Permit x CITY OF TIGARD
MECHANICAL PERMIT
-k.N ...44; Q
a COMMUNITY DEVELOPMENT Permit #: MEC2010 -00071
T [ GAR 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/16/2010
Parcel: 2S103BC06400
Jurisdiction: Tigard
Site address: 12148 SW LANSDOWNE LN
Subdivision: FYRESTONE Lot: 3
Project: Crystal
Project Description: Replace furnace.
Owner: FEES
CRYSTAL, ROGER Description Date Amount
12148 SW LANSDOWNE LN
TIGARD, OR 97223 Furnaces < 100K BTU 02/16/2010 $46.75
12% State Surcharge - Mechanical 02/16/2010 $10.80
PHONE: 503 - 703 -8794 Minimum Fee Adjustment - Mechanical 02/16/2010 $43.25
Contractor:
TRI COUNTY TEMP CONTROL INC
13150 S CLACKAMAS RIVER DR
OREGON CITY, OR 97045
PHONE: 503 - 557 -2220
FAX: 503- 557 -0919
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.
Issued By: S(1� n,� Q `d On 3L.. Permittee Signature: C \ Q n
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.
FE8-15 -2010 08:22A FROM: TO: 5035981960 P.1
Mechanical Permit Applicati� 1.1)14 0111(1 1 `,1 (1. \I 1
Received
City Ti AI(� itNo.:
131 Hall Blvd., Tigard, OR 97223 FEB ` Date/13y: J Per r , . I , (�
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit
I' !t .11t 11 Inspection Line: 503.639.4175 CITY OF TIGARRD Date ReadyBy IIITI ®See Page 2 for
Internet: www.tigard or.gov BUILDING DIVISION Notified/Metbod: Supplemental Information
:S 5,-,4� KT;:
ilel off? vVOilc coi411H tt>Al Pb'E +' �11rnu. iu F t.3
❑ New construction ® Addition/alteration /replacement Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to she nearest dollar).of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY - OW CONS'PRIJC1'ION • - Value: $
RESIDENTIAL EQUIPMENT / SVS'FEM$FEES.
® 1- and 2- family dwelling ❑ CommerciaUindustrial ❑ Accessory building
• For special .information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. Co. [ Total
' JOB -SIT
SITE INI?ORMATTUN AND LOCATION lfeatirtp,/cooling
Job site address: 12_144 [_144 eW Larodoton Lane) Air conditioning
(requires site plat. showingplacenrcnt) 46.75
City/State /ZIP: l Iew J. 611 Furnace 100,000 BTU (duets/vents) , 1 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in - wall, induct, suspended, etc. 46.75
Subdivision: Lot no.:
Flue /vent for any of above I 23.32
Other. , 23.32
Tax map /parcel no.: Other fuel appliances
•' DESCRIP"TION.'OF�WORK Water heater 23.32
■
, ^ Gas fireplace 33.39
K p
(,� Flue vent for water heater or gas
fireplace 23.32
Log lighter(gas) 23.32
Wood /pellet stove 33.39
Wood fireplace/insert 23.32
. - . . , - Chimney/liner/flue/vent 23.32
: .,PROPERTY OWNER 0 TENANT
Other. 23.32 '
Name: a Ai' ( 6 Environmental exhaust and ventilation
w 41 Range hood /other kitchen
Address: I "
equ 33.39
City/State /ZIP: Clothes dryer exhaust 33,39
( ) 1 10 D f ( toilet
Single-duct exhaust (bathrooms,
Phone: L�• Fax: ) t compartments, artmrtments, utili rooms) 23.32
;l. APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans , 23.32
Other: , 23.32
Business name: Same as contractor Fuel piping
Contact name: Diane Mason 514.15 for first four; 54.03 for each additional
Address: Furnace, etc.
Gas heat pump
City / State/ZIP: WaWsuspended/unitheater
Phone: ( ) Fax: : ( )
W.atenc�ater
Fireplace
E -mail: Range
-
CTOR Barbecue
CONTRA
Business name: Tri County Temp Control Clothes dryer (gas)
Other:
Address: 13.150 S Clackamas River Drive MECHANICAL PERMIT FEES*
City/State/ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee (590.00)
Phone: (503) 557.2220 Fax: (503) 557.0919 Plan review (25% of permit fee)
CCI3 lic.: 72623 State surcharge (12% of permit fee4 1 At., n T
'TOTAL PERMIT' FEE _r 1 4 f •
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: Di ( e Mahon Date: 216/10 _ • fee methodology set by Tri -County Building Industry Service Board
1 \nullding\Permits\MLC- I'enn4App dm 10(01 /09 440- 4617T /02/COM/WEII)