Permit r 3 ' v ! %.*M MECHANICAL PERMIT
.:? -„ CITY OF TIGARD
4. ipi
I! • COMMUNITY DEVELOPMENT Permit #: MEC2010 00116
f G A RD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 03/19/2010
T
Parcel: 2S111AD18300
Jurisdiction: Tigard
Site address: 14906 SW JONAGOLD TER
Subdivision: LADY APPLE Lot: 7
Project: Bremner
Project Description: Install a /c.
Owner: FEES
BEACON HOMES NW INC Description Date Amount
12703 SW 67TH AVE
TIGARD, OR 97223 Air Conditioning 03/19/2010 $46.75
12% State Surcharge - Mechanical 03/19/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 03/19/2010 $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:
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: cj_ Mci, t ry �� �Q � .A�. ) Permittee Signature: -__Q /l
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit App . : 1 OR OFFIC. r: t: Sf� ONLi'
1 City of Tigard i Received
11,,, i 3125 S W Hall Blvd., Tigard OR 9922 Date/By: "`)
Phone: 503.639.4171 1:ax: 503.598.1960 AR 16 2013 _
TI G ARD Inspection Line: 103.639.4175 Date ReadyBy Auit See Page 2 for
Internet: ww,vtigard- or.gov Notified/Method: ( Supplemental Information
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' 1CO1Vi111ERQrf3 iFEE DUKE %IJ$E.(� H (IiSr
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Meehar:cal permit fees* arc based on the value of the work
El New construction ddition /alteration /repiaoerneni
performed. Indicate the value (rounded to the nearest dollar) of all
D Demolition Other: mechanical materials. equipment. labor, overhead, and profit.
.:::,t, .. . , (,ATEGOR V: ROP ?;76NSfIRi1c'*TJ9./ :,, ,.-
Value: S
] - and 2 dwelling i2ESIDENflA ,EO '
TJIPMEn'7' SYSt'�EMS E}�S, Y...
y g D Commercial /industrial 0 A ccessory building
For special Information use checklist.
Nlul y Master r builder D Other: Description Qty. Fa. Total
JOR 31TE- 11"PORMAT101 .,AND LOCA1.10? Heating/cooling
i 7 . / - Z n, -- Ai conditioning
Job site address: ,p06:, Vr %11111 y o r �•
t� r (requires ires site plan sllavinl'- placement) ) / 46.75 l i t ‘l =�
City/State/ZIP: / OR ! Furnace 100,000 BTU (ducts/vrnts) _ 46.75
Suite/bldg./apt. no.: Project name: 1 12. q g f Furnace 100,(t00+ BTU (duasiventx) 5.4.91 ^_
_ Heat um 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
• hydre,nic) 23.32
Unit heaters (fuel -type, not electric),
in -wall. in- duel, suspended, etc. 46.75
Subdivision: Lot no.:
Flue/vent for any of above 23.32
Other 23.32
Tax map/parcel no.: Other fuel appliances •
:; ' 'D 10 c
rt r.,-- r t-O R I ,; , , C . , .. Vl ater heater 2332
Gas fireplace 33.39
/+
Flue vent for water heater or gas •
1 1,,-. o UGC e- / 0/7e- fireplace 23.32
Loa lighter (,as) 23.32
Wood/pellet stove _ 33,39
Wood fireplace/insert 1 23.32 _
C . > NE, Y QWPtTF�t • ,'::, ; ' AT : :::::.. r....,,,, , Chimney /iincr/fiuelvealt 23.32
Other. _ 23.32 _ •
Name: (In e , •f4 # l ile- Environmental exhaust and ventilat
Address: r — Range hood /other kitchen
equipment 33.39
City/State/ZIP: �1' Q. jib (, le. Clothes dryer exhaust
33.39 _
Single -duct exhaust (bathrooms,
Phone: 11) 2 6-60120 Fax: ( ) toilet cornpartrnents. utility rooms) 23.32
... { AhPa;1CA'I ' . '. .... t]. GOTNWT' . F PEkS015 , Attic/crawlspacc fans 2332
Business name: f /! e t Kt 1 ,, Other. - 23.32
_Fuel pipin-
Contact name: > < - jO f/ e SI4.15 for first four; $4.03_ f or each additional
Address: a- 's 100 Furnace- etc. -
l+� r !Y - Gas heat pump
City/State/ZIP: ,40,7344 04 t it 2 4, Wall/suspended/omit heater
Phone: j / ' )b /0.80 ///�
vim✓ r� qtr
Fax: _ ) 00 - , rn Waterheater
Fir2lace
E- mail; • ... l #.. .. ffl&/ iijn • CO L Range •
:CO1'JTMcF.QR: : Barbecue -
Business name: _Clothes dryer (gas)
Address: Other:
�� MECHANitA1kLIyER14ft 1 S* :•..: : ::
City /State/ZIP: t:U//. a 5 ct 4 1 ,ems Subtotal ./�
Phone: ( ) Fart ( ) _ Minimum permit fee ($90.00) 0. CO
/ Plan review (25% of permit fee)
CCB lie -: / 5 4.7
Authorized signs State surchar ( 12% ofpe rmit fee)
Y TOTAL PERMIT FEE I CQ.1�0
a C Th is permit applica expires if A permit ix not
FR i pe obtained within IRO
/ d ays after it has been accepted as complete.
Print name: QD ` Date: 3 r _ ! i✓ ! ` Fee mCthodology bet by Tri County Building Industry Service Board
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SITE PLAN
PREPARED BY: e cr,,l' ‘..4 DATE: v1/016' 4 1 t 0
1 CUSTOMER NAME: f\ 0iN0,6, & J &E__." 0 3? ADDRESS: 1 4cto(4 5 4. 3 ,, g
CUSTOMER PHONE: q--i-\) :)3c--- (&-} ZC)
PROPERTY BOUNDARY LINE
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