Permit A
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00660
T [ Cs AA D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/11/2009
Parcel: 2S104BA06600
Jurisdiction: Tigard
Site address: 13905 SW NORTHVIEW DR
Subdivision: CASTLE HILL NO. 2 Lot: 99
Project: Appelbaum
Project Description: Push /pull existing furnace.
Owner: FEES
APPELBAUM, RONALD G Description Date Amount
13905 SW NORTHVIEW DR Furnaces < 100K BTU 12/11/2009 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 12/11/2009 $10.80
PHONE: 503 - 936 -3147 Minimum Fee Adjustment - Mechanical 12/11/2009 $43.25
Contractor:
A -TEMP HEATING & COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 -9519
PHONE: 503 - 650 -5014
FAX: 503 - 557 -2990
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 cation Ce = . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or .' ect questions to OU " •y :If g 503.246.6699 or 1.800.332.2344.
■
•
}
Issued By: / 1 g2 Permittee , ,
�! Si.S aIL®�'r
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.
12/10/2009 17:28 503557299 ? CEI\ ED A -TEMP HEATING PAGE 01/02
cci> niCal Permit Application 4 503.598.1 .2 - - `: -_ �
,..: i . " Ci of Ti and DEC 1 1 2009 _, '� �. ,
c f ReeCivcd /� Ff it No.: 6 �1 y�
`� Datem /21// 09 . 1Tn h�GC, i. j Q4„9
13125 SW Hall Blvd., Tigard. OR 97223
Plan Ilk I 0 Phone: 503.639.4171 f a L: Date Review i1er Fermle
rI
Inspection Line: 503.639.4175 QTY OF TIGARD Date/By • 0 `' Is ItT' B DIVISION - Data Ready/By: ni t", ® see Page z IM. Intcmct. www - or Notificd/Mcthod: Supplemental Information
'+<l, �Iv *i n +'1: {�,.n �, �. V J pr,� r zr;sl�';a' i . ; . `'� ' ^ ', yy �� J 1!fyTc's, ^r , �t'?3 : t ,:ra: t, . ,; > r « 5a r . w ..,r .. S rs �t
' ,. `1 S; �At 1 3 R �. ry ..�t^+� , , r ti h �„� Ipy a � !,��` /r S! pS =�7,.Y y ', C..nS,J1�,7�+S�Art k, .�1�j'1 tiel q�3 ; ,ii t'du,7 r1�E , 4k �1117 pA.��1lF; . "7. r te 'I' 6,1 6`? d :1
dNA` ' 1f1�LR ilV�e.t11�4. A�7t1iNF ...d'.-09�7S�St.aua, i AMe alt S.ki +l IAII:N'7 Mt?Rir. .. n? �f +J7 �j�:{,. .+
�• +�, � Cr,,,. ma ,�t;�rG. eat,.^ n� :y • t ,rw 3.M' •xt
❑ New construction 11 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 0 Other: mechanical materials, ecjuipment, labor overhead, and profit.
t, �, K 1 �LTi �' �y/ ^Y�r e'� r1� tj� Yd41 °il
Value:
i 1, ''' 65(2,111 " } l . .1 r` p '„D M1 !Q . iar is " nn.& il d ki k . f w I ° ?< ;� ) '.f�+ .''lt ieli M ,
1 - and 2-family dwelling ❑Commercial /industrial ' 'A' kt 1 1 WZ, - 1 1 i � 0 .1 \ t r `) �' I.,':" ai
y ❑ Accessory building ^�' e >•wa a Q : , . • s, �r . uti „
❑ Multi- family El Master builder Per special information use checklist.
