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Permit • IL r CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2010 -00067 TIGARD, 13125 SW Hall Blvd., T OR 97223 503.639.4171 Date Issued: 02/12/2010 Parcel: 2S112BB02500 Jurisdiction: Tigard Site address: 8340 SW COLONY CREEK CT Subdivision: Lot: 0 Project: Cissna Project Description: Replace gas furnace. Owner: FEES CISSNA, TAMARA L Description Date Amount 8340 SW COLONY CREEK CT Minimum Fee Adjustment - Mechanical 02/12/2010 $43.25 TIGARD, OR 97223 Furnaces < 100K BTU 02/12/2010 $46.75 PHONE: 503 - 476 -5264 12% State Surcharge - Mechanical 02/12/2010 $10.80 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: Natural Gas 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. Issued By: /el/ Permittee Signature: O �/L/ C62 —�"j6/1./ 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. 02/12/2010 10:06 5035572990 A -TEMP HEATING PAGE 02/02 s ECEIVED /I s itanigal PeY ix A / 01 (tit 0 1 - 1 if I � i f0 i N1 v ' ' ' ,, . 4.` I ><cat><o �� � ���Y t4 C rt:lRA 1iita�!!>�#i -'� � �La.ct � � , > I t R 1 'Erntit Nn.' °�� City of Tigard R o:B e v y ,02 /.//0 - /`9EC'�0 /O -00000 j ' n & Xi ; , 131255W1- lallRlvd,,Tigard.OR 97223 FEB 1 2 201 PianRevt ��11crPcm,it: i i 1l Phone: 503.639,4171 Fax: 503.598.1960 Date/By: "- ,,artA i cctio nspn Line: 503,639.4175 Mac Reedy /Bye h':: ® See Page 2 for si 1 G A It 1-ii i' 2 g CI OF TIGARD No tified/Method: 7' Supplemental Information r�uta:�r1 Internet: www.tigard-or.gov ov _ , BUILDING DIVISION , }rt r Ott. � ,� K 1.7 f'd dt o ,� I :1 u( t1IN N11 1 I I .''' r' t .' , 4 1f 1,tp1 {'�'ii 3! f, "yt�',ri i Q 9 �o 'W. .!' f J4 rd tt✓ ! .' , r t ! , �jjtl.r rl� ';1p1i t;; t .'li l y I .0 t , i „,, nog' 4 IS V ' i a �1 t! i X ?.t ., . lA 1 � 9" �.1 ' M ∎ ( p i`.,., G 1 awerw i� ' 'Ih �{Ot r � .t. - IR , - A > b I d 4 , null 1 Mechanical permit fees are based on the value of the work ❑ New construction Addition/alteration/replacement performed. Indicate the value (rounded to the ncareat dollar) of all El Demolition Other: mechanical materials, equipment. labor, overhead, and profit. >a t .1 Alf t x a '� • ;11 ' •o 'Iii 'g ,,p,w Value, $ t ll i { s}1'�t „ °l i i (. lt 't:. • r n W r a „ i.' pp �� l�yy t,y�pyt, ,. . It (` {: in 1 1 Jt, 1 �`.p t P ,l. { ! tl.. IIN Yfl 1g§ t, x, a rvt ,, ,�r6 �, tk�,,., r• �. S'.tu d3" t trr,.,� rn �,.. '�,t{ , "3 �"�', ? / 'pd�' 1� � � a ', 1 ^t l', , , . 11 . 1Y� 1 MA I, r �Y%� l 11'. I I in,rr POI'? "' ,. ila 1- and 2- family dwelling 1:1 Commercial /industrial 0 Accessory building For spr_cial information use checklist. ❑ Multi family ❑ Master builder ❑ Other: Description Qty. Ea. Total ,t •n!,;•; t r{o qq 4 n(� {Y , i' a { I1 1 °' � M, ! �,�j 1�f Y19�( �1 { 9 r.� Hcatin cooI1n y g „ �1111�,y� „L �IIp l � il l ' %. � k---1 tO t I�f 1 1'tft 1{ 4,: fi/ g ri ! Air conditioning _ lob site address: . 