Permit
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2010-00058
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/09/2010
Parcel: 2S110DD12400
Jurisdiction: Tigard
Site address: 10730 SW HIGHLAND DR
Subdivision: Lot: 0
Project: McShane
Project Description: Replace existing a/c and furnace. A/c must be located in the same location with the same
distance to the property line, or will have to maintain 3' setback as with new installation.
Owner: FEES
MCSHANE, MARY ANN Description Date Amount
10730 SW HIGHLAND DR
TIGARD, OR 97224 Air Conditioning 02/09/2010 $46.75
Furnaces < 100K BTU 02/09/2010 $46.75
PHONE: 503-460-0469 12% State Surcharge - Mechanical 02/09/2010 $11.22
Contractor:
BEN'S HEATING & AIR CONDITIONING LLC
PO BOX 80607
PORTLAND, OR 97280
PHONE: 503-233-1779
FAX: 503-651-3345
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $104.72
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 by calling 503.246(((..66699 or 1.800.3332.2344.
Issued By:
C2, , , ) n_I l Permittee Signature:
y .~Xv v fl )
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.
IA __......
• mrerrnicaifieEnitA fiat CEIVED I(m (,)1 I ISE ONLY
City of Tigard Received
Date/By: . 1 E
,‚ a 13125 SW Hall Blvd., Tigard, OR 9722Q7223-.,- B 0 9 2010 Plan Review
I Phone: 503,639.4171 Fax: 503.598.19RE Date/By: Other Penni':
. _
Inspection Line: 503,639.4175 - . I.■ A RD . Data Ready/By: El See Page 2 for
internct: www.ligard-or.gov CITY OF TIGARD Notified/Method: ' Era Supplemental Information
•-• ...- • B Pk t • ., 6,L
. . .
00,0***K -..p , F•toSitafidAL .FEE" SCHEDULE - USE CHECKLIST
• : •
Mechanical permit fees* arc bused on the value of the work
El New construction 7 Addition/alteratiOn/replaccment pertbrmed. indicate the value (rounded to . the nearest dollur) of all
LI Demolition 0 Other: mechanical materials, equipment, labor. overhead, and profit.
' . . ... exittoRY wt..: ..::: ' '''' ti.011m7-",..'4.2'g,...:7,::,•;i:.,.;:.:A.,;f:w.,-. :' : Value: $ ' WO (7 --
. ....
:...,... •:'.RESBDENTIAL EQUIPMENT / SYSTEMS FEES"
IFI I. and 2-family dwelling El Commercial/industrial ID Accessory building
For special information use checklist.
12 Multi 0 Master builder 0 Other: Description 1 Qty. I Eu. j Total
• • ' JOlikTp 04.taivikrtot44$0..:10d# td14.7?*:•4/P7?,•: Hewing/cool_
_
0 ' .
X A i • ' Air conditioning or heat pump
Job site address: 1 . II et
(requires site plan shelving placement) / 14.00
. -
City/State/ZIP: - 77te'A e7P 971.a il Furnace 100,000 BTU vluets/vents) , 1 14.00
•
Furnace 100,000+ BTU (duets/vents) 17.90
Suite/bldg./apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
in in-duct, suspended, etc. 10.00
Flue/vent for any of above f 10.00
Subdivision: 1 Lot no.:
Other: 10,00
Tax map/parcel no.: • Other fuel appliances
. ... - . - . • ..7.....OzsdiortiOS:0•*enik;;::;.:::,.:::::T...1.:ii-,1-:.,..,...;,: Water heater 10.(x) •
• • • • •• r. , • • — .,..: • •••••• : ! ;74. `,114fes.!-!■11 r. ,.
Gas fireplace 10.00
e ... ,, , ,, ,, 6,4 rwitiqz.c.. Flue vent for water heater or gas
fireplace i 0.00
sapte440
d ititIc sitsi-ew\ Log lighter (gas) 10.00
•-•. ...' , Wood/pellet stove I 0.00
__.-------
Wood fircplace/insert 10.00
, PROPERTY OWNER : ... • • . • I ..... • : • • .;,..::.„; ....:t:. - • V i,... ,.., .,.: . ::, .'l .:. Chimney/liner/flue/vent 10.00
..
10 (IU
Name: Al I. . 1 1J Ai a :• A .- Environmental exhaust and ventilation
-, Range hood/other kitchen
Address;
/07 ..SIJ 411,,v.r . I . e.ui ment 10.00
City/State/ZIP: - • Is,. (3 Cr? ;a 41 Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms.
Phone: o ) , / .--- 0 6" Fax: ( ) toilet compartments. utility rooms) 6.R0
0 APPLICANT • . • . , ..i • 7 ,:i: ..fERROKit'P:.ki.'• Attie/crawlseLlee fans 10.00
— ' Oilier: 10.00
Business name: e i1/2 . 11 #1,.. t A, LLc. Fuel piping
Contact name: Cl #( # g,,4,cfp,1/4.) $5.40 for first four; $1.00 for each additiona
Furnace, etc,
Address: Gas heat pump
City/State/Z1P: Wall/suspended/unit heater
..
—
Phone; (57/ ) 313 - 1 qto Fax:: (J)'3) 6 rl- 7 Yi— Water heater
Fireplace
1-mail: Range
. .
• .. coNniAtrok • ..: ..-:•... . . - •.. :; -:•••..:• Barbecue
Clottescq dryer er spa
Business name: &,#., t J J4(- 4.- Arrr Lle- Other:
Address: e , 6 g 2- O 7 •• • :MECHANICAL PERMIT FEES*
City/State/ZIP: AI_ 972er) Subtotal
t,, Minimum permit fee (572.50)
P ( 31 3 ) ,233 - I? 2 7 Fax; (j-v 3 ) 4,j-/-.73?j--- Plan review (25°A of permit feel
. •••-.112C13 lie.: / eirq 2 ki ININ. ... State surcharge (12% of permit NO
TOTAL PERMIT FEE 11:
Authorized signature: r IIIKI rrlii... • ..10. T1111 permit application espires if a permit is not obtained % n
ithin Ian
days offer ii has been accepted as complete.
[ Print name: (//d e (1, r i...; alimiiiii izamommi • Fee methodOlOity set by Tri-Cooniy linildinit Industry Servicu Board
440-40177111/02/COMMEB)
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