Permit M
iii
a CITY OF TIGARD
MECHANICAL PERMIT
, COMMUNITY DEVELOPMENT Permit #: MEC2009-00609
T t GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/13/2009
Parcel: 2S103BCO3800
Jurisdiction: Tigard
Site address: 12425 SW ALBERTA ST
Subdivision: Lot: 0
Project: Kessler
Project Description: Push /pull furnace, vent furnace and water heater.
Owner: FEES
KESSLER, MARGUERITE E Description Date Amount
12425 SW ALBERTA
TIGARD, OR 97223 Furnaces < 100K BTU 11/13/2009 $46.75
FlueNent For Any of Above 11/13/2009 $23.32
PHONE: Flue Vent for Water Heater or Gas 11/13/2009 $23.32
Fireplace
Contractor: 12% State Surcharge - Mechanical 11/13/2009 $11.21
ANCTIL HEATING & COOLING
4320 N WILLIAMS AVE
PORTLAND, OR 97217
PHONE: 503 - 281 -0752
FAX: 503 - 282 -5722
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
Total $104.60
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 que ': - to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: �_ , 1 ( Permittee Signature: , � Lt ` - "■____) ,jgf
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 Applicatio EC E IV I � . t i "' ¢ Y� 4 f Tig 9 Penmi N ' �/ /� r lk�� d , .•� Cr< 01 • ■ MI. t� kE: �� � `r- /
�r D / � y 13125 $W Hall Blvd
,M
OR 97223 NOV 12 2009 p
DatrrRy:
A n Phone: 503.639.4171 Fax: 503.598.1 960 Older Permit:
44 1; 1,, i i ., Inspection lane: 503.639,4175 Datc Ready /By: Sec Page for
•" ;anemic www.tigard•or.gov CITY OF TIGARD Nntaied/Method:
BUILDING DIVISIO Supplemental Information
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New construction 0 Addition/altcration /replacement Mechanical permit fees' are bash on the value of the work
performed. Indicate the value (rounded to the nest dollar) of all
❑ Demolition C.3 Other: etr
mechanical materials,
equipment, labor, overhead, and profit.
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+
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Forspec/al informatton use checklist.
0 Multi family [] Master builder ❑ Other
a �ptrd r k u 4Ne, nh i +. Tr •rr ;�. r w n ncscription Qty. Ea. Total
i,t'4..�y ��P ! )ra r a w t d l trY � 1 �.ru Y j 1 d tr 1 1�if '
`1' "� .. ,I 0 + f+t a i ii• , s', i�t,��t�"!1r�uF40,r0,44 t 0( , j:��'s0 b!¢l1j� �,(�:Gl Yli n f 9; l,r 1 Heatinglcooling
Job site address_ 12425 SW Alberta Street Air conditioning (requires xitc plan slowing placement) 46.75
City /State /ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducte /vents) 1 46.75 46.75
Furnace 100,000i- BTU (duct iverm) 54.91
Suite/bldg. /apt. no.: Project name: #128498 Heat pump 61.06 I
Cross street/directions to job site: Dula work _ _ 23.32
Hydronic hot water system f 23.32
_
_,_ Residential boiler (radiator or
_h 23.32
lheit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75 •
Subdivision: 1 Lot no.: Flue/vent for any of above 1 23.32 23.32
Other. 2332
Tax map /parcel no.: Other fuel appliances
,x"' t v � 1 "Y " ti " r Ir v ti ,o - da0r+ v: r { �k�r p)"1p ll { 23.32
rri i �s ,J! ti ' ' Ir , 1e tfe , a ¢P a ,ld b A ,li\ Y N W ater h eater
o., >wr.L t, ;l�� -�: ^M i� & , W' ,tit��;,,�yl,� : �� ,� _ . ,. ��r �� ) t r >« "( ,rrfJt���1�r�r�IJ ^e t� �1(db���l.. ll.Ltl�u '� "'1P;; � ., ■
Gas fireplace 33.39 ,'
Pusblpull furnace. Vent furnace. Vent existing water heater. -
vent for water heater or gas
fir place I 23.32 ' 23,32
Log lightetss) 23.32
Wood/pellet stove 1 33.39
Wood fireplace /insert 23.32
+ .� tQ,,,uk t �tr .a.., l� r �� �� r r � a,� r � dr i �yy Kt e. .+ Chimnoy /liner /f_l_ue/vent
'r`. � 2332
t t xi vwM Jf 'J !it 1,, t , l k{ , 9 7sl
+ v,, , � »� r �i r tre £ Ix. ' . Y ,t+r7Y;J t: ;' Other: 23.32
Name: Margie Kessler Environmental exhaust and ventilation
- Range hood/other kitchen
Address: 12425 SW Alberta Street •. ui.ment 33.39
City /State/ZIP: Tigard, OR 97223 Clothes dryer exhaust 33.39 •
. Single -duct exhaust (bathrooms,
Phone: (503)590-1761 Fax ( ) toilet com•artments. utili rooms 23.32
r - r Y /P a r. ^r Attielcrawls )ace fans 23,32
et r 1� $l : kl >,l,.., 4NTt (.'' ,,..r +ri�tri 1
�ti �/ rr�1d. r h (a> 17 �.d( rJt�, �tr ���6 ,. -IuFy 1f, •.r. r,. UtAcr, 23.32
Business name: An etil Heating & Cooling Fuel .1 • in
$14.15 for first four: $4.03 for each additional
Contact name: Christine Barton _
Furnace, etc,
Address: 4320 N Williams Avenue Gas heat . um
•
Wall /suspended/unit heater MEM
CitylStatc /ZIP; Portland, OR 97217 . Water heater MA
Phone: (503) 281 -0752 Fax:: (503) 282-572 Fireplace �-
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r 't t p: r ' - i �4 �A r •I ....: `e" � . , , r -.,� Clothes dryer ( ts) lal
Business natllC. Anetll _ Other ;� pq r r rV,
Heating and Cooling - `' ( r1 t i �0 4s ` v k/ , , ,r A. 4 4, 39
=r . . ' i . +i. a t i r p, r. x!n Subtotal 93.39
Address: SAME AS ABOVE _ - _- -. - --
- - - t� -
. - Minimum permit fee (490.0
C1N /StateIZ - -' pl an TvvioW (2S %o o f p e r m it f cc
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_ __ Stair, sur chargr (1�f p er m it fee) t 04.60
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- - -'- days Mier it has keen accepted A>; cOlnptetc.
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