Permit i pil CITY OF TIGARD MECHANICAL PERMIT
' CO MMUNITY DEVELOPMENT Permit #: MEC2010 -00073
T IGARD' 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/17/2010
Parcel: 2S 103BC07900
Jurisdiction: Tigard
Site address: 12207 SW LANSDOWNE LN
Subdivision: FYRESTONE Lot: 18
Project:
Project Description: Replace furnace.
Owner: FEES
ROBERTS, JOHN L & Description Date Amount
COWDIN, LINNEA A, 12207 SW LANDSDOWNE Furnaces < 100K BTU 02/17/2010 $46.75
LN 12% State Surcharge - Mechanical 02/17/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 02/17/2010 $43.25
Contractor:
A TEMP HEATING & COOLING INC
16000 SE EVELYN ST
CLACKAMAS, OR 97015 -9519
PHONE: 503 - 650 -5014
FAX: 503- 557 -2990
Type of Use: 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 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.
a s212_
Issued By: CAC I) Q ) j NA Permittee Signature:
1
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.
02/16/2010 15:40 5035572990 A -TEMP HEATING PAGE 01/02
Mechanical Permit ApplicatioRECj 4.$46:11:6 f>rt ifs r uti L > ,,-,'4. :.
' Ca of Tigard �� ir,
� Received
V g Dafell3 Permit No,; Eili
gs•` 13125 SW Hall FJlvd,, Tigard. OR 97223 y' _d: tl
w' Phone: 503.639.4171 Fax: 503.598.1960 FEB 1 7 ' �� Other Permit:
,. tf Inspection line; 503,6+39,4175
T i G'A'1: +tl Date Rcady/By: I ® Seel ! " aq e 2 far
1, Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: 11 C Snppld�ricntal Information
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n'' � onlreplacemcnt performed, Indicate the value (rounded t � 1 v,. � ' - 1 aa,nrrd 1, n,,,. i,
aluc of the work
❑ Ncw construction Addition/alteration/replacement
Mechanical permit fees* are board on th o' he nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, d., erhead, and profit.
[ l) t it jf r({ltlr. a i! n n , 1. rN „ Value;
Pi Ai � Pi1, ,,$ �ljt' ri1j,,',il + ! lil y , iji,zl ;� $ °11t> I w �, c >r rrra y� Ili �l !�I��p $� +' Y �,! il:Ult. i �, 1 i i �I
1- and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building {1l 1 ,°.Jvl,. tins, ,rr-1� , , r�r id.,, Iii 1 ,li li 1� �v14t. , g} r r �, � tf I n , 1 ,
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111 Multi-family �y � ❑ Massttcr� y�pp El Ot For special trlforrnafJOrr use ,aseelrllxr.
k) i1i l' r ,! r �I' `''�1I'hl'l"(iK�rvJlll ,i�u+f W W'lv `Ltl i rl j Description I QP v. Fa, I TOta1
'.: Phi i 9t!11jll, l .i� 11 t ' 1 { i „ ° II ri ,,' .” �!u i r, v,l{ {; It'I ll - cating /coo
jlilt (, i." ,. r ��b 1 �,,,+ � . „ L � � � �1 I � q � i ,, I ,l f3 ling i
� A ir conditioning
�ob site address: 0, M 1 m_1. � A4 , `: ' a rc uirca ait� show placement) 46.75 /,
City /Statc/ZIP: - ' At At / <9 Furnace 100,000 BTU (ducts /vents) 46.75 0 iii IP Suite/hldg./apt. no.. Projcctnbmc;
Furnace 100.0001- BTUJducta/vanta) 54.91
Neat pump 61.06
Cross street/directions to job site: Duct work j 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
—
Unit heaters (Reel -type, not electric), i
