Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010-00153
• '4 Oi Date Issued: 04/07/2010
T [ GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1S134AD03400
Jurisdiction: Tigard
Site address: 10945 SW 108TH AVE
Subdivision: BLACK BULL PARK Lot: 12
Project: Frisch
Project Description: Replace gas furnace and a /c.
Owner: FEES
FRISCH, JEFF Description Date Amount
10945 SW 108TH
TIGARD, OR 97223 Air Conditioning 04/07/2010 $46.75
Furnaces < 100K BTU 04/07/2010 $46.75
PHONE: 12% State Surcharge - Mechanical 04/07/2010 $11.22
Contractor:
COST PLUS HEATING & AIR
7132 N FESSENDEN ST
PORTLAND, OR 97203
PHONE: 503 - 286 -2009
FAX: 503 - 286 -6552
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
Total $104.72
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notificati. - ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct s • -stions to Ob C by -fling 503.246.6699 or 1.800.332.2344.
Issued :y: /, Permittee Signature: X
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
Cl of Tigard Received
`J g DateBy: 1 1 /45 Permit No.: i lce aD1D /57
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
14 C Phone: 503.639.4171 Fax: 503.598.1960 Other Permit: eze,2607^ 001,$"
Date /By:
TIGARD Inspection Line: 503.639 Date Ready /By: 2111 ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction ® 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 ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
® 1- and 2- family dwelling 0 Commercial/industrial RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning
Job site address: 10945 sw 108 th (requires site plan showing placement) 1 46.75 46.75
City /State /ZIP: tigard or 97223 Furnace 100,000 BTU (ducts/vents) 1 46.75 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project name: 2/l 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
Subdivision: Lot no.:
Flue /vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
gas to gas furnace repacement,replace existing a/c same location 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
® PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other: _ 23.32
Name: jeff frish Environmental exhaust and ventilation
Address: 10945 sw 108 th Range hood /other kitchen
equipment 33.39
City /State /ZIP: tigard or 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)7842355 Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ® CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: costplus
. Fuel piping
Contact name: stove sanderson $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: (503) 781 9090 Fax:: ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: cost plus heating &air Clothes dryer (gas)
Other:
Address: 7132 n fessenden MECHANICAL PERMIT FEES*
City /State /ZIP: portland or 97203 Subtotal
Phone: (503 ) 286 2009 Fax: (503 ) 286 6552 Minimum permit fee ($90.00) 93.50
Plan review (25% of permit fee)
CCB lic.: 47978 f State surcharge (12% of permit fee) 11.22
� TOTAL PERMIT FEE 108=
This p ermit application expires if a permit is not obtained within n 1 180 101 Authorized signature
days after it has been accepted as complete.
Print name: steve sanderson/ Date: 04/05/10 * Fee methodology set by Tri- County Building Industry Service Board
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CUSTOMER INFORMATION
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