Permit q CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00125
Date Issued: 03/25/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1 S133DD04000
Jurisdiction: Tigard
Site address: 12558 SW BRIDGEVIEW CT
Subdivision: VILLAGE AT SUMMER LAKE NO. 3 Lot: 79
Project: gROH
Project Description: Install gas furnace.
Owner: FEES
GROH, DENNIS Description Date Amount
12558 SW BRIDGEVIEW CT Furnaces < 100K BTU 03/25/2010 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 03/25/2010 $10.80
PHONE: 503 - 524 -2267 Minimum Fee Adjustment - Mechanical 03/25/2010 $43.25
Contractor:
THERMAL FLO INC
7236 SW DURHAM RD 100
PORTLAND, OR 97224
PHONE: 503 - 670 -8343
FAX: 503- 598 -6746
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: , 1 ! I IA Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit A r
FOR OFFICE r c:tiE UNIX
City of Tigard ! r ° . Received
Dat
III 13125 SW Hall Blvd., Tigard, 97223 may: MI Fermi' No. • • • 41 .b, m i
Phone: 503.639.4171 Fax: 503.SQ�il02 5 2010 Plan Review
TiGARD inspection Line: 503.639.4175 M'' Da1e Other it.
Internet: wwtt'.tigard-or Date Plan
r ri • 2 See Pnge 2 for
^i _ i s : 1 , Notified/Method. SuppkrnentalInformation
...., TYYP:: YOR�C : COMNiERC).Ail F
O New construction in' Addition /alteration /replacemexlt Mechanical permit mss= arc based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials. equipment, labor, overhead. and profit.
....: CATEG0TtY:-OF lOtROC.1 ...:.,,.. :
Value: S
∎itES1AF,�R'TIAL. Ei 171PMEM;1 SY5TEIK'$ FEES"
►_ 1- and 2-tarn ily dwelling ❑ Commercial/industrial ❑ Accessory building • -
❑ Multi family L] Master builder 0 Other: Description Fo p cral f rmarl a clr sr.
6a, Total
-;JE)B Sire . i'+iftlp • 4.T11O1 °AND �1:;0CA1F e ,. t
Ina onus e i
Qty.
Job site address: r r � G 9 7 - Air c onditioning
e e ( a1rCS site Ian showin • lacer/lent 46.75
City / State/ZIP; 7 / ar54.-- O / 9 ? 2 2 Fumace 100,000 BTU (duets/vests) 1 46.75 . •G
i ✓ Furnace 100,00(H- BTU (ductsivents) 54.91
Suite/bldg. /apt. no.: Project name: R i 2
Heat pump 61.06
Cross street/directions to_ job site: ()network 1 23.32 '
{1 M"het. a l '
•
T H dronic hot water system 23.32
r � j Residential boiler (radiator or
hydronic) 23.32 1
Unit Heaters (fuel -type. not electric).
in -wall, in -duct. suspended, etc. _
Flue /vent for any of above - 23.32
Subdivision: Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances •
:DE.SCR1'TIOA iDF irO$?Fsw 'i" Water
..._ .:...., .. � � .�. � 23.32
�` heater
4 r, / M s� Far A p� Gas fireplace H 33.39
Gem L 4 G IiC/ Flue vent for water heater or gas
2e)•L P o' • `, r fireplace I 23.32
Log lishtcr (gas) 23.32
Wood /pellet stove 33.39
_Wood frreplacc/msert 23
,. ► `'1" - FIN .V.1 7 , i�lER° L] : : " other: y/finar /fluc/vent 23.32
µt ..... ' other: 23.32
Name: /D //,Izi,
J Yo Environmental exhaust and ventilation
Address: Range hood/other kitchen
_
Gil' e uinment 33.39
City / State/ZIP: a9 Sio
Clothes dryer exhaust 33.39
Phone: y Q ÷ ���� p ( )) Single-duct exhaust (bathrooms.
• toilet compartments. utility rooms) 2332 1
+CANT : :: 0 - , CON tl l'iRB.00 Attic/crawlspaoc tans 23.32
Business name: •�' I.i
1 _ • i, d / Other: 1--3'.32
Fuel p
Contact name: L/ --
�. /� , eleOley 514.15 for first four; S4.03 for each additional
Address: 'Z t' Itp / „f g t re., 100 Pomace. etc,
Gas heat pump
City /State/ZIP: / ieD Q / D 7 22 - Wall/suspended/unit heater
Phone: ,,, / ' )w?D . / Fax: :0 / ' ) , 17; •1 / - Waterhe,att:r
�
r ne- /� Fireplace
E -mail ... .tif it ' Therm,. i . / / . cI D/� Ranee .
• -CON'T.R,' C - OR ` ; . Barbecue
I Business name: Clothes dryer (eas)
4 AU' ' ■
Other:
art? r r r
M)uC;JtL4NI�i,Y'F3RMI FEE6" ,
City / State/ZIP: _ S ubtotal
Phone: ( ) Fax: ( ) Minimum permit fcc (890.00) �dr
Plan review (25% of permit fee)
CCB iic.; ! State surcharge (12% of permit fee) (1. ;II
TOTAL PERMIT FEE j Dc
• Authorized signat� r This permit application expires if n permit is not nbt>ained within 18U
dsrvs alter it has been accepted ax cnmpleic,
Print nam e: " �e /QD�y1 / Date: g - Z 5 f /t, - Fee metltodology set by Tri- Count, Buildins Ir trl• Scrvioc Hoard
1• lnuilAnn:TenninAMEC- PmnitAeadoc 10/01/09 ✓ ✓`'7 4404617r (11/02 /COM/WEB)
Z00 /ZOO d OEOZ+9 f „ i,, �2.,44. A (14 VIa3Hl 9bL9883609 1.9:0L 0L0Z /9Z /E0