Permit a
MECHANICAL PERMIT
C ITY OF TIGARD
IL
;- COMMUNITY DEVELOPMENT Permit #: MEC201000293
, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 06/30/2010
Parcel: 1S134AD08500
Jurisdiction: Tigard
Site address: 10544 SW'WINDSOR CT
Subdivision: WINDSOR PLACE Lot: 22
Project: Jackson
ProjectDescription: Replacing existing furnace.
Owner: FEES
JACKSON, PHILLIP TRUST & Description Date Amount
ANDREWS, TERESA TRUST, BY PHILLIP D
JACKSON/TERESA ANDR, 10544 SW Furnaces < 100K BTU 06/30/2010 $46.75
12% State Surcharge - Mechanical 06/30/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 06/30/2010 $43.25
Contractor:
A TEMP HEATING &.COOLING INC
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'. �,, f Permittee Signature:
Cal 03 639.4175 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.
06/27/2010 07:03 5035572990 A -TEMP HEATING PAGE 01404
Permit Application � °
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v Pho SW Hall Blvd Ti g ar figEI) sJ'�ls Plan Rcvi 11 ` ne 1 503:639d171 Fa
Ante/13: Other Permit:
T I G A R D inspcctton l;inc: 503.639.4175 t Date Rcady/By; 91 Se Pap 2 for'
wit„ t,, s I nternet .tvww tigard- or,goy JUN I N z 9 � (� 1 Nottficd/Mcthod; Suppl mii nral Information
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i I ;p,a',�,�ill�l itlr irl,l' .w�,91 1. ,l(� r i O t jt1 ht � 1 14. "i N "P tlf i iil; Il, tt' POS l' �1 I �'1; ' #0:1 f }1' f YE' ,',1 'JiI'11`I{+}i
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•. - ..,, se as rr.n r v u1n;M
® A ` l . €4 ®PIVI. permit fees* arc based onth value of the Work: 3ION Mechanical
1 1 I) l s l lL l7x
; D .New constntctlorr a 1/ fi t
performed, Indtcato the value (rounded t the nearestelollar) of all'
El, Demoliiion El mcrii, labor: , vcrhead, and profit.
l ii I it + I e, f r+ ,r t t' D sr r m , r r
Othcr; mechanical materials, C quip
2I 1 , j,s ii 1 i { I I CK` 0 � ({!0 01 0 r iGi `1 01 01 1��4 s li t S I' 1 11 r 1 1 E N I I Vi ! (jlrit rt r Value
1; ii r +" iail` elA itjttt $ ,?,+ gWinfi 1 �Yr , i
El 1 - and 2- family dwelling ❑ Commercial /industrial 17 Accessory budding .. i 1i 1°^ �"'� „Na ^a,;u,'d „m , . u� tv �„ 11 15„e,,.. Ill, 1f� ;
Master u
D, Multi- family 0 builder Farspectallnformationus checklist.
❑ Other
� r ° rl I 111 } I j11 r , Description �t :ty, � Ea, I Total
it 111 , J 1' 1
o ,?: ,,,,Il,i l ,1,�; Sg Iqt w E 'lat , ll + , �.I
u , , ; 1 1 ,IIIIWi�' ,rr� Resting/cooling
Job site address: �" ji' J_
` /f ,5� �,t 1 for ����++ Air 'conditioning
site plan showing placement) 46,75 .�
City /State/7.TP; �, --d O. q- rum. 100,000 BTU (chefs /vents) 46
U Furnace 100,000+ BTU (ducts /vents) 54.91
Suite /bldg./apt. no.: Project »ame: _ Heat pump 61.06
Cross street/directions to job sitc: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronia) 23.32
Unit heaters (fuel -type, not electric),
in - wall, in -duct, suspended, etc. _ 46.75 _
Flue/vcnt for any or above 23,32
Subdivision: LOt. no.; Other:
23.32
Tax map /parcel no.: Other fuciappliancca
, tan ,1 , 1 , r 11 ) , _, t , �iE, f I' ,� r�� e ` li1;i1,'1 ,1 r l',{Il,'j� w ater: 23.32
,I„ y� c,�, j�il �lll1 1 �'.Ir j ' +�1: � � .1,, . H, r 1 rlj II rl I��11t1
i , r r, i �,,s, ,r o , a1 i r..r,., v � E,iw, �I,.��li ,
1 Gas fireplace 33.39
1 - A ''1 AI 0 ;-. - ' .� . /'1 -/ y Flue vent ',for water heater or gas
fireplace 23.32 .
