Permit •
1. CITY OF TIGARD MECHANICAL PERMIT
ii COMMUNITY DEVELOPMENT Permit #: MEC2009 -00690
� Date Issued: 12/30/2009
` 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
:I.1GARD Parcel: 2S104AC08600
Jurisdiction: Tigard
Site address: 12482 SW 131ST AVE
Subdivision: MORNING HILL NO. 9 Lot: 229
Project: Piatt
Project Description: Install gas furnace.
Owner:
FEES
PIATT Description Date Amount
12482 SW 131ST Furnaces < 100K BTU 12/30/2009 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 12/30/2009 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 12/30/2009 $43.25
Contractor:
SKY HEATING & AIR CONDITIONING, INC
1637 SE NEHALEM ST
PORTLAND, OR 97202
PHONE: 503 - 235 -9083
FAX: 503 - 235 -0454
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.
/9
Issued By: ' r
y ' t t _ 6, Permittee Signature: ,-/0 G / e /9-770 77D
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 'A E IVED r
pplicatac� �E 4�a�r�-r �.° �.�, �r+� ,< •�� t �, �.
r 0 E C 2 9 nyg ._1 , � , �: '., d ,,,,J't)It t)1e1 1(.1 ,.km .;}' 4``, .�-;'rs' -, 0 City of Tigard t —:t: RtwivCd ° 13125 SW Hall Blvd., Tigard, ()R 97223 _ y / , Q 9 Pamir No,: / C Oe 690
® ^ +! Phone 503.634,4171 Fax: 503.595,1960 2009 p PIaji Q,uv iew/ - 11
f f)rta Inspec[ion Line; 503.639.4 175 Dute /By: Odle, Permit
: :o Internet: www.tigard- ur.gov CITY OF TIGARD Date Ready /By' 0 ,e P a g e 2 fur
BUILDING DIVISION NotitiecV (
Melhod: f k Supplemental Suppleontal tuturm_tiun
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CELE:CKLIS'1•
❑ New con ruction tindditiot /alteration /repltuement Mechanical permit fees* are based OD the value of the work
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
❑ Other: _ mechanical Ina[crials, equipment, labor, avcrhCad, and profit.
CATEGORY OF CONSTRUCTION Value; 5
• El 1- and 2-family dwelling 0 Commercial /industrial RESIDENTIAL EQUIPMIF:NT /SYSTEMS FEES*
❑ Accessory building
❑ Multi-family Q Master builder For special information use checklist
❑ Other: Description
JOB SITE INFORMATION Qty. j Ea. total
ORMATION AND LOCATION Heating/cooling
fob site address; i 2..C4 S l/U vbi s � . Air conditioning
(requires site plan thowing.plaa:n,ent) 46,75
(City/State/ZIP: • "� 1 �r ‘::ii1 Zrz r Furnace 100,000 BTU (ducts/vents) ( 46.75
Suitr/bldg. /opt. no: Project name:
Furnace 100,000+ BTU jducts/vents) 54.91
- Heat pum2 61.06
Cross street/directions to job site: Duct work T 23.32
' 1 hot water system _ 23.32
Residential boiler (radiator or
_ hydronic) 23;32
Unit heaters (fuel -type, not electric),
-- _ in-wall, induct, cusp oded• etc. 46,35
Subdivision; Lot no.: Flue /vent for any of above 23,32
_ Other: 1 23.32
Tax map /parcel no.' Other fLrl appliances
DESCRIPTION 0 ' 'WORK Water heater 23.32
L�/ / Cas fireplace 33.34
— 1 C�� v t° • Flue vent for water heater or vas
fireplace 1 23.32
'- Lo• lighter ( as) 23.32
•
Wood/•eJlrt stove 33,39
Wood frt:.luce /insert 1 22.32
[] PROPERTY OWNER Chimney/liner/flue/vent 23.32
❑ TENANT
Other 2 3 . 37
Name: r a H Environmental exhaust and veil tali [kit
Address: C) Range hood/other kitchen
_ et m•mrnt 53.39
Cit /State /ZIP: �. /��Q . Clothes dr erexhaust .. 33.31
Single-duct exhaust (bathrooms,
Phone: ( ) fax: ( ) toilet eom.artntents, utilit rooms) 23.32
❑ APPLICANT ' ❑ CONTACT PERSON Attic /crawls.ace fans 23.32
Business name:
Other: 23.3?
Fuel Piping
Contact ruuii , s A , $14.15 for first four; S4.U3 or each additional
Address: / . ( �. Furnace, etc. ..
�' Gas heat pump
('icy /$tote / "LJI': Wall /suspended/unit heater f _
}hone; ( ) Fax: : ( ) Water heater •,^ — ,......_ -_
�"•.� Fireplace
male: Range _•.
,CONTRACTOR • .. 13urbrcue _
'97
Clothes dryer as
� Ale ,e,4_,..+1 .t A i L Y` (gas)
Business nave: 5
i r� / Other;
Address; /6r) 5 ,(/ '�� MECHANICAL PERMIT FEES*
it ate 'L 11' y `'
_._ }/ St/
..._ /O/" 1 /Gt /A ce i 6 4-. Subtotal
C
Minimum permit fee ($90.00) :■ 90
Phone; Ir ) Z el 07.3 Ftx:9) ) 2.-s 06 y
Ptah review (25 0 ,4 of pennn fee)
C•Cli lice: co7 f q ✓ State surcharge (12% of permit fee)
TOTAL PEILMIT FEE t t. :4'1...4
,.-
Thia permit appliutriun cxpirta if u permit is out ubta ! i.'1 withi 1BU f U L
Aulhonzed signature: .,.4✓
1
tea✓ days after it hug been accept as complete. /� c
-
Print name:
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