Permit
r ~ CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2009-00599
» 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/10/2009
Parcel: 1 S 133C D 13700
Jurisdiction: Tigard
Site address: 11882 SW TALLWOOD DR
Subdivision: Lot: 0
Project: Jarone
Project Description: Install furnace.
Owner: FEES
JARONE, PHILIP T Description Date Amount
11882 SW TALLWOOD DR Furnaces < 100K BTU 11/10/2009 $46.75
TIGARD, OR 97223 FlueNent For Any of Above 11/10/2009 $23.32
PHONE: 503-590-7514 12% State Surcharge - Mechanical 11/10/2009 $10.80
Minimum Fee Adjustment - Mechanical 11/10/2009 $19.93
Contractor:
ROSE CITY REFRIGERATION HTG & AIR
PO BOX 19207
PORTLAND, OR 97280
PHONE: 503-636-5371
FAX: 503-655-4669
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of the rules
or direct questions to OUNC boy calling 503.246.6699 or 1.800.332.2344. , /
Issued By: Permittee Signature: 141%1
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Nov 10 09 04:49p Rose City Heating and Air 503 -655 -4669 p.2
Mechanical Permit Application RECEI FOR OFFICE USE ONLY
•
City of Tigard 't``
h Date:$y: // /D
• 13125 SW Hall Blvd_ Tigard, OR 97223 '�'�_ OQ `'
'Mr' (:leer Permit:
Phone: x03.639.4171 ra.: 503.598.1960 N O V 0 9
T I G A RD Inspection line: 503.639 ?5 Date lteaely: y: II H See Page 2 for
Internet: wst'w'.tigard- or.gov CITY OF TI Ir NFI ethnl: Supplemental Information
PLA,NNINC /ENCINEERING
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of work
❑ New construction ® Addition/alteration/replacement
cement
performed. Indicate the value ( rounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials, equipment labor. overhead, and profit.
CATEGORY OF CONSTRUCTION Value. $
1 ®t. and 2- family dwelling El Com Commercial/industrial RESIDENTIAL EQUIPMENT/ SYSTEMS FEES
❑ Accessory building
For special information use checklist.
I ❑ Multi family ❑ ]blaster builder ❑ Other:
Description I Qty. I Ea. I 'final
JOB SITE INFOR1IIATJON AND LOCATION Heating/cooling
Job site address: 11882 SW Tallwotui Drive Air conditioning r
(requires site plan showing, placement) 46.7$
City:State'ZIP: Tigard, OR 97223 F'uma0 100,000 BTU (ducta'vents) I _46.75
Furnace 100.000 t- 1311 U (duxrvents) 54.91
Suite tilde apt. no.: Project name: Heat pump 61 06 -
Cross street /directions to job site: Dud. work 23.32
llvdomic hot water system 23.32
Residadial boiler (radiator or
hvdronic) 23.32
Unit heaters (fuel -type. not electric).
in wall, in -duct, suspended, etc. , 16,75
Flue /vent lor any of above 1 I 23.32
Subdivision: l I,nt no.:
Other: I 23.32 1
Tat mapiparcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Craw fireplace 33.39
Install 96% efficient furnace Flue vent for water heater ar gas
fireplace _ 23.32
l,oe lighter (gas) 23.32
Wood /pel let stove 33.39 —
Wood fireplace/insert 23.32
® PROPERTY OWNER I ❑ TENANT O - !linerrnue/vent 23.32
Other: hr: 23.32 i
Name: Phil Jurone F,nvirounental exhaust and ventilation
Range hood:other kitchen
Address: 11882 SW Tullwood Drive
equipment 3139
CitylStatc /ZlP: Tigard, OR 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)590 -7514 Fax: ( ) toilet compartments. utility rooms) 23.32 ,
® APPLICANT ❑ CONTACT PERSON Atlic/crawlspace fans 23.32 j
1 Other. 23.32 I
� Business name: Rose City Hearing & Air
Fuel piping i
Contact name: Jeff Pangborn $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address: -
Gas heat pump
City/State/ZIP: \Fall /suspended %unit heater
Phone: ( ) Pa :: ( ) Water healer
Fireplace
E -mail: jeffiiIrosecityheating.com Range
CONTRACTOR Barbecue
Clothes dryer (eas)
Business name: Rose City Heating & Air F
• Other:
Address: PO Box 19207 MECHANICAL PERMIT FEES*
City /State /ZIP: Portland, OR 97280 Subtotal 70 07
Minimum permit fee ($90.00) 90. j
Phone: (503) 636 -5371 Fax: (503 ) 655- 166,9 Plan review (25% of permit fee)
` fie.: 161325 _ Stale surcharge (12% ofpennit fee) 10.80
T OTALPE RMPT FEE 100.80
-- This permit application erpires if is permit is not obtained within I
Authorized signature. days utter it has been accepted as compkte.
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