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Permit , a CITY OF TIGARD MECHANICAL PERMIT a COMMUNITY DEVELOPMENT Permit #: MEC2009-00631 T I G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/25/2009 Parcel: 1S133AD11400 Jurisdiction: Tigard Site address: 10704 SW 127TH CT Subdivision: AMART SUMMER LAKE NO. 3 Lot: 170 Project: DeFrancisco Project Description: Install gas furnace. Owner: FEES DEFRANCISCO, ROBERT Description Date Amount 10704 SW 127TH CT Furnaces < 100K BTU 11/25/2009 $46.75 TIGARD, OR 97223 12% State Surcharge - Mechanical 11/25/2009 $10.80 PHONE: Minimum Fee Adjustment - Mechanical 11/25/2009 $43.25 Contractor: SKY HEATING & AIR CONDITIONING, INC 1637 SE NEHALEM ST PORTLAND, OR 97202 PHONE: 503 - 235 -9083 FAX: 503 - 235 -0454 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: Oil r � 1! kA, Permittee Signature: -c u AVP 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. 7 r, Mec:lanical Permit Application : , .� , K l gilt t11 1 It i11'141')Nl 'r . fi r' i � ter. 1 � r : City of Tigard � ' CEIV�iD : ' J P rnait N u.' �� ��� i1 1 ° 13125 SW Hall Blvd., Tigard, OR 9 ` v �H� , - Plan Review � . 1A Phone, 503.639.4171 Fax: 503.598.1960 Other 1 c,o,it: Uak /By: 3A- 4 inspection Line: 503.639,4175 NOV 2 5 2009 1 1 , Date Ready /By: Sur : 10 See Payer 2 fur Y akfi.. Internet: www.tigard- or.gov Notified/Method: C, Suppiuu,uurat Information CITY OF TIGARD TYPE C iltYlEVNG DIVISION COMMERCIAL FEE' SCHEDULE - USE CHECKLIST ❑ New construction 'Addition /alteration/replacement Mechanical permit fees" are based on the value of the wort: performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demo Iition © Other: mechanical materials, equipment, labor. overhead, and profit, CATEGORY OF CONSTRUCTION value: $ ' RESIDENTIAL EQUIPMENT / SYSTEMS FEES" til 1. and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Nlulti•fttmily ❑ Master builder ❑ Other: De criptiutt J Qty. . ^ f a. Total JOB SITE INFORMATION AND LOCATION Heating/cooling ._ ^7 Air conditioning site address, O O i )1/4-7,) 1. (_� ^V � (requires site plan showing placement)_ 46.75 City /State /ZIP: m_ O2 q z.--4-- Furnace 100,000 BTU (duets/vents) ( 46 75 , 1 Furnace 100,000+ BTU (ductsivents) 54.91 Suitc /bldg. /apt. no.: . Project name: Heat pump d1 06 .,. Cross street/directions to job site: Duct work 23.32 _ �1 I r J " Hydronlc hot water system — 23.32 Residential boiler (radiator or hydroaic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in-duet, suspended, etc. 46.75 ' Flue/vent for an y of above 23.32 Subdivision: Lot nu.: . _., - Other . 23.32 Tux leap /parcel no.; Other furl appliances DESCRIPTION OF W K . . Water heater 23.32 r • � ///7 �/ , Gas fireplace 33.39 1 (/( T / It Y 3 Y( ,e. 14 VI C , . Flue vent for water treater or gas KS v J `�� -'�� tireplaoC 23.32 - - ,..,.. — Log ItOter (gas) 23.32 ... Wood/pellet stove - f 33.39 — Wood fireplace /insert 23.32 — • Chimney /liner /Iluc /vent 23.32 0 PROPERTY OWNER ❑ TENANT Other , - -3 3' � Narne: S Environmental exhaust and vent — ilatiuu Range hood/other kitchen Address: equipment 33,39 City /Slate /"LIP: CA. 1 Clothes dryer exhaust I 33.39 ,____, - Single -duct exhaust (bathrooms, Phone: ( ) Fax; ( ) toilet compartments. utilitYrooms} 23.32 - - Auic/crawlspacc fans 23,32 ❑ APPLICANT• 0 CONTACT PERSON Other 23 . 3 '- 1 Business name bur i iu __ _ P P , g- Contact name: • 49 . S14.15 for first four; $4.03 for each additional C. •, Mb Furnace, etc. _ -. -. Address: ♦ Gas heat pump City /State /G(P: Wall/suspended/unit heater —, Water heater _Pnonc. ( ) Fax: ( ) Fireplace E- mail: -- Range , • CONTRACTOR • Barbecue _ . - Clothes dryer (gas) , .I Business name' � \ IS ' • - 1 .. C_ Other: 1 - Address: ! � 0 6 �/ 1.�.yti -4- . MECHANICAL PERMIT FEES" - Subtotal ����p - City /State /ZIP: . - �9-1 _ Minimum permit fee ($90.00) "1%V Phone: ( r 2 ) 7 a t Qs j Fax• VU3) 7.-5-7 Q ( 5—__ Plan review (25% of permit fee) CC't3 tic. G / State surcharge (12% of permit fee) 1 t;) .. ©� 7 " f " • • TOTAL PERMIT FEE .. tI I) 0 , O j � ` y " This permit Gpptiraliou by it a permit it net obtained within ISO Authorized signature; J day after it hex been accepted as roulplrto. Dale! , 1 Dot f ha . F °e nutlwdology sot by Tri County ttuildi„ g Industry Soviet Board PfII1t !lame. la-. :. rr",i,rna,Acru,iu\MtiC- PcrmitApP (la'. I0101 /U9 W 1. V ll' CoY r 1 sr (It3i) Z0 /T0 39 d 3d GNd 9NIltl3H AAS VSVOSEZEOS 65 :iZ 600Z /bZ /TT