Permit
q CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2010-00090
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/03/2010
Parcel: 25111 CC21700
Jurisdiction: Tigard
Site address: 10290 SW GREENLEAF TER
Subdivision: Lot: 0
Project: Stark
Project Description: Install a/c.
Owner: FEES
ANDERSON, HELEN TRUST Description Date Amount
BY EDWARD JONES TRUST CO, 12555
MANCHESTER RD Air Conditioning 03/03/2010 $46.75
12% State Surcharge - Mechanical 03/03/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 03/03/2010 $43.25
Contractor:
TRI COUNTY TEMP CONTROL INC
13150 S CLACKAMAS RIVER DR
OREGON CITY, OR 97045
PHONE: 503-557-2220
FAX: 503-557-0919
Type of Use: SF
Class of Work: NEW 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 by calling 503.246.6699 or 1.800.332.2344.
t
Issued By: Permittee Signature:
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.
FEB -27 - 2010 09:41A FROM: TO:5035981960 P.1
1(A
Mechan .Application R i' � rka k ; ,,r , r r I ,�t1 1� r ; r . t 3 t � t rt'
„ r ^ � l-f -,- ) I " It I I ti m1I \1 \ , i J t
', J � fi i ���r 5t � � �_'� --...,,,,,i.,, qa � , dy
• a 17. - 0 r q „y Cit Of Ti ecel 1'' ' 1: �.,''''L a:.
1 - . ' F . ► 1. , Permit Nn.: 2 6 •IJLT(
" •s ,13125'SW Hall Blvd. Tigard, OR 2 .2 �4 : i '
• -
s I ® i ;Phone: 503.639.4171 Fax: ,i 9: ;4,0 (/ n Dn qw Other Permit:
p15,1 400 0 , Ins coon Line: 503.639.4175 5.�.IY 6`r°'q y"
•
d
l ft' +; 1 i.. . Internet: w S g BUILDING 1 o�/By 1 See RI Page for
7 °- l��- ww.ti and -or. ov BUILDING N +. ie�Method: Supplemental information
. , „ T,YFE o1 WQRK . : oOM1.4t - 4 f AF FEE S bfE'DiJ[,E llSF C)FIE LOST
❑ New construction . ® Addition/alteration/replacement Mechanical permit fees* are based on the value of the work y
performed. Indicate the value (rounded Lithe nearest dollar);of all
❑ Demolition ❑ Other: mechanical materials, equipment. labor, overhead, and profit.
CA TEGOttY. ` . OF C t3JVSTRRUCTION Value: $
1- and 2-family dwelling Accessory building y ailing ❑ Commercial/industrial ❑ Accesso buildin For special irtJa / SYSThMS FEk
RESIDENTIAi Et? '
tue yheckll E .
❑ Multi- family ❑ Master builder ❑ Other:
Description 1 Qty. Ea. 1 Total
'JOB SITE: 1NFORMATIO]s('-AND ...00ATION • ' liestim/cooting
102(10 6 WI rec 1 f ( conditioning
Job site address: °I V CC.J7 YY��JJ l. L ` lla 6 `�:Q1x.) (requuires site plan showin�gplacement) 1 46.75
- Tigard
City /State /ZIP: £112244- Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ductsA'ents) 54.91
Suite/b1dg. /apt. -no,: Project name: Heat pump 61.06
Cross street/directions to job site: Duct work .. 2332
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in'wall, in suspended, etc. 46.75
' Flue /vent for any of above 2312
Subdivision: Lot no.:
Other: - 23.32 _
Tax map /parcel no.: Other fuel appliances
1)E$CIU1! )ONOF WORK,
'Water heater '2312
Gas fireplace p 33.39
}({ I r� �/}/ y Flue vent for water heater or gas
4 In tall � air c LL�r I I o� fireplace 23
Log lighter (gas) • 23.32
Wood/pellet stove 33.39
Wood,fireplace /insert - 23:32
- - Chinutey/liirer/flue /vent 23,32
PROPERTY OWNER , • ❑ TENANT`. • . • -
� ' tither: 23.32
Name: 9 t (r(� Uto K Environmental exhaust and ventilation
Address: 001C) t
-Range bood/other kitchen
equipment . 33.39
City/State/ZIP: - Clothes .dryer ;exhaust . . 33,39
( ��) �6�4k r - Single -duct exhaust (bathrooms,
Phone: Is Fax: ( ) toilet compartments, utility rooms ) 23.32
•
` ® APHP ICANT; ❑ CQNTACT PERSON` Attic/crawlspace fans 2332
Other: 23.32
Business. name ::Same as contractor
RIC( piping
Contact name: Diane Mason 514.15 for first four; 54.03 for each additional
Address: Furnace, etc.
Gas heat pump
• City /State /ZIP: Wall /suspended/unit heater
• Phone: ( ) Fax: : ( ) W.ater heater
Fireplace
E-mail: a
CONTRACTOR? Barbecue
Business name: Tri County Temp Control Clothes dryer (gas)
Other:
Address: 13150 S Clackamas River Drive ER
MCIi'ANlCA6;1'E12MI,T ° FE$S* '
City/ State/ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 557.2220 Fax: (503) 557.0919 Plan review (25% of permit fee)
CCB I ic.: 72623 State surcharge (121/4 of permit fee)
TO'I'AI, PERMIT FEE III
signature: This permit days after has ac epted as complete. within IRO
Print name: 1)10P P.Q f Date:, 42jel) b • Fee methodology sel by Tri - County Building Industry Service Board
t:\B Idui ` fcno-'App uoc tOW1/e9 440.4617T (I 1/02/COMPWIR)
0, Lela SXir CkQz