Permit ,, : :::_.::.,. CITY OF TIGARD
MECHANICAL PERMIT
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=c ..., COMMUNITY DEVELOPMENT Permit #: MEC2009 -00656
< [ GA D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/09/2009
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Parcel: 2S114BB09500
Jurisdiction: Tigard
Site address: 16192 SW 104TH AVE
Subdivision: SWANSONS GLEN Lot: 36
Project: Byers
Project Description: Replace furnace and w /h.
Owner: FEES
BYERS, THOMAS Description Date Amount
16192 SW 104TH
TIGARD, OR 97224 Furnaces < 100K BTU 12/09/2009 $46.75
Water Heater 12/09/2009 $23.32
PHONE: 12% State Surcharge - Mechanical 12/09/2009 $10.80
Minimum Fee Adjustment - Mechanical 12/09/2009 $19.93
Contractor:
WATTS HEATING & COOLING INC
580 PORTLAND AVE.
GLADSTONE, OR 97027
PHONE: 503 - 786 -2858
FAX: 503- 786 -2807
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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: C \.(° v`U� "
V MAN f Permittee Signature: Q
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.- 9. 2009 10:51AM WATTS HEATING No. 0018 P. 2
Mechanical Permit AppliC2tiO FOR OFFICE USE ONLY
City of Tigard Received -
li ° 13125 SW Hall Blvd., Tigard, OR 97223 D C 0 9 2009 DatelBy: I �j• iraM
Phone, 503.639.4171 Fax: 503.598.1960 Plan Review
Data/By, Other permit:
Ti C n RD Inspection Line. 503.639.4175 atioa
C ITY OF TIGARD Date ReadyBy: ®See page 2 for
Internet: www,tigard -0r,gOv Notified/Method: Supplemenal t fnform
�3UILDING DIVISION
'
Notified
. y1Air L� d ('� __ _ }i. y,A form Y7� CT
, l i .,' • ' AL:1? Y6.?b 1'�_ ,� p ;:i ,3� � . t, S.Y' ` . Y M1. ,�r] . •y'•• . QJ 4,IKE `,' Ur_b bill 0) &10
\i tn, .
Mechanical permit fees" are based on the value of the work
El New construction .1 Addition/i lteration/replacement
❑ Demolition ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
7" mechanical materials, equipment, labor, overhead and profit
;,, i i ; i a ►�. "GOTt`, a ', " �.IC 1 ,,70) z ' tr t' i '` Value S
,21- and 05 - i7,I'XAJ E� 1 a j ► S'T l §Y•I' .101:#0.
and 2- family dwelling ❑ Co ❑ A ccessory building
El ❑ Master builder ❑ Other: For special information use checklist.
4, . .`? f,,a t ;�t, ' ire7 , 's 1s O ')(ON.AND, Y,'OCATIQII, , - H
Description eating/cooling
1 Qty. L Ea. Total
Job site address: 2- _ 14-) - Air iwirea ab oning
re res site Olen showing placement) 46.75
City/State/ZIP: zy� 477.477.z- " _Furnace 100.000 BTU (ducts /vents) / 46.75 p
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldgJapt. no.: Project name: A c 6 f 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, in -duct, suspended, etc, 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.: 0er - 23 32
Tax map /parcel no.: Other fuel appliances
. i a r ` 0,S: 1 IP i
7bhr,OF i { 14 Y, ,:i Water heater - 23.32 g 3 ,3...4'
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"" / �,� Gas fireplace 33.39
1 _ ,. /2GU G .� t..-41- • deA � Flue vent for water heater or gas
fireplace __ 23.32
Lod lighter (gas) 23.32
Wood/pellet stove __ 33.39
Wood fireplace/insert 23.32
i'ROiP T3l� 12 ChimnyAiner /flue/vent 23.32
?. * . . . .:. Other
23.32
Environmental exhaust and ventilation
Range hood/other kitchen
Address: > equipment 33.39
City / State/ZIP; /i p,-d ®2 f f 2 Clothes dryer exhaust 33.39 _
Single -duct exhaust (bathrooms,
Phone: (01),- 9 gy Fax: ( ) toilet compartments, utility rooms) 23.32
} 2, ' 'G ? '`• Aiiis 'IGA w 1a y >" ` ;COr ?A Attic/crawls ace fans 23.32
Other: 23.32
Business acme:
,,,r t'G0 f - 60b Fuel piping
Contact game. a 6 t L[-. 514.15 for first four: 54.03 for each additional
Address: s--6 e ;z ,..././4„....,,a/ /4/G Furnaces eta
Gas heat pump
City / State/ZIP' �j/Gz /"..e_- 7. ' 7 WalUsuspended/unit heater
Phone: (5) j ' 7; G . 78 Fax:: (6-03 6 - 2807 Water heater
)r - mail: Fireplace
/ . / s 6 e i - . G o - i. Range
t i'' t 7t4l-` ?i ' ' 1"n ) �? ': ' CONPRAC' Q1t ' 7,>>; " r:., t Barbecue
Business name:
Clothes dryer (gas)
Other:
Address: .1' // G7'"7'' f - - MEetatOAL PE1%M7 F Pl;ES ;" ;i
City/State/ZIP; - Subtotal '7p-. e
Minimum permit fee (590.00) g0 -
Phone: ( ) ! Fes' ( ) Plan review (25% ofpermit fee)
CCB lie.: / fV &o 7- State surcharge (12% of permit fee) /V
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TOTAL PERMIT FEE i(,z7. 2
Authot72ed signatur 'Ibis permit application expires if a permit is not obtained within 180
_ days after it has been accepted as complete.
Print name: 66 s�Q G,i £ Date: / 9`d j • Fee methodology set by Tri-County Building Industry Servi a Board
o.,:,,c..n1P..,,.w.ss r- E ...n li A.nAnn IRM7/M - \O S ad(1.11A 7T r1 7rnM/WCA‘/ t I I