Permit r,"' h MECHANICAL PERMIT
� CITY OF TIGARD
i
` � COMMUNITY DEVELOPMENT Permit #: MEC2010 00187
� 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/27/2010
4 TA g Parcel: 2S 112CA061
A
Jurisdiction: Tigard
Site address: 15267 SW THURSTON LN
Subdivision: Lot: 0
Project: Jackson
Project Description: Change gas furnace and install new gas furnace
Owner: FEES
JACKSON, JOHN L & CAROLYN M Description Date Amount
15267 SW THURSTON LN Furnaces < 100K BTU 04/27/2010 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 04/27/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 04/27/2010 $43.25
Contractor:
EAGLE HEATING
PO BOX 33767
PORTLAND, OR 97292
PHONE: 503 - 261 -1110
FAX: 503- 261 -6421
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: J/ Permittee Signature: 17-1( &a d- UJ ►t/
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
FROM : EAGLE' HEAT INGBAC FAX NO. : 5032616421 Apr. 27 2010 1E1:47AM P2
Mechanical Permit A licatio g4-iv..
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City of Tigard CEIV Permit No. :ire ... .„ J/ (� -- p01
.) Plan Review
% B .,'1gard, " 13125 SW li ail l vd i U lm
irk
° Phone: 503.639.4171 Fax 503 598.1960 Ot i P
s:u �. Date03y:
Tci`G 17' inspection Line: 503.639.4175 APR 2 7 2010 bate Ready/By: ruin: RJ Sec Page 2 for
6u..4- t Internet' www.tigard- or,gov Notified/Method. Supplemental Information
CITY OF TIGARD
TYPE ;_' ' :v. 9I$VG..DIVISION COMMERCIAL FEE' SellI_DIlt.tt - USE CHECKLIST
�___ Mechanical permit fees; sue based on the value of the work
❑ New construction 21 Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
I] Demolition 0 Other: mechanical materials, equipment. labor, overhead, and rp ofit�
CATEGORY OF CONSTRUCTION _ Value. $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
[6,,,� 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
[] Multi family ❑Master builder [] Other: For special information use checklist.
Description Qty. 1 Ea 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: `' Z. 6 s c)..) 1 J V r s `fi ri L c ;- a Air conditioning 1
(requires site plan showing placement) 46.75
City/State/ZIP: 7 / $ ct rc j et ( 2. Z ti Furnace 100,000 BTU (ducts/vents) 1 46.75 y 6,a61
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 (fad -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.:
Flue/vent for any of above 23.32
Other. 23.32
Tax map /parcel no.: Other fad appliances
C1-1-----6—q' DESCRIPTION OF WORK Water heater 23.32 •
°y 4-1---- ea 2 n4.Ca 421 -e,/ -L'.� 'T ' l l /nt ca./
(iae fireplace • 3339
!d' Five vent for water heater or gas
y � () . r t fi lace 23.32
Lo: Ii_ ter :as =MI
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
0 PROPERTY OWNER 1 ❑ TENANT — Chimney/liner /flue/vent 23.32
— Other 2332
Ntune: Environmental exhaust and ventilation
Address: Range hood/othcr kitchen
e. utpmcat 33.39
City /State/Z1P: Clothes dryer cxhtumst 3339
Phone: ( ) Fax' ( ) Single-duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
f51. APPLICANT � Q CONTACT PERSON Attic/crawispace fans 2332
' Business name: I for G (} "- ].. '`z C1 1 A (Scher: 23.32 1
Fuel piping_
Contact name: S14.15 for first four: 54.03 for each additional
Address: Plum etc.
City /State/ZIP: Gas heal pinny
Wan /suspended/unitheater
Phone: ( ) Fax: : ( ) Water heater
E -mail: -" Fireplace II
— Range
CONTRACTOR Barbecue
Business name: E 71 :"- 16- i,. am Clothes dryer (gas)
Address: - 0 6 o x 3 3 6 c der: IIMI
P MECHANICAL P`ERMIT FEES*
City/State/ZEP: ,PC L „--7' 6 f, ` . R 2q Z — subtotal 416 r
Phone: (r7d3) Z �, ` Ca Fax (6 3) Z6 6 L 2 _ Minimum permit fee ($90.00) 3
Plah CCB lic.: 11,0 1 f a O Odic) "c ( % ofperatfr the)
State surcharge (12% of permit fee) �•
TOTAL PERMIT T 4 EE * 0
Authorized signature: .. / .. rte. r ( plication ,
-- • �+ Z — C) Thi permit ap
days been accepted as cr obtained within 18n
r .� .M A ..-n , `,. aft it h ccep conideta
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