Permit MECHANICAL, PERMIT
Er CITY OF TIGAR
COMMUNITY DEVELOPMENT Permit #: MEC2009-00587
Date Issued: 11/03/2009
TIGARD; 13125 SW Hall Blvd., Tigard OR 97223 503:639.4171 Parcel: 1S133DC10500 •
Jurisdiction: Tigard .
Site address: 13240 SW BRITTANY DR
Subdivision: BRITTANY. SQUARE NO. 3 Lot: 71
Project: Stock
Project Description: Install furnace and vent.
Owner: FEES
STOCK, MICHAEL & MARY Description Date Amount
13240 SW BRITTANY DR Furnaces < 100K BTU 11/03/2009 $46.75
TIGARD, OR 97223 FlueNent For Any of Above 11/03/2009 $23.32
PHONE: 503- 524 -6247 12% State Surcharge - Mechanical 11/03/2009 $10.80.
Minimum Fee Adjustment - Mechanical 11/03/2009 $19.93
Contractor:
ROSE CITY REFRIGERATION HTG & AIR
PO BOX 19207
PORTLAND, OR 97280
PHONE: 503 -636 -5371
FAX: 503 - 655 -4669
Type of User SF
Class: of Work: ALT 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 formore the 180 days. ATTENTION: Oregon law requires you tofollow 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: 94/ „9,30/31... l e-7Q /(j
r�
Call 503.639.4175 by 7:00 a.m. for an inspection that,business day.
Thispermit 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.
Nov 03 09 03 59p Rose City Heating and Air 503- 655 -4669 p.1
Mechanical Perm Appl RECEIV ' ( � ?, , a ° _ " "' i ,rFOR`OF FICEIUSE O r N� LYn� " ,' I W itt Vi � ' t�P rz
■ilwrt i Iwlla�:� s'.tii_. s A, Fr:f � 4: °.:
q�, �r Cit o f ti Recaivcd
�9 h 54 5 g lvd:. N Date;By i ii .> a-� A�/ ' NrinrtNa, /6(i02V 1:91,1,2905.2.
..��V5
s 13125 IIall Blvd I tgard, OR 97223 N O V o 2 200i; Plan Review .ur�6 -
w Phon ; 503.639.4171 Fax: 503.598.1960 TIGA �Date;lly Other Permit:
Tr1 ARO' ' Inspection Line. 593'539.4175
• CITY OF 1IGtY P � i de 1 uli - Bv; 1-1 p Scc .Pagc 2 for
- • !C Int.tncl: witiZt tiga or. � illoutied. • �lethn I Sapplementat Information
BUILDING DIVIS ON • f
TYPE OF WORK COMMERCIAL f EE" SCHEDULE - LSE CHECKLIST .
❑'New construction Addition/alteration/replacement Mechanical permit fees" are based on the value of the Work,
performed. indicate the value (rounded to the nearest dollarj,of all
❑ ❑ Other: mechanical materials, equipment, labor, overhead. and profit.
CATEGORY OF CONSTRUCTION Paluc:9'
El I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building RESIDENTIAL EQLII I SYSTEMS FEES*
For special information use checkltsi,
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling ■
Job site address: 13240 SW Brittany Drive Air conditioning
(requires stra plan showing placement) 911.75
City 'State; /.1P: Tigard, OR 97223 Furnace 100.000 BTU (cucts/venu) 1 46.75 6.75
Fumaee,100,000* BTU (ducts :vents) 54.91
Suite /bldg .apt. no.: Project name: _ [Czatptimp 61 06
Cross stieet'directions to job site: thtet work 23.32
1h'dronic lint water system ' 23.32 1 - ' �
Residential boiler (radiator or
hvdronic) 23.32 _
• [Init healers (fuel-type, not electric),
.. y in- wall,. in -duct, suspended, etc. 46,75
Flue /vent for any of above 1 I 23.32 23.32
Subdivision: Lot no.:
Other: 1 23.32
Tax map :parcel no.: Other fuel appliances
Water heater
G
DESCRIPTION OF WORK _ 1 23.32
as fireplace
33.39
• Install 96% furnace blue tent for water heater or gas
fireplace 23.32
Log lighter (gas) _ 23.32
Wood/pellet stove :33.39
Wood fireplace /insert 23,32
•® PROPERTY OWNER D TENANT Chimney /linerll]ucrvcnt 23,32
)their: 23.32
Name: fblike and Mary Stock ,Environnecnta exhaust and ventilation
Add ress: S: ine
.Range hood'other kitchen
equipment 33,39
City; State'ZIP: Clothes dryer exhaust 33,39
Single -duce exhaust (bathrooms, •
Phone: 1503)524 -6247 • Fax' ( ) toilet compartments, utility rooms) 23.32
• 0 API'EICANT ® C:ONTACT PERSON Attie'rawlspace lhtis 23.32
Business name:
- Other: 23.32
- Fuet piping
Contact naive: Chad Bruw $14.15 for fi,rst four: 53.03 for each additional
Address:
Furnace, etc.
Gas heat pump
City :State /7JP. Wall.' uspendcd'unitheatcr l
�-
Phone: (503)519 -6330 1tax :' ( ) Watei
Fireplace
I? - moil:
Range
CONTRACTOR Barbecue
Business name: Rose City Heating & Air Clothes dryer (gas)
Other:
Address: PO 13or 19207 MECIIANICAL PERMIT FEES*
City /Stat•'ZIP: Portland, OR =97280 Subtotal 76.07
Minimum permit fee (S90.00) 90.00
Phone: (503) 636-5371 Fax: (503? 655 -4669 Plan review
( 25% of permit ice) 6\17 . CC13 tic.: 161325 3/ State surcharge t 12:ro of permit Ice) i 10.80
TOTAL PERMIT FEE . 100.80 +
•
This permi a pplication expires if n permit is not obtained within 180
Authnrl - stgnalur days after it has been accepted as complete.
( n.,._. 11 11.1 no 1 " Fee methpdo loev set. by Tri- Ctmnty Buiidinc Indusln• Service Bna;d
r:.i_ ' Aoljf'o /-n 01j2/oy