Permit ,Md,
' CITY OF TIGARD MECHANICAL PERMIT
Ip
' = COMMUNITY DEVELOPMENT Permit #: MEC2010 -00018
1 3125`SW'H all Blvd., Tigard OR 97223 503.639.4171 Date Issued: 01/15/2010
I1G'ARD' g Parcel: 2S102BA02900
Jurisdiction: Tigard
Site address: 9789 SW JOHNSON ST
Subdivision: JOHNSON & GRANT Lot: 5
Project: Thibeau
Project Description: Install furnace.
Owner: FEES
THIBEAU, VAL Description Date Amount
3531 SW DOLPH CT Furnaces < 100K BTU 01/15/2010 $46.75
PORTLAND, OR 97219 12% State Surcharge - Mechanical 01/15/2010 $10.80
PHONE: 503 - 246 - 4658 Minimum Fee Adjustment - Mechanical 01/15/2010 $43.25
Contractor:
OREGON HEATING & AC
PO BOX 397
DUNDEE, OR 97115
PHONE: 503 -691 -9699 .
FAX: 503 - 691 -8556
Type of Use: SF
Class. of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with: approved plans. This permit will if work is not started within 180 days of
issuance, or if work.is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: t /t/ , °i le/a /67
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the. project.
. Approved plans are required on the job site at the time of each Inspection.
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Mechanical �'errt�itA he r �b� ' 4;114 ^x ,i l'FOR01, 1.11� ,1 ,, v }r Clyl:4 t i �P
pn � 9 � � Received "r R 0 �s' "lo o f S., L 3 r r 1 0(' •
`'"' � u . City of 1 Date/By: / IS / W ' crmittso. "1C2OIO -coo /a
13125 SW Hall Blva : T1 and OR 9722 Plan Rev e
g N 1 20:10
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5y '. ,t H1011C :, 503:639.417] Pax: 503:59$':1 60 4 O ther Permit:
�&s _ s r, o, Date/13y:
�T t f,li ct; Inspection Line'. 503.639.4175 ' bate keady/By: hats: ®See Page 215i lll m nx+ Internet: www.tigard- or.gov CITY OFTIGARD Notified/Method: /O Supplemental Information
1 NG DIVISION
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J IF , Yf : r (T , 91 l'J,0, 1 r ., .., V r1 , .. f' i �'` 'A'T i I, to ". lwe.
D New construction J Addition /alteration /ireplacement TvLechanical permit fees' are based, on the value of the work
performed, Indicate the value (rounded to the nearest dollar) of all
[l Demolition ❑ Other: mechanical msterials labor. overhead. and profit.
"a trf ( r r � yt��� 'Value $
r1. t�� 75 r '..X: .iilVl 4?h' r,�.,� . S'. g r Y. y iif 1 .,. ky k '# gj. 5 q r dr ,r �, . ry . .. 1 ; r r[ r , ,,, .���}`. ,. ..,y M
1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
. For sp aial »tformariort use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. Total
s'. a '( r it , : d i $ . ! Q+ (J1Y '' * 0, r ! . \ ,ti „ R A Yt
O rr HIeafin cool@
( Air conditioning •
Job site•address. GI rl t � s ory., S`� _ (requires site plan showing placement) 46.75
' City /State /ZIP: —' 1 ..., . 0L-iia.3 Pumace 100,000 BTU (ducts/vents) 1 t 46.75
furnace 100.0001+ BTU (ducts/ventss1 1 54.91
Suite/bidg. /apt. no.: Project. name: 1
_ Heat pump 61.06
Cross street/directions to job site: Ductwork 23.32
14ydronic hot water system 23.32
•
_. Residential boiler (radiator or
hydronic) 23,32
�.. Unit heaters (fuel -type, not electric),
in -wall, in- duct, suspended. ctc. 46,75
Plue /vent -for any of above 23.32
Subdivision: Lot no.:
_ _ Other: 23.32
9 yy�yy yy ���� � Other fad appliances �w
Tax map/parcel no.:
, `,,(�., ) i ,, .' r r1' IP ,w � , . ��Y >r ' 1 , 1 t L y 1r ', Nr .� i :1 € t ' -{ ' �� � {�r1i, Water heater 23:32
J -er Gas fireplace 33,39
l Flue Wen[ for water treater or gas
fireplace 23,32
' Log ligtrter (gas) 23 23:32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
y �, } � n ( Chirnneylliner /flue/vcut
23.32 _{
23.32 ,
sa l.l fr >' . gti∎ �Ttt � 4 :, V /,i4 i>Y.,l �r' � r F - -, . ' 1 i.'.r Chini
Name: J Environmental exhaust and ventilation -µ-
Address: 3 I S M�� V 1 h cquioot 33,39
City /St Range bond/other kitchen
,�
� C1 a
a[�ZIP Clothes dryer exhaust � 33.39
Q 1`#
Single exhaust mants (u utility rooms) Phone: ms) 23,3 �07� ) A o�►�.t� � 1,.g5'g' Fax ( toilet compartments, uYiliry oa,2
f r.15i'JC.IC1 ` `r'' ` '4.e 1 cr :r9. N'>�`At�3t' 1424+ ° u% c ' Att i c /c ra op il
wiLtce fa _ .32
�3
p Other 23.32
Business name: r 0 1 Fuel piping
Contact ( -- • $ 14 . 15 for first four; S4.03 for each. additional
' +� 1 t Pumace. etc.
Address: •
0- Z O K ,D,1-1., L Gas heat pump
City /State/ZIP: \ y - » . 9. Wall /suspended /unit neater
1
Phone: ( L 1 9 "0 9 (p9,9 �. Fax:: 6Z (a t Ti. Water heater
-- • Fireplace
E -mail: }� Range _—
N r +, ti ✓ r r " 1' 7V . n , ii z. t . * f .. r 7 . � ' ,, r r 1 1 r r , r � +'
' � a, • •A Barbecue
.d l]' ,o. �... „ (( : v , ; ,_:,•r . . .Z;. R., . r .4: t . . � v, , h ".m °�• � - -. �.. ,_..,:,,,r •
Business name: V Ilk ..A Oil L. ` #_ _� tab O dryer (gas)
Address: 41
City /State /ZIP: til ,(I p. D I i i. _ M Subtotal
q l 11191( t SS/ ^ Minimum( permit tee ($90.04j O `�
Phone: t u l / � E (% t ) 111 W Plat review 25 %of rmit fee
CB;lic.: "�: ✓ _ State surcharge (i2% of permit fee) i8,0
I _ ry TOTAL PERMIT FEE , 1 Orr .
This pemutit expires it a permit is not obtained within 180
Authorized signature: 11 ..I. I 1 _ days after it has been accepted as compute,
Print name: t a AIIII Date: ti . Fee methodology set by Tri- County Building Industry Service Board
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