• Log lighter (Pas), 23.32
Wood/pellet stove 33,39
Wood fireplace /insert 23.32
" ,� �,;�rlt + iP M jib t'fll E1 {{1 �1i t 1 1 1 l+�� !t �JI I�' 1 I 9" " '4 p+p iq , ,;� +yep Chimney /liner /flue/vont 23,32
h f hgi le: t " f J.{ , ,,.i p U 1)I V ( Ir,t�ir..rl� rrl,nL sit i.iC'1.11l, {dlI P,I�O,' Ir ij1�1 le������ll;hll , r , • "
other; 23.32
Name: A X) ',C 10Y Environmental exhaust and ventilation
Range hood /other Rachel]
Address: SAME, AS ABOVE equipment 33.34
City /State /7_iP: SAME AS ABOVE Clothes dryer exhaust 33.39
Single-duct e (u
(03q r� compartments, utility Phone ity roo
23.32
ms) l�� Fax; ( ) toilet com.
+, :�, t � I + 1 + r r n I lr I1r IH, 1 ,P , prtmntsity roo
��I��'1il , 11ti 1 11 ' 1u 14t • ,H,,, 9i ��1�IERi�„�, 11. ! 19 '1 Ekltill i t Atticfcrnwpacefans 23.32
71 1, 1 1 , I r,IA. .�.�.. .. � w i Lem.,er, � ,- .:,rW,r 1V.�1�1l4'1� .
Business name: A TEMP HEATING AND COOLING, INC Other: 23,32
Fuel J1t
Contact name; JULIE RAMSEY OR DIANE HATTER $14.15 for first foitr; $4.03 for t ich additional
Address: 1600(1SE EVELYN Furnace, etc.
Gas heat patnp
City /Statc /ZIP: CLACKAMAS OR 97015 Wall /se ended/unitheater
Phone; (503) 650 -5014 Fax: ; (503);557 -2990 Water heater
Fireplace
E -mail; J14AMSEY a@ATEMPREATING.COM Range
I i, Jlis' 11111 I, hhlltl h' 1d.. a I'� 1 1 1V i j ` ,t iii l f1 l''1 1 2� 't '0 "0f ' jf J l'.r�11 s h l 1 t1 111' 11 Ih ll' (st ilti' P`I jj+) e qr n 1 .
ail �.,1 u.4 11
L, ,J !� 1�11t�.� Id�u�� -�,� ,sI I,�,�, ,,,�. I�, ill{ rrN, 11fV 1J��ll' �. 1�111�o: li, llsl�l, �! l��, IlJi� (,l��llj,�.i,flRli,ll��.�il( Barbecue
136sincss name: A TEMP HEATING AND COOLING, INC Clothes dryer (gas)
Other;
Addrssr 16000SEEVELYN tall r �R "l' r ,IitY{
4 1: �Ls1s{ lifl9r ',il4irl1l��l9,nraUlllhjlia ;lii •
City1Statc /ZIP; CLACKAMAS OR 97015 ; ubtoial M
PI ne: (503) 6505014' PAX: (.503)557 -299q Minimum permit fee $90.00) �[ r
Plan rcvicw (25 %ofpc ink lee) 11112:=
CC►3 lie.; 71878 fixate surcharge (12% pc mn fcc) fThir _
• TOTAL PERM T.EEE k.do , 1 Sr
AUthorizCd 5ignatUCe�
This permit application expires if a permit 1 not obtained within 151)
'� days attar It hns been accepted ,s complete,
Print name: JULIE RAMSEY Date: / J ' Fee methodology set byTti -County Buildin industry Service Ruud
1:11 3uI1ding1Permlts \MP.C- PumhApp.doc t /n1 /00 440.4 (It /o2 /COM/WF.H)
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