiP: Itsok 0 e , Water heater
r, (� Fireplace Phone;(gi=5)"L (—g - Ran
(\>� Fax;;(1-0 2:2)44 r O c t 5 1 Rte.e
E-mailt `-c--C\ t Or G(A.Y\ / * . .coo,-‘ Barbecue
r3: '" rrae :"" it , a"rh #t "?,,
r ""a Clothes dryer(gas) 11111
'' . 't",',,
r , 1.
Other
Businessname: � ,,, x "G,' . e. '.',"r�;cca 'i 1 t 1,t' ::
4' it,"atai-+t 'vzamt_ :;_.,c�«, - ...r� Cr7l'..t'x
Address: Subtotal
City/State/ZIP: Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) Fax:( ) i State surcharge(12%of permit fee)
CCB lie,: 4 . TOTAL PERMIT FEE
- This permit appticati0n expires if a permit is not obtained within ISO
idays after it has been accepted as complete.
Authorized signature: / / "Fri'
Q -----,"' '� Fee methodology aet by Tri-County Building Industry Service Board
I Print name: Ct*CtA-.p\:,LQ V t *Sorg, Date: al-Z.115- 7 Q •
,.. •,_,.. ., ... ..._... , .,Anna,4Tn Nn9rr'lfhnvFa, 6