❑ Other Description
++"" b 9 4 p Qty. I Ea. � Total
9 i sf i t • .is :, ji % ,_ a 1 ,1, � 1 a ' 6; 1t � � ? I I ' i i lk `a; enting/caolIng
Job site address: i / Air conditioning
�,/ 1. L�� � ���� r luires site plan showing placement) _ 1 46.75
City /State /7_ i l IP: 11.d 0 i q a ;3 Furnace t00 BTU (duets /vents) 46.75 I'p
PQ _L1 .1 rn Furnace 100,000+ BTU (ductdvontt) 54.91
Suifc/bidg. /apt. no.: Project name: F/,Z' Heat puny l 61.06
Cross street/direetions to job site: Duct work 23.32
Hydronic hot water syst 23.32
Residential boiler (radix or
hydronic) 23.32
- Unit heaters (lllel -type, nor electric),
in•wall -duct, suspended, etc, • • 46.75
Subdivision: Lot no.:
Flue/vent for any of abolre 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
pp{{
s r C� °'1' }� l, h11 '11 1 ,' W S,' iHT yl , ��a?c t f i " , , .� J; iI Te 1 ? I xf�, Water heater 23.32
47t u ■ V ∎ ;, W . C. V .a.e:, 3 rat:
dos fireplace 33.39
4 . . 0 ..a � ,l o . I i A.' L Flue vent for water heater or gas
..4:)., A._ /
I fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert ' 23.32
, ' r I w , r, r 4.4 I i T(r'(� �r l +r. ; r t ' 7 ,3� �S i ., Chimney_ /liner /flue /vent ° 23.32
: .. : . , , t i ' w 4 de 4, . , l' ll .� it 4 d ?•'• tf',4a "' t . Q 1 zlextr a �'n3t43ii 41: Other: 23.32
Name: V
.
r .r iti .,, f ,1- all , . , Environmental exhaust:and ventilation
0 Range hood /other kitchen
Address:
`�Q�'1 -.■ 0 equipment 33,39
City /State/ZIP: 0 G..) Clothes dryer exhaust ; 33,39
r - - - Single - duct exhaust (batlprooms.
Piton / Pa toilet compartments. utility rooms) 23.32
r« �, �., a 7:: r
i . , 4 a } r11� e , , 6 t I' ! 1:i 1a e i r i 7 e `; ,' i" Z4 1 Attic /crawlspacc fans 23.32
Business name A . fb • • .r w. , = ?� l Other: 23,32
C Fuel piping
Contact name:' A . 1 � , �. - $14.15 for first four; $4.03 for each Additional _
Address: I I _coo E i �� -Y! Furnace t etc.
/State/7.TP: � Gas heat pump
y C )j � Cl WILY n c 1 '' _C ) I 5 - `Fall /suspended /unit heater 1.
Phone: 63 (D� 60 /Y Fax:: 9 ' t Water heater
Of 7 Fireplace
E -mail: • , t
at .1 j R r ' .� to 0L, ■ I � IM Ran
iShl i.. ioi S * $ u , off r a ' , J.. .1. r , , ¢� y 3 .. 4 I � } t i ' , ,,t Barbecue
e , . i: . t' g, "L•: '0 .t. i. ',k rJ : ti" „ 11th $ i . 1 13.z i ttr 'ifi;iri '.',..
Business name: 1 f Clothes dryer (gas)
T U I it i 4 A y !.7
O ther
Address: �,,+: : r r -u. {v ' r . {r ! J rro
i a __ V1 !' ' tF p,I S r t �i':t a` � ,,, t 1 a r ' i , L � qtr,,
� itu# , ts`t46 voatu, x�a, 1:4r 9R E C1oS k; i ',„ t? V�4 .
City /State/ZTP: x � 9lot - Subtotal
l i �
� �^ Minimum permit fee ($90.00) ; ,1.24'
Phone: � 7l� J W ,,5-1:) W _1,4 Fax: 603L65`7 1.76) Plan re oew (25% of permit fee)
CCB iic.: (� State surcharge (12% of permit fee) JO ,.j"
')TOTAL PERMIT FEE / j^ �
Authorized si • natu l jf A , L Lif This permit application minima If a permit is not ohtnint4I't l'tlt{n I
_ days after Rims been accepted an complete.
Print nam : lrrf ry ' J 1 _ By • Fee mcihudology act by Tri -Count building Industry Service Board
Ihnu Mine ermltd \MBC•Ptrm';App.dap 10/01/09 440•1517T(II /D2 /COM /WE13)