Permit 71 a CITY ®F TIGAR MECHANICAL PERMIT
"'; COMMUNITY DEVELOPMENT Permit #: MEC2009 -00653
f CARD 13125 SW Hall Blvd.. Tigard OR 97223 503.639.4171 Date Issued: 12/08/2009
T
Parcel: 1S135CCO2500
Jurisdiction: Tigard
Site address: 10265 SW KATHERINE ST
Subdivision: Lot: 0
Project: Zwingraf
Project Description: Replace furnace with gas furnace.
Owner: FEES
ZWINGRAF, JOSEPH R Description Date Amount
10265 SW KATHERINE ST
TIGARD, OR 97223 Furnaces < 100K BTU 12/08/2009 $46.75
Fuel Piping 12/08/2009 $14.15
PHONE: 12% State Surcharge - Mechanical 12/08/2009 $10.80
Minimum Fee Adjustment - Mechanical 12/08/2009 $29.10
Contractor:
ROBBEN & SONS HEATING INC
2214 SE 8TH AVE
PORTLAND, OR 97214
PHONE: 503 - 233 -5841
FAX: 503 - 238 -8849
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: ` ; ea , %._.12 . ' ' 1 r • Permittee Signature: sstsInp •
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.
• ' Dec' 8. 2009 i0:117AM Robben & Sons Heating Inc. .. No. 5930 P. 1
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L� ' �.aay .u�.aaa A. 61 11111 rn.117p l%_at 6�V11 .s. e. i sEJ (!)I' 1 It.'l (7Sf (:) , t o ' , y t �, $f`a
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9 -r" • ` Ciry of Tigard .:
13125 SW Hall Blvd., Tigard, OR 97223
R ECEV E� , All" � .�-
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1. Phone: 503.639.4171 Fax: 503.598.1960 Ian Revie
.,S°er:.- - inspection Line: 503.639.4175 (1 2009 DateBy: OIIkr Pecmir:
K6Ii {'A'Rr'i P V L J
Internet: www.tigard- or.gov DEC DetelteadylBy: 67 see Page 2 for
Notified/Method;
rim Supplemental Information
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❑ New construction \ Addition/alteration/replacement Mechanical permit fees' are based on the value of the work
performed. indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other:
mechanical
t .r r , ' materials, equipment,
, I' a - a , U { s' qr. P a,�'' e r r ;fi Value: $1a rlt , n profit.
overhead, as labor, eada
I -and 2•fam f '�; ,f •. r�s. �h� '):i�....,'� t , . _�•, .. _ Fri 2-family dwelling ❑ Commercial /industrial iii • ! o. i S t T S
A building - .x ..
❑ Multi - family ❑ Master builder Q Other:
For spetia( information use checklist.
`f , n y Fr9 o r n Description Q(y. Ea, I Total
;,'uf�; . >dtc Eh.e,wa c 3s S EE a .,fr �:° � cr..' i�t" 3�a `. �.: c Heatit cooling
Job site address: Mf A � �, l _ , . Air conditioning or heat pump
(requires site plan 3110winx placement) 14.00
• �'. a y0 a far Furnace 100.000 BTU (ducts /vents) \ 14.00
Suite/bldg. /apt. no.: Project name: ' � � lruntace 100,0004- BTU (ductsivcnes) 17.90
Gas heat pump 14,00
Cross street/directions to job site: Duct work 14.00
t Hydronic hot water _system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
-
in - wall, in -duct. su5ended, etc. 10.00
Subdivision: Lot no. Flue /vent for any of above 1 10.00
Other: 10.00
Tax map /parcel no Other fuel appliances
r s:4 u i 1 , "'If 1 a . M ± 0 ' f'• t, i "ski s +; hea te I
wt�S��� . � uit€�;?i�'sz��i r 10.00
y ��
Gas firelace 10.00
■
>�Y1fLl1 1 _ Flue vent for water heater or gas
fireplace 10.00
`f,I... IL - •• Log lighter (gas) 10.00
Wood /pellet stove 10.00
wood fireplace/insert 10.00
,{� 5�' "�•? , ra �i " 1�' ') s , ° `'r" �t a t'� �t�- ��g Chi
��t mney /liner /flue /vent _ 10.00
, !�Er' ' Vhk"+� •' iNn �if.V^^.'U... . � � _r; �,:ii -, . . ∎.1!Y' Other:
10.00
., . _ tI r . ,Environmental exhaust and ventilation
Address: iii, � tm►A1r,�.f Range e hood/other kitchen
10.00
,` `, - Clothes dryer exhaust _, 10.00
Single -duct exhaust (bathrooms,
Phone • 4 ii Fax ( ) toilet compartments, utility rooms) 6.80
41%40:41.01 +T . l ` " ' ' ,,�n "� � : to � `� v., : i' Attic/crawlspace fans 10.00
.. ,v, !! . 7i . kr: a .;,:. ., P t :i.. .1i.ir
Business nam'. 1
Other. 1 1 0.00
�� ` 1 .�a1r �v���\ t•r Fuel piping
Contact name: r �� �1 55.40 for first four. 51.00 for each additional
Address: ,^ �� Furnace, etc. \ 4
�. � Gas heat pump
City /State /ZIP: vl bi ` .", . Walllsuspended/unit heater
Phone: • _u& • + AO , 4v..i, Fax: : G6: t>�'� =t♦ water heater
_ � Fireplace
�= �,iM►) � I�������, tiN. �� M Range
v t� tf�} )�' � �2 � I�;', i G dr,,ry �r��T_'A g 1}� -t�,p �, _
°r r n h 3 {5� � 7 r;ti i `� -"y�, rlt' l,NSE r3tH nrJ� Baf
t ,
I,t1 +•� -� ") �ASi'� n ,k �I tstf. A �4. `,,'�^ >��;� m� n ltecue
' (7b ti 1 ' a 3 in ea..41 Clothes dryer (gas) -
i t
Address: Other, _ . ui =
221 _ . 41 \ A der ) U e- >i > » n �> 1 kt'?F'' ,�d' _ :::
City /State /ZIP: it ��- (�(�� Q� q z Subtotal _
Phone: 603) 23 3 -58q 1 Fax: (503) 238 - 884 Minimum permit fggl$12 0T ��
CCB sic.: f IN Plan review (25% of permit fee)
State surcharge OA of permit fee) M r
TOTAL PERMIT PEE I,. CD
Authorized $igriatnr -- r "this permit epptica aspires if a permit is not obtained thin 180
r 4 days after It has been accepted es complete.
Print 'lame: ,'M
_ �1 r bate: r t� r Fee methodology set by Tri- COimty Building industry Service Board
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