Permit 1_. CITY OF TIGARD MECHANICAL PERMIT
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: = COMMUNITY DEVELOPMENT Permit #: MEC2010 -00066
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/12/2010
T 1G ARD' Parcel: 2S 111 DD 12300
Jurisdiction: Tigard
Site address: 8514 SW AVON ST
Subdivision: CHESSMAN DOWNS Lot: 49
Project: Nielsen
Project Description: Replace gas furnace.
Owner: FEES
NIELSEN, MARY C Description Date Amount
8514 SW AVON ST Furnaces < 100K BTU 02/12/2010 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 02/12/2010 $10.80
PHONE: 503 - 432 -1644 Minimum Fee Adjustment - Mechanical 02/12/2010 $43.25
Contractor:
A TEMP HEATING & COOLING
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: ,/e / Pemiittee Signature: Del /5 j - hU/✓
J 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 09:09 5035572990 RECEIVED A TEMP HEATING PAGE 02/02
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al Permit �A.ppli(catu ni " '4. 7 '.r , 6 () NI, A 4 144,7.,' - e. .0r c't u .
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ti 13 125 5W Hall Blvd., 'rig, : i ' 9 '223 P l a n Review
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max & R D Inspection Linc. 503,639.' BUIL D1V1S1 c Rcady /By: Supplemental rnfarmaNen
T ;ti'A`Rf� interact; www,tlgard- or,gov Notified/Method: „!,_
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Mechanical permit fees are based on the value of the work
Li New construction ria Addition /alteration /replacement: performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead and_proGt
rar . 11.7 y�T .t m,, l ��� Value. $
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r F EC � ��Lor i 1 , 1 1 I. ert ',�l x'1 ' 4. .1 1 . . �J t '�lW.itl C barsR h . s ;; 1!"' tip'
x $rJSli��'�{ lk' �'�, �,� d ■ qt y,�,� ' ) ,.' t{ 4Wigt1,i.. r� "R ...e ,� fggrf2 41,1GS1 �'�,{ .
$ 1- and 2- family dwelling ❑ Commercial /industrial 0 Accessory building For special information use checklist.
❑ Multi family ❑ Master builder 0 Other: Description I Qty. , Ea. 1 Total
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• t r" '. ? /l' J a cl iii <r 1 . k nit' , bt u s ,fy,u i 't .�t� t `ii l a Hcatln, Conlin_
Job • 4 •
on Air conditioning
Job site address; , 5 - W ) ro•uitcs • Ian shoµ'in_ •laccment .111 46,75
Furnace 100 BTU (ducts /yenta) 11. 46.75 � S
City / State /ZIP: '�� ♦ ` •�' purnnco 100,000+ 13TU (ducts /vents) 54.91 MIN
Suite/bldg./apt. nn.: �'rojcct name: Q�/1, lica pump 6 61.06
Duct work A 23.32 Ela
Cross street/directions to jell site: H dronic hot. water • tart 2332
Residential boiler (radiat.r or •
— h dron rt! 2332
ljnit heaters (Rid-type, not electric),
in - wall, in -duct, suspended, etc. 46,75
Flue /vent for any of abo io 23.32
• Subdivision: 1 T,ot no.: Other: 23.32
Tax ma / arecl no.: r Other fuel appliances
. � ! i ) r; ^V'l� 61 �� �1 ip � �rr a n � i 'alb e � d t� "r'r Water , replace
' 33.39
23.32
yli' „ a ; A Gas fi lace
`_ * - plus vent for water heater or gas v f ireplace
_ Lop (gas) 23.32
Wood /.ellet stove 33.39
23.32
, mn � Wood fireplace/insert
,,,. -.,a r . .. r : (t' , y , . ...” I ra, r r Sy744� '" /liner/flue/vent �' e m m < FS ' Y. T' �1 t 0 , 'u � +' i
t 23 3
N ?� /kilt ,151 ut A: nits Y , z'. k�4 a /'1 Other: a nd ventilation
23.32
v ' nti�
Name: 4 � environmental exhaus
/ Range hood /other kitchen
Address: / _ ' li equipment 33.39
OW t J d er r► /' Clothes dryer exhaust i; 33.39
City/State/ZIP: Single -duct exhaustt. (hat7rooms, CSOI Phone ( • . . -- r L toilet compartments, utility r ooms) 23.32
EMT l 7 . I e . �' r r 1 , - r � 514 Pf t2 c �' b Attic /crawlspace fans 1 23,32
.,m N` t�. e w 1 l l a� t i ..• n i i i c4 d ,4,1 4) II� . "� Other 23.32
Business namc.A_7 j . p aL 4, a A i \ Fnel piping '
Contact namc:T � -"i A - 814.15 for first four 84.03 for ench additional
� - �f-~ Furnace, etc.
Address A r} *,/ ' ens heat pump �
City /State /ZTP; i A. us I •i2. ''1Q Wall /suspended /unithc
I'� Q Water heater _
Phone: AI-51(211 , Fa?1: ' 659 L� Fireplace •
E-mail: s fan' yi Ran•c
' .i. t a . it,1 �'iC i (, �'` 1 _4 Si' 7�$ d ir�rt �e lv�i 6 . ',•I� l q '" " Barl)ccuc
>S ri` ,l u s dryer
Clothes (lam s) IIIN
Business name: A i * 4 4 A ��--•• ,, ,I Othehe c ^ �
Address: _ ! �/ ', f1t7 ,"A 'aa 1. tr a fi b' , 1 t01 �
City /Statc(ZTP: LAcickahoa.: Ca OS ; . Subtotal
q Minimum permit fee ($90.00) !1J , t�
Phone! + _� � Pax: ���s I C� r Plan rexiew (25% of permit fee) ,�
AV ,
CCB lie.: ( State surcharge (12% of permit fcc) 0 t
` - `� TOTAL PERMIT FEE
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•this permit application efptres if A permit In not obttelne w 181
Authorized si;natu c: 1 y ( �� days After tt' been accepted as enmplete.
Print name: I _" • ' Date: r •2— ' Q • rae methodology set by Trl -County Building lltdastry Service Board
t:lnundinR \rM.m Ares.C- PermhApp. doe 10 /01/no 440- 4617T(1 1/02/COM/WCD)