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Permit CITY OF TIGARD MECHANICAL PERMIT N ol 12 COMMUNITY DEVELOPMENT Permit #: MEC2009-00693 1-1 G ARL? 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/31/2009 Parcel: 2S103DD05800 Jurisdiction: Tigard Site address: 10955 SW GARDEN PARK PL Subdivision: GAARDE PARK Lot: 41 Project: Ottoman Project Description: Replace electric furnace. Owner: FEES OTTOMAN, NORMAN R TRUSTEE Description Date Amount PO BOX 1569 SHERWOOD, OR 97140 Furnaces < 100K BTU 12/31/2009 $46.75 12% State Surcharge - Mechanical 12/31/2009 $10.80 PHONE: Minimum Fee Adjustment - Mechanical 12/31/2009 $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: Electricity 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 0 NC by calling 503.246.6699 or 1.800.332.2344. Issued By: 4 1 • , / I L. Permittee Signature: af2.-.2 .. A 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 -31 -2009 09:21A FROM: TO:5035981960 P.1 Mechanical Permit ApplicatioRECEIVED • h(/It (11 1 11 I 1 til (►\l 1 City of Tigard Received 4 Permit No.: , _ • h . 13125 SW HaII Blvd., Tigard, OR 97223 DEC 3 1 2009 y �' ' - Phone: 503.639.4171. Fax: 503.598.1960 Plan Review Other Permit: Datc/By: I I t : A It 11 Inspection Line: 503.639 CITY OF TIGARD Date Ready /By: IM to See Page 2 for Internet. www.tigard-or.gov Notified/Method: Supplemental Information BUILDING DIVISIO 1 �.�1. r+ S. , .; ; �77'R 41{FiKW4RK., CO%IMERC1AkL FiF *''1 -- • OKLfs ; ' ❑ 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 materials, equipment, labor, overhead, and profit. - CATE©ORV'OETOSISTRUCT1ON - Value: $ . ..RESU)ENTIAL) ' 111PMENT /SVSTI`M.S.FEES« ® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building ❑ Multi family ❑ Master builder - For .special- injormation use checklist. ❑ Other: Description ! Qty. I Ea. 1 Total :. -.y • 'J08:SITF INFOR.MATION"•AND LOCATION Heating/cooling Job site address: 0 g5�i 5- U W PAC. Jkpl v 1 , Air conditioning ty 118 cirri �� (requires site plan showing placeraeat � 46.75 City/State/ZIP: Furnace 100,000 BTU ( ducts/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 in -duct, suspended, etc. 46.75 Flue/vent for any of above 23.32 Subdivision: I Lot no.: Other: 23.32 Tax map /parcel no.: Other fuel appliances . DFSCRIPTJQN,`OF `WO1 K Water heater - 23.32 kJ? � e le iyt, tC j LrvtWr, Gus fi ent 33.39 �,LJ�,� 1 I Flue vent for water heater or gas fireplace 23.32 - Log lighter (gas) 23.32 Woodipellet stove 33.39 Wood fireplacefmsert 23.32 Chimney/liner/flue/vent 23.32 A PROIWR`Pl n ' 1 QWNER • 014-Y 1 TEN'ANl 1 w LU 1 . ' Ether. 23.32 Name: Environmental exhaust and ventlletion Address: a x, r, equip hood/other kitchen equipment 33.39 City/State/ZIP: Clothes dryer exhaust 33.39 . fib- n Single -duct exhaust (bathrooms, Phone: (61/a) L � i r1 Fax: ( ) toilet compartments, utility rooms) 23.32 ` ' Attic/crawls ace fans 23.32 ®APPU1C ■ .CON'[�CT RERSON P Business name: Same as contractor Other: 23.32 . Fuel piping Contact name: Diane Mason $14.15 for first four; S4.93 for each additional Address: Furnace, etc. Gas heat pump _ City /State/ZIP: Wail /suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range coNTRAcrOi Barbecue Business name: 'f County Temp Control Clothes dryer (gas) Other: Address: 13150 S Clackamas River Drive MECHAN PEW` City /State/ZIP: Oregon City, OR 97045 Subtotal Phone: (503) 557.2220 Fax: (503) 557.0919 Minimum permit fee ($90.00) Plan review (25% of permit fee) CCB lic.: 72623 l State surcharge (12 %ofpermit fee) 1 ,,,^ Q a TOTAL PERMIT FEE (�J DU Authorized signature: .c Y V This permit application expires if a permit is not obtained within ISO days after it has been accepted as complete. Print name: Ili w'V Moon Date: 1451 C191 • Nee methodology set by Tri•County Building Industry Service Board I tauitdmt,V'ctmuaiMLC Pernm App doc 10/01/09 440.4617T (11 /02/COM/WEB) /9 Va c