Permit
n CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2009-00611
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/17/2009
Parcel: 2S111 DC13700
Jurisdiction: Tigard
Site address: 15845 SW OAK MEADOW LN
Subdivision: Lot: 0
Project: Pitkin
Project Description: Replace furnace and a/c, leaving a 3' setback between a/c and property line.
Owner: FEES
PITKIN FAMILY TRUST Description Date Amount
BY NORMAN R/JOYCE F PITKIN TRS, 15845
SW OAK MEADOW LN Air Conditioning 11/17/2009 $46.75
Furnaces < 100K BTU 11/17/2009 $46.75
PHONE: 12% State Surcharge - Mechanical 11/17/2009 $11.22
Contractor:
TRI COUNTY TEMP CONTROL
13150 S CLACKAMAS RIVER DR
OREGON CITY, OR 97045
PHONE: 503-557-2220
FAX: 503-557-0919
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $104.72
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: q ~ Permittee Signature: Qu ✓'`Yt p
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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MechanicaLPerniiteAppDication r�r� ` „y," I i l litil ( A v .- v .' � 'N a / .,, ,, r:
:, ' 1 i,i' Received
III City, of Tigard oatetny: 1 1'ermitNo..
13125 SW Hall Blvd., Tigard, OR 97223 y •
Plan Review
Phone: 503 ' Fax 503.598.1960 i .Other P 1 ($Q .S® .t n
DatclBy: `f
1 kill Inspection Line:' 303 639_4 Date Ready/By: n - See Page 2 for
„IN e, ", _^° Internet: www.tigard-or.gov Notified /Method: Supptemenhtl latonnaHnn
TYPE OF. WORK COMMERCIAL FEE• SCHEDULE -.
0 New construction Mechanical permit fees* are based on the value of the work
Additiotr /alteration /replacement performed. Indicate the value (rounded tote nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
I -and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® y g ❑ Commercial/industrial ❑ Accessory building
El Multi-family ❑Master builder ❑Other. . For special information use checklist,
Description I Qty. I Ea. I Total
JOB SITE :INFORMATION AND LOCATION Heating/cooling
Job site address: 1 5$45 6W occK roc) U1 . Air conditioning • )
+ " (requires site plan showing placement) I 46.75
'r�(1/
City/State/ZIP: t,►"d. 61122-4 - m
Fuacet100.000BTU(ducts/vents): 1 46.75
��JJ" Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldg. /apt. no.: Project name:
Heat pump 61.06
Cross street/directions to job site: Ductwork . 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
tn-wall, in -duct, suspended, etc. 46.75 _
Subdivision: Lot no.: Flue/vent for any of above 1- -
Other:. 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK .Water heater - 23.32
* _ � Cu f � , � / ��` � Gas fireplace 33.39
' t ` r o Flue' vent for water heater or gas
fireplace 23.32
Log.lighter(gas) 23.32 •
Wood /pellet stove 33.39
Wood-fireplace/insert - 23.32
.PROPER'TY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
NO i � 11
Other: 23.32
Name: Environmental exhaust and ventilation
Address: G �
Range hood/other kitchen
equipment 33.39
• City/State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone:: ( Q ( - k 1 of Fax: ( ) toilet compartments, utility rooms) 23.32.
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32 .
Other: 23.32
Business name: Same as contractor
Fuel 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
Water heater
Fax ::
Phone: ( ) ( )
Fireplace -
E -mail: Range
CONTRACTOR. Barbecue
Business name: Tri County Temp Control Ot s dryer (gas)
Other;
Address: 13 S Clackamas River Drive MECHANICAL PERMIT FEES*
City/ State/ZIP: Oregon City, OR 97045 Subtotal C t3)
Minimum permit fee (590.00)
Phone: (503) 557.2220 Fax: (503) 557.0919 Man review (25% of permit fee)
CCB lie.: 72623 State surcharge (12% of permit lee)
TOTAL PERMIT FEE
This permit application empires if a permit is notobtained within 186
Authorized Signature: ((y days after it has heen aceptd ns complete.
Pnt name: V I art Mean Date: 1 t (I LQ 1 • Fee methodology set by Tri-Comity Building Industry Service Hoard
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