Permit CITY OF TIGARD
MECHANICAL PERMIT
` COMMUNITY DEVELOPMENT Permit #: MEC2010 -00239
'T E G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/25/2010
Parcel: 2S 104 BD00600
Jurisdiction: Tigard
Site address: 12665 SW 136TH CT
Subdivision: OBRS HEIGHTS Lot: 2
Project: Whitaker
Project Description: Furnace replacement.
Owner: FEES
WHITAKER, EVAN Description Date Amount
12665 SW 136TH CT Furnaces < 100K BTU 05/25/2010 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 05/25/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 05/25/2010 $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 $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or . 00:332:2344:--,
Issued By: ' — ^ %�'� Permittee Signature: (P) .7)1
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
\lay, 25. 2010 9:01AM Robben & Sons Heating Inc. No. 7979 P. 1 -- - -. --. - - --
Mechanical Permit A l icatio n g _°
City of Tigard A 1
13125 SW Hall Blvd., Tigard, OR 97223 '`' - 11� >
1 ' Phone: 503.639.4171 Fax 503.598.1960 MAY 2 5 2011 arm Revi
l I i ; A u1) Inspection Line: 503.639.4175 Y ew
Other Permit:
Internet: w ww.tigard or.gov Y G Date c d Melh° Supplemental See pent for
CITY - 1 I(xA i ofifiedlMe7hod; 0 Se ge 2 for
,t. a
TYPE F ;WOIIIC
•
�. � O ' r .. v ;.,;. i .y •,(.' 1''•.5. n`S C ' ��0,.:vSG10UL . - . U$E CHEGYQ.IST
Mechanical permit fees" are based on the value of the work
❑ New construction Si Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of e11
❑ Demolition ❑ Other:
mechanical materials, equipment, labor, overhead, and profit.
Cimoitir OF ; O • til ; >
. ... . CTYOItI, � � .1. ,.�.: � i �,��.::'( �ci,.r, Value S
M 1- and 2-family dwelling d ;I<7% of Information JIP M�NT use checklist.
EES•
Y g ❑ Commercial/industrial ID building
. „
❑ Multi - family ❑ Master builder III Other: For special rnjormarian use clreckllsr,
' ,'-JOE $1 TF.rINl�0.11**mI�'�se4X!fI1�L�Q 1`1TUN .:.�,yb;u— QrY- Fa. Total
Description
�srt � Hearing/eooli
Job site address: 2 \':� /1
Air conditioning
--+' ` J�� 1 (requires site plan showing placement) 46.75
City /State /ZIP:: f11� - Fumacc 100 000 BTU (ducts/venle , 13
Suite/bldg. /apt. no.: Project name. r r ` � Furnace 100 0� BTU (decuivents) 34
N` Heat pump 61.06
Cross strect/directlons 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
Tax map /parcel no.;
Other: 23.32
Other fuel appliances
„ 1.. " ; :D ON+OFIAVORCfJ . t'r h^ 4 '"`"VL 3 ,'}; , rr' {'1 Water heater 23.32
$. • � � �r Gas fireplace 33.39
t-- Flue vent for water heater or gas
fireplace 23.32
•- La li ter (gas) - 23.32
Wood/pellet stove _ 33.39
Wood fireplacc/insert 23.32
Q Pitopti4T*r'OWNER i + �:,....f.!:!;:;?;::..,,.‘ L hlily ',i z ( Chimney/liner /flue /vent 23.32
Name; '' _Other 23.32
Environmental exhaust and ventilation
Address: ���4p1 ` Range hood/other kitchen
equipment 33.39
City /Stale/ZIP: A�
iks A., lb. *yg Clothes dryer exhaust 33.39
Single -duct exhaust
Phone (bathrooms
�$ Fax( )
toilet
d APPLIC `- n <. �. !Oh:
compartments, utility rooms)
�, f s
,s . •;, .. , ,> � .:: w,b� , � rya, cdl�lr�r e .J ,��),°�r'�,1M Attic /crawtspac® fans 2332
Business name: Other
�`� -��. Atop, t- v� 1.� l�� Fuel piping 23.32
Contact name.
$14.15 for first four; $4.03 for each additional
y1 Furnace, etc.
Address
1
City /State/ZIP ~ Gas heat pump
tei„t�taike do • \ WalUauspended/unitheafer
Phone:' • w �; �, 4 ,
� 110 ,rivi ' ti I Water heater
E-mat _ Fireplace
,!:v ;;i lC1lVTiiA *,YSti t u
i..i: �, „s�:+ 1 ,,,� >�1,•t t � f; .♦ q r h+Jtyt Barbecue _
Business name: �r 1 �__ ,, ' Clothes dryer (gas) -
Address: ���•,� � ,r•, _
Other
City /Statc/ZI': _ [�'� � : kc.1�,,, -;' ,�. . 0 c., g1r;1►31�;F)JE3”
loo IL "� ^* Subtotal
Phan • s)IV API - Fax: Iiito hfl • Minimum permit fee ($90.00)
CCB lie.: \ Plan review (25% of permit foe)
1) f ii State surcharge (12 %ofpermit fee) `�n
TOTAL PERMIT FEE ��, j�V,
Authorized signature: � _l M St i& This permit application spires if a permit i9 not obtained within 1: ,
Print clam: ' days after it bas been Accepted ma complete.
'� � alk Det • " : • Fee methodology sat by Tri- County building Industry Service Board
r:'Boildint.pennlist C-FattnitApp.doe 70/01/09
410 - 4617T umrrn►nn.mnl