Permit
l
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2009-00362
R 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/21/2009
Parcel: 2S 102AD03350
Jurisdiction: TIGARD
Site address: 12605 SW HALL BLVD POOL
Subdivision: Lot: 0
Project: Manchester Square Apartments
Project Description: Gas line to pool heater
Owner: FEES
THOMPSON LIVING TRUST Description Date Amount
BY J RONALD/CECILIA I THOMPSON TRS, Fuel Piping 07/21/2009 $5.40
1847 N 150E 12% State Surcharge - Mechanical 07/21/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 07/21/2009 $67.10
Contractor:
HEAT RELIEF CO
13122 NE DAVID CIR # 800
PORTLAND, OR 97230
PHONE: 503-261-9915
FAX: 503-261-9814
Type of Use: MF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $81.20
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: r Permittee Signature: u-yL, awWa~
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.
i .-,
Mechanical Perm � . , +, q ONLY , • , , , ' ,
e Permit. Application RECEIVE E ,� l F R OFFICE U SE
C I of Tigard - ecerved .
�h � g Permi N
t o_: I I , ,, gy p
e� 2009 Date /B y: M.d�!� ` 'L� �a—
7, 13125 SW "Hall Blvd., Tigard OR 9 JUL 1 2OO
S Plan R ev i ew
Phone: '503`.639.4171 Fax: 503:598.1960 Other Permit:
Date /By:
D Inspect L 503.639.4175 CITY OF TIGARL Date; Ready/By: Juns: g
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g g BUILDING DIvIsIo ar0t i fied/Meth o d: Supplemental Information
BUILDING r � r JJ >. xrk 3 RCIA * °mot ".< snFt L z
.00. , l'4-'P� F RK b MME SEE S( HEDL� SE CHECKIST
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New construction ® Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed, Indicate the value (rounded to the nearest dollar) of all,
❑ , Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
� �lEGO O AIT9: „,s" �v. ,G Value $
1 - and 2-family dwelling C omm er ci al/industrial . - ' '' '' `Q : FEFS �'
Et 1- g❑ 0 building For
El Multi - family ❑ Master builder ❑ Other _ is as Q T tai
� � t cc �: s _'z # nom+ ..� ". si,' " t - - __ I— y— --Ea:- -'I O - --
r spec information 'on use
Bescriphon - t .
g is o B:$ ORMA'f10 = D LO A 1!I c f: ,,. Heating/cooling
e 5- . . xW ., • ,n.�Wrn+'+�- nssh'ttvA�is��^�i✓. _:.'.$"4'+, „ze ^ ..:?9 ;;F .9 i >r:... ., �� _•___-
Job site address: / c) ) 4 ,_,, a /� / Air conditioning or heat
�o?��.� ,St SW (� �� (requires site plan showing placement) 14.00
City/State /ZIP: 77 0 c 7 3 Furnace;100,000'BTU (ducts/vents) 14.00_
Suite%bldg. %apt. no.: I Projectname: Furnace 100,000+ BTU (ducts /vents) 17.90
Gas heat.pump 14.00
Cross street/directions to job site: Ductwork' 14.00 •
• Hydroniclhot' water system 14.00
• Residential boiler (radiator or
hydronic) - - 14.00
' Unit heaters,(fuel -type, not electric),
in -wall, in.duct 10.00 .
Subdivision: I Lot no.:
Fluelvent for any of above 10.00
Other. • 1 10.00
Tax map /parcel no.: Other-fuel appliances
" ' f .10 ' Water heater 10.00
Gas fireplace 10.00
' Flue vent for water heater or gas
794Y3 , ' . . Ae � - - _ --- - - fireplace -- - :0:00 • I Log lighter (gas): I 10.00
Wood/pellet stove 10.00
• Wood fireplace/insert 10.00
' yt ti p .,, ® , ; ; Chimney /liner /flue/vent • 10.00
Other: 10.00
Name: a ,. A , / 1 ,- ( 5 - 40 ; , , ,J , r� Environmental exhaust and ventilation
Range hood/other kitchen -
Address - i i 01 Rio A> L equipment 10.00
City/State/ZIP: - Clothes dryer exhaust 10.00
• .. - Single -duct exhaust (bathrooms,
Phone: ( ) - ,: ' • • . Fax: ( ). . . ;toilet compartinents,.utilty rooms) 6.80 ..
x ! ° , 3 ,"`f,, :< ° _ t a� , a- A t t ic / fans ,.10:00
Other: 10.00
Business name: HEAT RELIEF '
Fueh piping • .
Contact-name: MARK DEFRANCISCO $5:40 for first' four; $1.00 for eacha •tional
Address: 13122 NE DAVID CIR DR # 800 Furnace, etc: .
Gas heat pump
City/State/ZIP: PORTLAND, OR 97230 Wall/suspended/unit heater
— --
Water heater `: _ •
Phone:' ( 503 ) 261 -9915 I Fax: ': ( 503 ) 261 -9814 Fireplace S y v
E- mail - Range
Sys 'l $ice . . 1 .sy: x se« " 4 ,r -4 r "." y ;;, B
Y
,;-- °:,i :,. ® i ter. -` Clothes dryer (gas)
Business name: HEAT RELIEF - Other `''(L 1,,k&4f -i✓ 1
e,
Address: 13122 NE DAVID CIR DR # 800 , " 4: ,, tr , ;,� ; s if ,-- , -, , , r
-
Subtotal
City/ State/ZIP: PORTLAND, OR. 97230 y •
. Minimum permit fee ($72.50) lc S7) .
Phone: (503) 261 -9915 Fax:, (503) 261 4814 - Plan review (25 % of permit fee) ._F}— -
•CCBlic. :122424 . State surcharge (12% ofpermit fee) Z7
TOTAL PERMIT FEE ,a / _
This permit applicator expires if a permit is not obtain within 180
Authorized signature: 2/Y21 . em•• < 40 - '- - days after it has been accepted as complete.
Print name: MARK DEFRANCISCO Date:
y * Fee methodology set by Tri-County Building Industry Service Board
I:\Building\PermitsN4EC -Pe miApp.doc 04 /06/06 440 -4617T (11 /02 /COM/WEBI