Permit CITY OF TIGARD MECHANICAL PERMIT
V
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00278
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/18/2010
TIGARD 9 Parcel: 2S104AA11000
Jurisdiction: Tigard
Site address: 12285 SW 128TH AVE
Subdivision: BELLWOOD NO. 3 Lot: 129
Project: Blessing
Project Description: Install furnace.
Owner: FEES
BLESSING, CAROL Description Date Amount
12285 SW 128TH AVE Furnaces < 100K BTU 06/18/2010 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 06/18/2010 $10.80
PHONE: 503 - 997 -6484 Minimum Fee Adjustment - Mechanical 06/18/2010 $43.25
Contractor:
SUNSET HEATING & COOLING
0607 SW IDAHO ST
PORTLAND, OR 97239
PHONE: 503 - 234 -0611
FAX: 503 - 234 -0439
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: 4 Permittee Signature: oA7 /L j cw— 69,-1
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicati 0 .; -: 1 ' rot: OFFICE th• ONLY .
', •. , ,, Rtualved
IN..- y City of Ti Bird Tigard, oft 97223 J 17 20 10 Date/$y: 6 • / , /v . t er ra Pennitx °.`tire . //0 � D0 2` 7111
13125 SW Holt d., ! Other Permit
P Phone: 503.639.4171 Fax; 503.598.1960
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Internet Line: t www . 503.639A175 r.gOV i ( 0".-' sapplewnutal Information www.tigard-or.gov P , , d/Met io
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I � � •' • "' ` " " Mechanical; permit EGOS" are based on the value of the work
El New construction ditiott/alterationp
/re laccment performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition [ Other: mechanical niatenats, equipment, labor, overhead and profit
Value: $
} , I, ,.. { 4 1 lr , j r ' ! 1 J*„ 4717 .
- and 2- family dwelling 0 Commercial /industrial ❑ Accessory building For gieclal lnjormalion use checklist.
❑ Multi-family El Master builder [] Other: Description 1 Qty, 4 > a. } Total
. 1 ' t r ^[ 1P t 41'd r 1 J %1::',',.',':::!;:,‘:°I ! ' " 1 4 i
,a' ,
i�p ��� yI +:1 ,'tit X}?N� u, : t '1'; Heating/cooling
:'.° ( t !;I t,' l ", "i,:J �8'i:�fi rr 1(Itr'P.'r� Ai conditioning
5 j , { - 7 ' (roi wires site plan altowin r piaeement) 46.75
Job site address: vu Lr
�� Furnace 100 00(1 I 3TU (ductslvunte) � 46.75 15
City/State/ZIP: OA.'" O] Furnace loo 00o+ B'TU ductslvents) 54,91
� S i Heat pump 61.06
Suitc/bldbJupt. no,: project name: � 23.32
_
Cross stmt/directions to job site: Duct work li drone hot waters stem 23.32
Residential boiler (radiator or 23,32
hydronie) - —
Unit heaters (fuel -type, trot electric),
--- in -wall, in -duct, suspended, etc. 46.75
Flu'/vent for any of above 23.32
Lot no.: Outer: 23.32
— Subdivision: — ---
Other fuel applinuces 23 32
Tax map /parcel no F pi I , ll Water heater
F . � 1 oQocr :rite:', :: : : , �. VI \Y ,,4 �
•,.‘,`::;,:;,,::::' �, � � rr� 1 li��� y Gas fire lace 33,39
Flue vent for water heater or gas 23.32
r fireplace 23 32
Log lighter (gas)
Wood/ ellct stove 33.39 ,_—._
_ _ Wood tirnplace/insort _ _ 23.32
_ Chimney /liner /flue /vent 23.32
{ { }} i ; r ;n :,s,. , ' :1: { I vi )70 23.32 ,,,.
,. r o ' k . r.J,;., .r,., : , jll...: : I, , ... " . .. t � ., �,.
,., , Other: �.
W st knmust and venlila
Nom; V� Rangy viron hood/oth Cr kit
Address: 33.39
S' a, � _ e ui ru rnent
Clothes dryer exhaust 33.39
City /State /LIP: Single -duct exhaust (bathrooms, 23.32
�� toilet cum utili room
Phone: Fj(�j) �1" l e Fax: ( ) - 2332 23.32
� T' ;r ,„ Atctc/orawlspaoefans
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♦♦��qqyy��7( �7�R i .. l ) 1, �t Other:
�, � t ',,;' � .{ ,' ac1M'A'.7�FFM�F;Mr ,. ,n t . �,. --
Businees name: _ Fuel 1 in ,
$14.15 for llrst four; $4.03 for each additional
Contact name: _ .- Furnace, etc. _ — .
Address: Gas heatLusrrp
—~ Wall/suspended/unit t
City/State/ZIP: Water heater — 111�
Fax: ( ) .lace
Phone: ( ) Rue
Runk
E-mail: Barbecue •
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Bub name: r j'tAU) set 1 ,ds�l t t r s�'. ?,! Gl ;li . vTt, 111 i r, r
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Address: QlfaC� -1 5 0 t Q Subtotal gt_! I 5
City /State/ZI1': _ p py�4'IG4,e,A- ` (1 2;31 Minimum perinit fee ($90.00). /yl
234 t T (�IJ j ) L 3 d 3e:. ptau review ( 2 5 permit fee) �!
TOTAL PERMIT FEE
hone: (G ))) 0 C (,r l 1 State surcharge (12% of permit fee) �� /
r Iv i Gt j 11131? ✓
CCB lie.: ^ --
This permit application *spires if u permit is nut obtained withlu 180
1 i"-'" --. days after it has been accepted as complete.
Authorized 'lame' ea Signature: G ".J � " Fee methodology net by 'r ri Couuty Budding ladustry Servke gourd
nt frame' ��G t ft it ;l.'
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Z0 /Z0 3E d ENIlt/3H 139\11 6Eb0bEZE05 8t' :60 0T0Z /LT /90