Permit
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q CITY OF TIGARD MECHANICAL PERMIT
0 COMMUNITY DEVELOPMENT Permit#: MEC2009-00448
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/25/2009
Parcel: 1 S 136AA02201
Jurisdiction:
Site address: 11153 SW 65TH AVE
Subdivision: Lot: 0
Project: KESSLER
Project Description: Fire damage repair: Install (2) gas furnaces w/duct work venting and gas piping, and vents for (3)
bath fans and range hood. 11/13/09, add wood fireplace.
Owner: FEES
KESSLER, JULES Description Date Amount
8700 SW 26TH STE H
PORTLAND, OR 97219 Furnaces < 100K BTU 08/25!2009 $28.00
Duct Work 08/25/2009 $20.00
PHONE: Flue/Vent For Any of Above 08/25/2009 $13.60
Range Hood/Other Kitchen 08/25/2009 $10.00
Contractor: Single Duct Exhaust (Bathrooms, Toilet, 08/25/2009 $20.40
AIR PRO HEATING & A/C INC. Utility Rooms)
7405 SE POWELL BLVD. 12% State Surcharge - Mechanical 08/2512009 $11.04
PORTLAND, OR 97206 Wood Fireplace/Insert 11113/2009 $23.32
PHONE: 503-771-7871 12% State Surcharge - Mechanical 11/13/2009 $2.80
FAX: 503-771-5579
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
Total $129.16
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.
Issued By: Permittee Signature: do c
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.
n CITY OF TIGARD MECHANICAL PERMIT
` COMMUNITY DEVELOPMENT Permit #: MEC2009 -00448
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/25/2009
T1GARD Parcel: 1 S136AA02201
Jurisdiction:
Site address: 11153 SW 65TH AVE
Subdivision: Lot: 0
Project: KESSLER
Project Description: Fire damage repair: Install (2) gas furnaces w /duct work venting and gas piping, and vents for (3)
bath fans and range hood.
Owner: FEES
KESSLER, JULES Description Date Amount
8700 SW 26TH STE H Furnaces < 100K BTU 08/25/2009 $28.00
PORTLAND, OR 97219 Duct Work 08/25/2009 $20.00
PHONE: FlueNent For Any of Above 08/25/2009 $13.60
Range Hood /Other Kitchen 08/25/2009 $10.00
Contractor: Single Duct Exhaust (Bathrooms, Toilet, 08/25/2009 $20.40
AIR PRO HEATING & A/C INC. Utility Rooms)
7405 SE POWELL BLVD. 12% State Surcharge - Mechanical 08/25/2009 $11.04
PORTLAND, OR 97206
PHONE: 503 - 771 -7871
FAX: 503 - 771 -5579
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
Total $103.04
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: C f1 ) ./ / 9 7 -07D L / ( -/ / p 4 /
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
- .0,5/ 21/2009 13:32 5037715579 AIR PRO HTG PAGE 01
:V
Mechanical Permit,, Application r r i Ic r
?..' City of Tigard Recewea ;
DatoB o 'ikr PcrmitNo,:,fi1 p
rt 13125 SW Hall Blvd., Tigard, OR 97223 y' s a �%f� ' /t�t�'a20 /� d
11 , Phone: 503.639.4171 Fax: 503.598.1960 D y Other PermiV 0
Inspection Line; 503.639.4175 "Qi 1 f
l i t t i i-) t)ate RcadyB 2 PI See Pepe 2 for
Internet: www.tigard- or,gov RECEIVED Noti ed/Method: Supplemental information • t t t le is 14 1 ` ,I R. ih ( Tii'1( tN - P ' it ,t�tf ��r r�';p'j 1, ?RF ?r c ?1 t "!
N : .,. ,..- ,yJat ad,... ; /..T A ,M r t �E.t.y;5 4 N , t t N ` lu ; nt .�,,a ;� I .�tr,;1 1 li { t y 1 '',-;,';:i.,-'1,'.? 1 l zt
. ,, +.,Y,.t 1 ,�$r�� S Itlttl'r �a�S { 1�ui_r + r ,C�,.....Jt ., ...ir. .. ,,.