3 L- ' C4 .X .,4.L.,-. rc•uires cite .ten Onwin .Iaccment 46.75 0_______9_2_"D--P-14 Furnace 100,000 f3TU�ductalvcnn� 46.75 ill' i (,z CitylStatc /ZIP: 1 (2 Furnace 100,000 BTU (ductslvents) 54.91 Suite/bldg. /apt. no.: I Project name: _ Heat •um r 61.06 Cross street /directions to job site: Duct work - IME1� 1-1 dronic hot water s st 23.32 Residential boiler (radia(br or • hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, sus.cnded, ctc. 46.75 . _ -' -- Flue /vent for any of abn.'vc 23,32 Subdivision: Lot no.: Other: 23.32 Tax map /parcel no.: Other Net appliances • T� ' t01 + + '' %' t 1 it; ' 4 Water heater 23.32 rl lr. ^; ," 1 r { tr r n',T; ` g 11 " , �ic O,Ifig V'.. r f , ,, ;'` t $ C�`� 1i.1,,;{���jl {,{ 6 ; 1 , Ftp'�I { H'1a�� ,.i.ii t , t ,� 4.v,. r l v iti, ,l +1C t. k5' tl ' Gas 33.39 Flue vent for water heater or gas �� td ---�- r'' - fireplace 23.32 Lo . li - htcr ( ,s 23.32 Wood /pellet stove 33.39 Wood fire • lace/insert • 23.32 Chi /liner /flue /vent' BM t r 1 I % 'u f 1'9 Iftl H{ %7i,u MI n !��� � r + t ".h 11 � t � ly C 'i'rj. ' It `s F 1{, i , P { 9t,t(..,;" n'1'r i, , C� .. f Y ,, . y .tt ,lf �.t4 j ��r . .,t. ' NI 1 ' t ,' rh� {� �,.. .,1 - Other: INN 23.32 Name: �� - .( C, y � Environmental exhaust :and ventilation W Range hood /other kitchen Address. m. / cquipment 33.39 , City /State /ZIP: our T- ~ t !WV 1 * ! Clothes tlr t exhaust i; 33.39 Single -duct exhaust (bathrooms, Phone . L_I r Pax: ( ) toilet compartments, utility rooms) 23.32 { �6t T,rL��.( r,�y� , : {t ; ' ' Attie/crawls ace fans ;' 23.32 , r ; I t r t n r r � + WI I t 1 If ' f ', i �1 t l i `{',1'� },i {� 'l I(r+�l U 1 lWW A l g a �.i�.j, ., ' 9 i1 p 'rtl�iyiw!�li�t 4,1!iStayt��4Fr1i��;p ',S it� 'tlf,(�;�rl' + {ta.l,t„ 'c�.3w,5'f 1d4 .� { {.. �� �� Other: _ 23.32 Business namc:�e�© ,01' l.-G�•CI1 Fuel piping ' + Contact name;-- l 1e_ ki: ±' f- $14.15 for first tour; $4.03 for each additionni Furnace. etc, Address: i5 Gas heat. pump � III � City /State/ZiP: C japigaroftaa____91S21 c Wall/sus • enclaunit beater 5`) 1 �� Water Pho ^ ne: ?� 42 �I Fax f Fire .lace E -mail: Ran :c Barbecue �- �, , yr +% v c +'e/ 1 p; } g %lf � � t' i t at {i + <t 1 pp "l Y! � r��(p >) �e l x ;t ' ! { rE �i 1 I I , d7 � ° � �� t k� I } }u � ri i l t r� 7 � I> l I l P i l i ti 9 [ I ,4U �1I1'y b�� � �d t�yt� � �� t �- Ci��, A i4 '� I fl f f� i�`,t1�'� ^tM ! ' p; '. ��ir,�E ��' Y, � 1 'J.. �'i ,{1 ", .;.tit �t� , a %1i . l , t �,l ,�.,� � V � Clothes dryer (gas) � Busin n ame r Inc Other: Address : - • . � i ' if rf � „I fir `E r'; , '; ,i t %1 �t� ° `` 'i, t City /SlatciZlP: C. , , , , , f .,5 ( 9, _ Subtotal MEN Minimum permit fee ($90.00) C ne: '31 lo 5b l9 t Fax. ) 6. ) Plan re low (25 °/n of permit fee) , C he.: rj ✓ ._ Dto , 09 ,„ V TOTAL PERMIT FEE . Thls permit nppHcatlon expire* if a permit In not obtalted within 180 Authorized signature :C _ ~ days aftor It bull heen accepted as comptetc. \ f)ato: " Fee methodology ect by Tri- Cottttty Building industry Service Board Print name ) �.- 1. \fitdldlna \Permits \AilC PcrmitA . � u / U.' MO- ar,1'17'(1I /o2 /CO's /wan)