Permit CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00367
DATE ISSUED: 6/20/2007
r 'T A D , 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S114BA -00300
SITE ADDRESS: 09875 SW SERENA WAY ZONING: R -4.5
SUBDIVISION: PICKS LANDING NO.2 LOT: 136 JURISDICTION: TIG
PROJECT: WILSON
Project Description: Install furnace.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
BONNIE WILSON Description Date Amount
9875 SW SERENA WAY
TIGARD, OR 97224 [MECH] Permit Fee 6/20/200 $72.50
[TAX] 8% State Surcha 6/20/2007 $5.80
Total $78.30
Phone: 503- 684 -6087
Contractor:
THERMAL FLO
7236 SW DURHAM RD. STE 100
PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 670 -8343
FAX 503- 620 -1953
Reg #: LIC 151847
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B • Ji / j Permittee Signature: S 7 4
-„4
Ca 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
06/19/2007 15:24 5036709064 THERMAL FLO PAGE 01
._:'
Mechanical Permit Apps ;�� " f ' ' , ' .. 1 t ►i( OFFICE It E I Si (iN t \ ' ,a 1. t
'''4 s City o f Tigard r -, ` Received
ty Date /r%y; ��G.
r Rlvd., Tigard, OR 974: 1
V ` ®� n 13125 SW Hall 54$M:6
� tl; Phone: 503.639.4171 Fax; 503.50M:601 � �� Plan Review
�/ Dote/py, Other Permit.
e. .4' Inspection Line; 503.639.4175 Date RcadvBy: ]uric. ® See rage 2 for
*e' : Entcmet: www.tigard.or,gov CITY OF ; IGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE" SCHEDULE - USE CHECKLIST
Mechanical permit; fees* arc based on the value of the work
['New construction lig. Addition/alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials. equipment, labor, overhead, and profit.
CATEGOR`4' OF CONST1RUCT1QN Value: $
V-1- and 2- family dwelling 0 Commercial /industrial ❑ Accessory building 1i E51DJf.NT1At. EQUIPMENT /SYSTEMS FEES*
For specla1 h(format/on use checklist.
❑ Multi- family ❑ Master builder ❑ Other; Description 1 Qty. [ Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump
.Toh site address: qg 7 5 5 L a 52f QI r o uii site ram showing placement) 14,00 {
City /State /ZIP: 1 , , Qs 6 0 ' C'7 F urnace 100.000 B TU(ducts/rents) ( 14.00 `� - UU
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.; Project norm:
— Gas heat pump 14.00
Cross street /directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
. llnit heaters (fuel -type, not electric).
in -wall, in -duct, suspended. etc. 10.00
Subdivision: I Lot no,: Hue/vent for any of above 10,00
Othcr: 10.00 1
'ON map /parcel no.; Other fuel appliances
DESCRIPTION OF WORK , Water heater 10.00
_ Gas fireplace 10,00
J _ � `� E _c_Q„ , Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace/insert 10,0
Chimncy/lincr /tluc/vcnt 10.00
❑ PROPERTY OWNER f 0 TENANT Other: 10.00
Name: 01...sk� .3- 1 1 Environmental exhaust and ventilation • Range hood /other kitchen
Address: 9 z"�, L � ( ' e �p, equipment 10.00
City /State /ZIP: lie t�., - c1 1� t ! s� ) L Clothes dryer exhaust 10.00 - Single -duct exhaust (bathrooms,
Phone: 'l7 IC3 Pax: ( ) toilet compartments. utility rooms) , 6.80
❑ APPLICANT ❑ CONTACT PEi' Attic/crawlspacc fans 1 0.00
Other: 10.00
Business name:
... piping{
Contact name; S5.40 for first four; $1.00 for each additional
Furnace. etc.
Address: Gas heat pump
City /State /ZIP: Wall /suspended /unit heater
Phone: ( ) I Fax:: ( ) Water. heater
Fireplace
F. -mail: Range
CONTRACTOR Barbecue
Business name: Thermal Flo, Inc. Clothes dryer (gas)
Other; _ 1
Address: 7236 SW Durham Rd MECIIANICAL PERMIT FEES'
City /Statc/ZIP: Portland, OR 97224 Subtotal_
Minimum permit fee ($72.50) `72,
Plionc: (503) 670 -8343 Fax: (503) 620 -1953 Plan review 25% of
(' permit fee)
CCB lie.: 151847 _ State surcharge (8 %o£permil fee) j,
TOTAL PERMIT FEE '75'_g)
This permit application expires if a permit is net obtained within 180
Authorized signature: I dnya after it has been accepted as complete.
Print name: Brenda Estes Date: 06/M7 " Fcc methodology set by Tri- County Building rr.{oslr Service Mad
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