❑ ew construction v ggddition /alteration /replacement Mechanical petmlt fees" arc based on the value of the work
❑ Demolition Q Other: C ITY OF TIGARD performed. Indicate thcvalue (rounded to the nearest dollar) of all
mechanical materials equipment, 1
. a 1 . abor, overhead, and profit.
t ., „, ,, I ,-::,77-17, . 1 ` T , dt r - r $
t {:!1 1p f ,.,t .r 'a1 ! ! i l lf if r vu pp .. i r s 1 vI Value ,$
,, .' ,... .... r, c. f. < +f .�..L, _a. .vx {. -, I ty r . ., ct, ..,. r 1rf ,n:t r.,� `f1 1 ..,{l: 1 A',tr }i 'tr:! t t D 7. 19 7 r t tl i u
1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building n I ° ' u onu '' "1 t' "' 2 r ' r °!;t' c
❑ Multi family Q Master builder Q Other: For special Irlformatron use checklist.
rr t , r�N, Description I Qty. 1 Ea. T otal
. ',i I1 t 1n, t 4t,11rt, i'�R' ��')nt r'r
ld l llE t if 0. ,
A .d,F!i Li. lc,�,:;�,..,1 Heating/cooling
Job site address: r 1( C Air conditioning or heat pump ad ,� p
rc� uires site plan showing taccmcnt) 14.00
City /Statc/ZIP: , c_
40 A Q Z - Furnace 100 BTU tducta�va __2„.....10
14
Suite/bldg./apt. no.: Project name: ) Furnace 100,000+ BTU (ductx/ventt) 17.90
Gas heat pump 14 00
Cross strcet/directions to job site: Duct work Z.- 10.00 "2-
- Hydronic hot water system 14.00
Residential boiler (radiator or
—
hydronic) I4.00
'—" Unit heaters (fucl -type, not electric),
in -wall, in -duct, suspended, ctc. 14,00
—
Subdivision: Lot no,: _ Flue/vent for any of above 7 6.80 2--
Other; 10.00
Tax map /pared no.:
1 Other Net appliances
t r. 'v ' t r, r q rt (' r r I T lti "^1" n, I q l V
�>l:! '+° gP,'+il ltt;r (1 .r li t r +r C, t It�Uf '4 ri B� +t w m 1 9 !rl '
I ) ir , .n .! , .al � l ia.ia�s � lf i .,.•..::r ' „i.¢i � i Water heater 10.00
� _ � / q fi
Gare lace 10.0
(' 0
, ij "� �-i',- c,_c. 4,.J r A, t c ,." � t, , /o , r fe ,, Flue vent for water heater or gas
fireplace 10.00
i i a . 1.. / Log lighter (R
10.00
• • Wood/pellet stove 10,00
Wood fireplace/insert 10.00
,1 it mtte /fl ue / vent 1
a : ,ill. , I � r ikI :...g :I! ,: 1.. cf .,4 t+! f. i 1f % ; lJ t Chi 0.00
,. re t.,C3., ty r7 ..".',, th i rrr';: :ib i' 1
Other: 10.00
Environmental exhaust and ventilation
Address: 6 t ... ✓e. Range hood /other kitchen 1 10,00 1
- equipment 1
City/State/ZIP: , , 4 + 7 22- Clothes dryer exhaust _ 10.00
Phone (� i ) Z [ ax ( ) Single-duet exhaust (bathrooms,
toilet campanments, utility rooms) . 6.$0 3
M r+t j'4 � ' 'E t � - 1� —�
::7;:'.'-;-:"""7:::,: � I t 1 1 l A,+ 1t i U� }I �,yt iili� 'F'it Z17 , T rl'�ilt� . lli m il Altic/rawl
SpBCC fans 10.00
�r,n,:q. p' ,Iry,�ritt, �` st�P..,i,,.,�',9,b d � S. � ,r �,, A � '� '�.� ''�'I $$�l ' >, ��
u ?rw a ,.e1Ju .el'AwSd.At1 h„ttl )e „1.
Other: 10.00
Fuel piping
Contact name: 4 G ` .ir ! for first four; 51.00 for each additional
Address: m« Furna etc,
t , Gas heat pump_
lisim
wan/suspended/unit heater
Phone: ( I f ,/ Water heater
Fir5lace
5 Range
v ” 4 %-,',(.::';'-', t'+ it l f 9r' !'g t t � r , 1 ri 1 q � t n al 1 . .i
; ,r .i,h n . dr.. r J, ' I a }, .. Barbecue
/V�.rc. . i, Elrl � ..h,6zY..,, t r tlsl. 1,0 ,1 t1.,,y,; t
A i )
I Clothes dryer (g
Address: e ` Other
{ ,i tt�,�U:' )�tittt , t
fir rtt '`-:7': '
/'hhil'i ,t ..; ",1n .:;k�`. tt� c "p ,1-j-;' ,��rl + ,.I
City/State/ZIP: e) ._ _ - J
7 7� Subtotal W a M
Phone: ( ) i_ Fax: ) / - Minimum permit fcc ($72.50)
CCB lie.: a y / I Plan review (25% of permit fee)
Q State surcharge (12% of permit fee) WNW
/ TOTAL PERMIT FEE
Authorized signature' Thi% permit application expirft if permit is not obtained within 1:1
days after It has been accepted as complete ..! V
Print name: (27,....9,. o c... r "� Date; Fee methodology set by Tri .
( 37._ � O f Y Cotmty illumine Industry Service Bo.
nnn •[,�T r„mn,rfl $/flPota,