Permit n
CITY OF TIGARD MECHANICAL PERMIT
> ' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00663
Z I G B. b 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/11/2009
Parcel: 2S102DD01500
Jurisdiction: Tigard
Site address: 8740 SW OMARA ST
Subdivision: Lot: 0
Project: Stevenson
Project Description: Replace furnace.
Owner: FEES
STEVENSON, MISTY Description Date Amount
8740 SW O'MARA
TIGARD, OR 97223 Furnaces < 100K BTU 12/11/2009 $46.75
FlueNent For Any of Above 12/11/2009 $23.32
PHONE: 503 - 481 -1643 12% State Surcharge - Mechanical 12/11/2009 $10.80
Minimum Fee Adjustment - Mechanical 12/11/2009 $19.93
Contractor:
FIRST CALL INSTALLATION COMPANY
13150 S CLACKAMAS RIVER DR
OREGON CITY, OR 97045
PHONE: 503 - 557 -0230
FAX: 503- 557 -0919
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. A I work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance . if work is s. - *ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility stification Center. ' hos- ules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or dir ct questions to OUN . '•y cal , • 03.246.6699 or 1.800.332.2344.
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Issu d By: `/' 4! / Permittee Si ature: I • .
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Call 503.639.4175 by 7:00 a.m. for an inspection that business • - .
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 -11 -2009 09:48A FROM: TO:5035981960 P.1
Mechanical Permit Application : ‘ : z 7 0lit(111 I I( . 1 Ins l t) City of Tigard . ' ` Dat e e/B y y : is / (f Per ilG� 0f0e) ein66 ,_
+* u e 13125 SW Hall Blvd .,1'igard, It..t r (N :' ! p, Plan Review C CT
1�� Phone: 503.639.4171 Fax: 51 .: ' ' ` Date/By: Other Permit:
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t I .) Inspect Line: 503.639.4175 y 8009 Date RcadyBy: ludo: 0 Sec Page 2 for
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t Internet: www.tigard - or.gov DEC 1 L Notified/Method: � Supplemental Information
TYPE Letiffilaf Tic Ali® COMMERCIAL FEE" SCHEDULE .. USECUECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ®Additi o 3 , I ptacemcnt acement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, tabor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1- and 2- family dwelling ❑ CommerciaUindustrial 0 Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. I Total
JOB SITE. INFORMATION AND LOCATION Heating/coolIng
lob site address:
Q rt y 6 CJ�V f T1,�rt ,.yt et Air conditioning
Q ( v 1 t lt�J (�, V' (requires site plan showing placement) 46.75
City/State /ZIP: T a7 Furnace 100,000 BTU (duets/vents) I . 46.7S
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 I 23.32
Subdivision: Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23:32
v Gas fireplace 33.39
RCP ACC Flue/vent for waterheater 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
Iiiti PROPERTY OWNER ❑ TENANT Other: 23.32
vt, Name: 1s a a Y1 Environmental exhaust and ventilation
Address: Cant) Range hood/other kitchen
equipment 33.39
City/State /ZIP: Clothes dryer exhaust 33.39
4$l- F ax: ( ) compartments, Single-duct exhaust (bathrooms,
Phone: ( ) toilet compartment utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: Tri County Temp Control
Fuel piping
Contact name: Diane Mason $14.15 for first four; $4.03 for each additional
Address: 13150 S Clackamas River Drive Furnace. etc. ,
Gas heat pump
City/State/ZIP: Oregon City, OR 97045 Wall /suspended/unit heater
Phone: (503) 557.2220 f'ax:: (503) 557.0919
Water
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: First Call Installation Clothes dryer (gas)
Other:
Address: 13150 S Clackamas River Drive MECHANICAL PERMIT F+ S'
City /State /ZIP: Oregon City, OR 97045 Subtotal /�'•
Minimum permit fee ($90.00)
Phone: (503) 557.0230 1 Fax: (503) 557.0919 Plan review (25% of permit fee)
CCB lie.: 182714 State surcharge (12 %of permit fee) r .
TOTAL PERMIT FEE w �,
This permit application expires if a permit is not obtained within ISO
Authorized signature: days after it has been accepted as complete.
Print name: Diane Mason 1 Date: 141 j 110 I • Fee methodology set by Tri- County Building Industry Service Board
Itauildin ¢1Pcrmitsllb;C- PermitApp.doc 10 /01 /09 440- 4617T(I1102/COWWCB)
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