Permit 1 L VI
74 CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2010 00173
Ti G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 04/19/2010
Parcel: 2S110BA03800
Jurisdiction: Tigard
Site address: 14430 SW MCFARLAND BLVD
Subdivision: SHADOW HILLS Lot: 27
Project: Mareno
Project Description: Push /Pull furnace
Owner: FEES
MORENO, FERDINAND A AND Description Date Amount
R JEAN, 14430 SW MCFARLAND BLVD Furnaces < 100K BTU 04/19/2010 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 04/19/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 04/19/2010 $43.25
Contractor:
ROBBEN & SONS HEATING INC
2214 SE 8TH AVE
PORTLAND, OR 97214
PHONE: 503 - 233 -5841
FAX: 503 - 238 -8849
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: /°1j'YW lit,( (J1 Permittee Signature: d Leer, � x
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.
Apr. 16. 2010 4:39PM Robe L.ns Heating Inc. 7598 P. 1 Mechanical Permit A licati 1VED r. ° 4. ; t t Ai , 4 r < ,
" ,c i r lk , i�. $ t' � ;
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1 ; € H� City of Tigard Date/By: Permit No.: l1.{� (! � (v . -00/23
"• i a 13I2S SW Hall Blvd., Tigard, OR 97223 APR 16 2010 Plan Review '
r , 0 Phone: 503.639.4171 Fax: 503.598.1960 Date/By: other Permit:
a t i'� it i it Inspection Line' 503.639.4175 CITY OF TIGARD Dote Ready/By: runs: I El See Page 2 for
.i< .4 Internet: www.tigard•or.gov BUILDING DIVISION Notified/Method: 1 Supplementer Information
TYPE OF WORK CO 111V1ERCIAL.'FEE" SCHEDULE'- USE CHECKLIST '
❑ New construction E AdditioWalte[ation/replacement Mechanical permit fees" arc based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: , mechanical materials, equipment, labor, overhead, and1trofrt.
• CATEGORY OF CONSTRUCTION Value: $
. .. — , REBID NTIAL EQUIPMENT /, SYSTEMS FEES"
and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: - Description 1 Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION . Heating/cooling
Job site address: �.- Air conditioning
. `' �� St �1P� (requires Site pier Showing placement) 46.75
City /State/ZIP CCA Furnace 100 000 BTU ducts/vents) 46.75 rail
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
liydronic 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 23.32
Subdivision: Lot no.: Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF .WORK . ' Water heater 23.32
Gas fireplace 33,39
r �� 1 i .. • �« ~ Flue vent for water heater 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
- g;ERiTY OWNER I • 1:1 TENANT • Outer: _ 23,32
Name; f'k V1 CY1 Environmental exhaust and ventilation
1b\ C Range hood/other kitchen
Address: equipment 33.39
\ '� 1 Clothes dryer exhaust 33.39
Cit /State/Zl' . ��`� � �� L Single -duct exhaust (bathrooms,
Phone; - ( ' di 0 Fax: ( ) toilet compartments, utility rooms) 23.32
0 APPLICANT . 0 CONTACT PERSON Atticicrawlspace fans 23.32
\ Other; 23.32
Business nam . 44 i wi t 1 � • ,'i,� (�t\ AIL _ Fuel piping _
Contact namc:C ilk 1 •. a'P c_ S14.15 for first four; $4.03 for each additional
ti
Furnace, etc.
Address: 2' B Gas heat pump
City /State /Z1P: O A; WalVsuspended/unitheater
Water heater
phone:
A lire MI I Fireplace
E -mail: " ri�.+ Okla di AilL . � r1Z � %Ai. • • Range
' CONTRACTOR Barbecue
•
. Clothes dryer (gas)
. ._
Business name; , 1 lliA LE, 10145 1 ga Other: . —
Address; ' ^{ do . ' . '. M ECHANICAL.PERMIT FEES*
city/State/ZIP: Aglit i . Subtotal /�
Minimum permit fee ($90.00) CklJ
Phone: l Z ` ✓` ' A Fax: (- :d62i`, plan review (25 %of permit fee)
i ""�✓
CCB lie.: State surcharge (12% of permit fee) \U •
TOTAL PERMIT FEE `(') , 1 )
A i 1 �\ ttr This permit application expires if a permit is not obtained within 1; i
Authorized signature: Rte ,_. days after it has been accepted as complete. Nil
Print name Y [' ; 1111111110 Date; tk/ ` 1 _ ' Fee methodology set by Tri- County Building Industry Service Board
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