Permit ._ MECHANICAL PERMIT
Ii
CITY OF TIGARD
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00641
, t i Date Issued: 12/02/2009
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S104BD02500
Jurisdiction: Tigard
Site address: 13570 SW FERN ST
Subdivision: Lot: 0
Project: Viestenz
Project Description: Replace furnace, install a /c.
Owner: FEES
VIESTENZ, KERRY D & JANICE L Description Date Amount
13570 SW FERN ST Air Conditioning 12/02/2009 $46.75
TIGARD, OR 97223 Furnaces < 100K BTU 12/02/2009 $46.75
PHONE: 12% State Surcharge - Mechanical 12/02/2009 $11.22
Contractor:
SUNSET HEATING & COOLING
0607 SW IDAHO ST
PORTLAND, OR 97239
PHONE: 503 - 234 -0611
FAX: 503 - 234 -0439
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $104.72
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 question • OUNC by calling 503.246.6699 or 1.800.332.2344.
all G
.
Issued By: � � ,_ PermitteeSignatur ����� = - �
CaII 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.
Mechanical Permit App ui�: 1 ►EIVED t �F ` o''z ` `� 'T
� R eceived r
"� ` Cit o f Tigard Permit No.:
l!. r. e DateBy: J a6 1 _ • 00r ., • 4 , I
`fFi' ° 13125 SW Hall Blvd., Tigard, OR (� n 1 2nno Plan Review
• s 10 W Other Permit:
J Phon 503.639.4171 Fax: SQ3. 6 Date/
.+,+ Inspection Line: 503.639.4175 Date Read Juris: El See Page 2 for
k : i Ready/By:
www,tigard- or.gov CITY OF TIGARD Notified/Method: T1 , Supplemental Information
.
BUILDING DIVISION
TYPE ••OF WORK CO MMVIERCIAL FFE* SCHEDULE — USE CHECKLIST •
/ Mechanical permit fees* are based on the value of the work
❑ New construction Addition /alterationlreplacemetlt performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF. CONSTRUCTION . • Value: $
=— — RESIDENTIAL R EQUIPMENT /:SYSTEMS FEES*
kr I - and 2 family dwelling ID Commercial/industrial ID Accessory building ,
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description Qty. , Ea. I Total
JOB. SITE INFORMATION. AND LOCATION Heating/cooling
Job site address: �� Air conditioning
`' J -1 v S ` ` i.C, '1, n � - (requires site plan showing placement) ` 46.75 U ��
(
�^ Furnace 100 BTU (ducts/vents) 46.75 L(., 1`
City /State /Z1P: 1 �
V Furnace 100,000+ BTU (ducts/vents) 54.91
t,
Suite/bldg. /apt. no.: Project name: i '- y i Z.- Heat pump 61 A6
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 -typc, not electric),
in -wall, in -duct, suspended, etc. 46.75
Flue /vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION :OF WORK Water heater 23.32 _
Gas fireplace • 33.39
•
•( a : • —1 ( LL_ Al C__ 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
[0 PROPERTY :OWNER:. ❑ • TENANT Other: 23.32 _
Name: VI ,: 0 l � Z-- Environmental exhaust and ventilation
Range hood/other kitchen
Address: $wf - yam equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (SL D) 544 - 150-
Fax: ( ) toilet compartments, utility rooms) 23.32
❑. APPLICANT : 0 CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: Fuel piping __"
Contact name: $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address:
Gas heat pump
City /State /ZIP: WaWsuspended/unit heater
Phone: ( ) Fax: : ( )
Water heater
Fireplace _
E -mail: Range
CONTRACTOR • • Barbecue •
Clothes drycr (gas)
Business name: St. ji se* 4- C )Li' ' ' C' cz—D f it Other: .
Address: 042C;"1 5 (,tit 1 ciejl J Sfr) MECHANICAL PERMIT FEES*
City/State/ZIP: jgy}- 1. trje. 102 3'- Subtotal (1 p
Minimum permit fee (S90.00)
Phone: ('C 7) 234-1-4i I Fax: (!j1- ) L 3■1 -C ++ .3e1 Plan review (25% of permit fcc)
CCB lie.: I Lpi 0 ' j State surcharge (12% of permit fee) ,1 c ,);}
• TOTAL PERMIT FEE •,CLI 1)- ,
'this permit application expires if a permit is not obtained within 180
Authorized signature: �, days after it has been accepted as complete.
Print name: '' Date: 1), I ` • Fee methodology set by Tri- County Building industry Service Board
1:\BuiidingPermiIsl.' EC- PcrmitApp. 10/01/09 440"4617T /02ICOMIWEB)
2 'd 6E'0 'E2 24.0�eaH gasunS d80: T 60 TO OaG
1\ke
C t
Li tiq E Efr
1 )r
Fuel] Copc.
DIRECTION
Name & Address:
- 1 b
Q trr t -2 . 1-.3
4C T 40 45
L 7
HOUSE
E rp s �
E'd 6Eb0- 4762 -EOS 2uigeaH gasuns dBo :aT 60 TO oaa