Permit - a
il C . ITY OF TIGARD MECHANICAL PERMIT
i V
2'.' COMMUNITY DEVELOPMENT
Permit #: MEC2o10 00023
TIGARD 13125'SW Hall Blvd., T OR 97223 503.639.4171 Date Issued: 01/19/2010
Parcel:-2S111 BC00300
Jurisdiction: Tigard
Site address: 14415 SW 100TH AVE •
Subdivision: TIGARDVILLE HEIGHTS Lot: 18
Project: Ornelas
Project Description: Install furnace and a/c with associated ductwork.
Owner: FEES
ORNELAS, STEVE Description Date .Amount
14415 SW 100TH AVE
TIGARD, OR 97224 Air Conditioning 01/19/2010 $46.75
Furnaces < 100K BTU 01/19/2010 $46.75
PHONE: 503- 310 -5634 Duct Work 01/19/2010 $23.32
12% State Surcharge - Mechanical 01/19/2010 $14.02
Contractor:
A TEAM HEATING
2307 PRATUM AVE NE
SALEM, OR 97305
PHONE: 503 - 365 -8326
FAX: 503- 365 -8333
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
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Total $130.84
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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 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: ■ �1] t,. _ . `l °, , — Permittee Signature: Q LAPP
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.
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1/18/2010 08:39 5033658333 A TEAM HEATING PAGE 02/03
Mechanical Permit Application
y Permit No_:
City of Tigard KEIVED Deed
` 13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503,639 4171 Fax: 503.598.1960 Pi'n xe~ Other Permit:
Int rnt Line: 503.639:417 JAN 19 2010 Dater
3 Date Ready/By: Ju a 0 SeePage 2 for
Internet- www.tigazd~r.gov CITY OF TIGARD Notified/Method: Supplemental Information
ni~' ~I
❑ Ncw eonslnlctioll dditiordalteration/replacement Mechanical permit fees" are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials. a ui ment, labor, overhead, and rofit.
I} Rat yy}}~~ ^ : ) Value $ ov
-45 i<~y„" ~DDe~w u J .~2 ~ h
C`"~"r ,A~?hn a, r
' and 2-family dwelling ❑ Corttmereial/industrial ❑ Accessory building For special information use clreckltsr,
Multi-fArnily Q Master builder ❑ Othcr: Description Qv. Ea. Total
Heating/cooling
Job site address: Air conditioning
(require., site lazr showing Placement) 46.75 ~itr.7
City/State/2IP: Furnace 100.000 BTU duct vents) 46.75
Furnace 100,000+ BTU ducts/vents 54.91
Suite/bldg./apt. no.: Project nwre: Heat um 61.06
Cross street/dircctions to job site: Duct work 23.32
Ii dronic het waters stern 23.32
Residential boiler (radiator or
h dronic 23.32
Unit heaters (fuel-type, not electric),
in-wall, in-duct suspended, etc. 46,75
Flue/vent for any of above 23.32
Subdivision: Lot no., Other: 23.32
Tax map/parcel no.: Other fuel appliances
""9?ar:sp Watcr heater 23.32
hl"L . ~u
Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
Lo lighter (gas) 23.32
CJ Wood/ cllet stove 33.39
Wood fir lace/insert 23.32
e /liner/flue/vent
~'A + 6,) A w L t+ ' ~ i ~t5 t u„d'N , + : Jr. Climb 23.32
a... rT,,,.~~aveHa~ •ir(
4~:~ ~1~ 0~~1 rk W k Z i5!~
Other: 2332
Name: Environmental exbauO and ventilation
Range hood/other kitchen
Address: r V. V a H1 merit 33.39
City/State/Z1P: - -7 ---G LI, Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
phone: r Fax: ( ) toilet corn att(ttents, utility rooms 23.32
r s+ ~b Attic/crewis ace farts 23.32
'a( w § 6 std ~`e," x8~*xa
A 1, t
Other: 23.32
Business name: F ue1 i in
Contact name: $14.15 for rrst four; $4.03 for each additional
Address: AAA Furnace, etc.
Gas heat um
City/State/ZIP: C Wall/suspended/unit heater
Water heater
Phone: ( Fax::
Fireplace
E-mail: o e,f- Range
a I r ~sn ' ° ; a i a' ° , k Barbecue
Clothes dryer (g.16)
Business name: -Fin &v lt,&4-i 6 Other,
Address:
a
City/State/ZIP: Subtotal
Minimum permit fee ($90.00)
Phone: ( (A _ 3" Fax: Plan review (25° 0 of permit fee)
CCBIic.: State surcharge (12% ofpermit fee)
TOTAL PERMIT FEE
Authorized Sigtlature: This permit application expires if a permit is not obtained within 180
days after it has been accepted us complete_
Print name: Date- H ° Fee methodology set by Tri-County Building Industry Service Board
rl2vildioa~r'<r:n:ealh'QGPermicAVG.doe 10/07/09 ~O~rb17Ti (I1/oyGUM/ a)
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