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Permit i t !, CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2009-00554 ..0—.1.60 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/20/2009 KT I G ARD, Parcel: 2S 111 AD05300 Jurisdiction: Tigard Site address: 8790 SW PINEBROOK ST Subdivision: Lot: 0 Project: Francetich Project Description: Push /pull existing furnace Owner: FEES FRANCETICH, KERRY E AND ROSALIE Description Date Amount 8790 SW PINEBROOK ST Furnaces < 100K BTU 10/20/2009 $46.75 TIGARD, OR 97224 12% State Surcharge - Mechanical 10/20/2009 $10.80 PHONE: 503 - 330 -3435 Minimum Fee Adjustment - Mechanical 10/20/2009 $43.25 Contractor: A -TEMP HEATING & COOLING 16000 SE EVELYN ST CLACKAMAS, OR 97015 -9519 PHONE: 503 - 650 -5014 FAX: 503- 557 -2990 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 1.800.332.2344. Issued By: / lA-x-1 Permittee Signature: rt af p 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. 10/19/2009 14:24 5035572990 A -TEMP HEATING PAGE 01/02 Mec ianieal Permit Application rtfil City of Tigalyd vd Cavbq -010 f a 13125 SW Hall B g lvd., Ti ard, OR 97223 RECEIVE; 1er Pcrntit: o Review Otl a Phone: 503.639.4171 Fax 503,598.1960 Date/By: Inspection Inc 503.639,4175 Rate Roady/By: rapt: Ri 5cc. Page 2 for T tG r1 F.il Internet.: www,tlgard- or.gov OCT 19 200'' Notified/Method: Supplemental Information r. ,t, v h c�,^ r •-r r<t •r b , >< *N F , trm �? is = r >, f7,1-',1-,,, 7 No r 'c •. �, r t w 1t W : , 4m, ,„.. ,e,: ( i � , ';1141 / : Mg r% � rv; tRI Q 81 ` l Ft q '1 :IF 7 t F� sfx :4 x : 4 1 � i<l Y�j ill x Y : . r' � :,: N ;n 1 1. `i41114LE'L�L4�1Y �.∎0 . 4' t , � , x4.NT� Iw'1�1G Slif 11 , 1) II[ 1 Y V 1 Mechanical permit fees* arc based on the v of the work 0 New construction Addition /alteratio performed. Indicate the vaiuc (rounded to the nearest dollar) of all ❑ Demolition ,y Other; mechanical materials equipment, labor, overhead. and profit_ V'.w ?" ,1, s f , ° � r,N - +r ' > � •° 1E. t' l i ' �. Value ' x � y,., .,1 � r . . V7 i w aadd p� e H �� A ^i .rl y^ �ets.p •dtilak. ' ,. S I 4:!' l`W lia 1- and 2- family dwelling 0 Commercial /industrial © Accessory building For special information use checklist. ❑ Multi - family 0 Master builder ❑ Other: Description • 1 Qty. 1 Ba. 1 Total P +M ) 4 1 k�J 15J ° • ter .4‘;'(4t74. N 9 4 P 0 iA'i��14 , A +•'." ttrt I Hestia: eooiin, o ,a o.i 4. „1 P j''.14,- ' , �"S ..b!.. � • ..) r'', " - .,�. Air conditioning EMI Yob site address: ( B (B19 0 1 i jC) ' - II • (requites site plan aho placement) City /State /ZIP: 1 Fumacc 100,000 BTU (ducta/vcnte) 46.75 • • Furnace 100,000+ BTU (ducts /ven 54.91 Suite/bldg. /apt. no.: Project name: nC . ^ � Beat •ump S 61.06 Cross street /directions to job it Duct work ;. IBMI 1.1 dronic hot waters stern Residential boiler (radix .r or hydronic) , 23.12 Unit heaters (fuel -type, not electric). in -wall, in -duct, suspended, etc. 46.75 Flue /vent for an of abo'rc I= 23.32 Subdivision: Lot no.: Other: 23.32 Tax map /parcel no,: �m Other fuel appliances IP^K r e ,:•, �1 u :y K y1 IV' x41 ,: f f . ia> 8 .4.' e :• • ^ i1.. 1 1L " (,`'', i� Water heater 23.32 iHrt M .5 M 5,d .�'d1� l d Y a .. a b!z_liie ' , ' , J it k &i 1on1 t : b e u , Gas fi •lace 33.39 1 - " - NI w iliz .4111....... / Flue vent for water heater or gas fireplace 23.32 Loi li•htcr as 23.32 Wood /•ellct stove 33.39 Wood fircplacc/inscrt ' _ 23.321 r1 ,,,, y 1 � !fit 1 l 011 eN ,� ." - O' -,, ',. }. Ch;mney /lincrlfluc /veal L 23.32 P i ltii i :01, iP Mitif rk A g5 { rn t 1 1 , Vitwizfi '�tUPIM A In "a1'S,Oi ll- . r Others 23.32 1 Name: E axiCrr -1- -\ Environmental exhaust and ventilation Range hood /other kitchen Address: I * A equipment 1 33.39 City /5tatcl7_1P: A ' ` ` Clothes d et exhaust ' 33.39 Single -duct exhaust (bathrooms, Phone' 1 ) M Fax' ( ) toilet com .artments, util rooms • 21.32 iiil•l '+' ti {l. w`hal'e r�_'�� ip• l r. I " � a + 'or t +i •',. *t w p " ,,411.6:rEki V'0 � A , 6 i 1' r q Attic /crawts•acc fans f � k1c"� 1. 9&C nt,, v �1 O t h er: 23.32 Business name " ma il • • 051_" m ;, Cal 1C, \nC,, Fuel i Ing Contact name: l - • t_ la_ . S14.15 for first Four; S4.03 for each additiona Furnace, etc. 1 Address: _. Eve _ Gas heat • u • City /StatdZlP: r C j 5 Wall/suspended/unit heater , Ph one: � Fax: : _ sl - Q Water heater Fireplace E -mail: Range c,p v � + a ffdp 16 f c , r; r ry s ±s « M l ' B5.0,,,,, S ` 1' ''' f r � 4 a'�I p ' k 1 � f ' p L i! t r lLid t.FG; �2 . ,, tM t t ,,> < <. t n n Clothes d cr :as Business n it t /l ame:A. T� n � A k ; • iif , , ,, p Ott j ,ry• i , �tt• 11try7 hcr '' d ' �q({} � t .1 a Address: _` 1- � j ilfj 9 n . y ^`+� iiin qr • 9 ggrai Y1i Cit /S tate/ZIP: ^ 4x �` .___ (��'i1Di S ) Subtotal --------- Minimum permit fee ($90 -00) . QC7 � Phone: (0513 L Fa ) 65 0 _Plan rcficw (25% of permit fee) - CC1 lie.: 1 ( 4g 1 '7 (24 t) State surcharge (12% of permit fcc) Jp, (j TOTAL PERMIT FEE lit g ■ ■. \ Thic permit application cxptrea if n permit le not obtained within 180 Authorized signature _ A. days after 1r hat heen accepted as cnmplett. Print name. . A i Date: ' Fcc mcthodoingy set by Tri- County nuildHng indus Scrv Board i:lnuil(liuRkne mit,AMEC -i emiltArp e 10101 .9 4402617T (11 /02 /COM/Wan)