in -wall, in -duct, suspended, etc, 46.75
Subdivision: Lot no.: Flue /vent rim any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
—
r r.i1'! ,(r i n,i'.l „iiE, '( t l I I' I J , 1 v l it I`ii�ll � 1 , , 11,d + 1 ,r `(! ' 1 :' I , l ail li ; r I , i°c �' Water heater 23,32
1 tz 1 d I)y/ !g° i i 1C 11 ���{ t §1ft ,1 yi��lj {�I$d t i li it 1 { I1r i i r i i j ;`
1+1,),V.r {I °,.� 11 ,( {..vGr ,Ir, w,Il: U;it�A�7:L'` , „nl,t.,:i k,grbl4_I•VLllt � ,i �4 i!�+ ,ill,', 1, , 9 {I'%I I V
Flue f vent f 33,39
1 ill \ �' J , ., � Flue vent for water heater or gas
_.*A.X.N1--34,11. fireplace 23.32
A lL.P.- -'Q' Ihtcr (ga9) -
— 23.32
Wood/pellet stove _ 33.39
Wood fircplacc /insert 23.32
Chimney/liner/flue/vent /liner /flue /vent 23.32
1 { v .1{11il�'Ifl'P r i't P1ilF tjl
'7'ajt9,�;eii ,Iti ,101 ti, l , I I Prr
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,a•,,;, �� ,I 11,61 -i ' J �1r1`iljll•, ! P 1'�j,l� ���' ",?'",�', P 1 i � "u,:,� � Other' 23,32
-
Name: environmental exhaust and ventilatinnj
Address: Range hood /otter kitchen
(�'►.,.[, . equipment _ 33,39
City /State /ZIP: (110014i-- Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: fill, �f r Fax: ( ) toilet compartments, utility rooms) 23,32
;C r 1 i i
, 1 '{!:' f,, "� "i " I rir i `f ,„ r fP lo' 1{it!' Attic/ernwlspace fhns 23.32
�'t6 r'1hP �f `��I'�I $$ °li ° � jl/ l'4' 1P�111,'> $ r t$rlll ;l l.Aiii i, d)?fll� :P ,, 4r 1,1;, $; `' ,?.` k),„$3 i t :
Business name, �/ Other, 23.32
i 1 Q � 0 , Fuel piping •
Contact name: . r ` • `o ' S for first four, $4.03 for d:nch Addttlonal R ,ok
Address: p � � � Furnace) c.
�� iy,' �V_ J Gas heat pimp ,
/I
City /State /ZiP: i e k , a 1 14 - i( 5 U / � 0 C 7/ Wahi /su
Phone:5D3 6 c. 4+ Fax: : (503 5t_ -9 b Water heater
Fireplace
E-mail: 11. is • A ..,...la ( .la . 4�4 �l ! ■ Range
�, h ::: ,t, !r• l, gllt,f, , A ar n °i , " a, "r { V 41 ',� llr Ij 1f Y I f , l f(1� r� Ifzlt f } y I j {V { I { 1 1l t C { I 1 Barbecue
/ ' 1 1 tI r{[w I ,!:i 14 i ° l�rtl 1 ..,aikti , , If.., Li V 'f°I$tX,n1„i!1, I�i 11„ 4,. $ ' $If,11 C11,6i1 1i $i,11$, I , 8.
Business name: ��7 ►r� la �.! Clothes dryer (gas)
`/ �I r 1 Other:
Address: G-f2 l r r ll l o l l s r I ', "v' r r i r ;
6f$1(I$�t$i1l(,l„ I�k'$$!¢P '1�?ttt�1lvt' Isrl`�I$�'sl,liflj$llllill$ati.
City /State /ZIP: a . i p i ''' '� CJ' l �` rubtotnl
Sail.. pax . � Minimum permit fee I'Ii90,OD) � D -00) Phone:
c � C_.1 tj iO Plan review (25% of pci licit fee) ---' —'
CCB tic.: l \T--1 -'—• State surcharge (12 %ofpcl ace)
TOTAL FERMI 'li' FEE (DO • 0'[,,
Th perm nn dication expires if a permit i1 oat obtained within 180
! Authorized Signature , , _ days after it has been accepted {,', complete.
Print name: /,,, L .,,, ` Date: '. , L l id • Fcc methodology act by Tri- County Buildin� Industry Service Beard
1; 1AUIldIng \Pcrmlu \MEC.PcrmitApp.doc 10/01/09 440 - 46I7T (1I /72 /COM /W13A)
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