Permit , , F CITY OF TIGARD MECHANICAL PERMIT
•
,. COMMUNITY DEVELOPMENT Permit #: MEC2010 -00020
Date Issued: 01/19/2010
i•ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S114BA10100
Jurisdiction: Tigard
Site address: 16325'SW MEADOWOOD WAY
Subdivision: COPPER CREEK NO. 2 Lot: 54
Project: Balsiger
Project Description: Replace gas furncace.
•
'Owner: FEES
BALSIGER, DONALD & SHIRLEY Description • Date Amount
16325 SW MEADOWOOD WAY Minimum Fee Adjustment - Mechanical 01/19/2010 $43.25
TIGARD, OR 97224
Furnaces < 100K BTU 01/19/2010 $46.75
PHONE: 503- 670 -0314 12% State Surcharge - Mechanical 01/19/2010 $10.80
Contractor:
CARSON OIL COMPANY INC
3125 NW 35TH
PORTLAND, OR 97210
PHONE: 503 - 471 -4365
FAX: 503- 222 -0186
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance With approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR -952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules
or direc s-to OUNC by calling 503.246.6699 or 1.800.332.2344.
Is ed By: Permittee Signature Lij //f
Call 503.639.4175 by 7:00 a.m. for an inspection that busine-s day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Jan, 18, 2010 8:58AM Carson OH Co., Inc, No, 9089 P. 1
l ' i , • -:,, ,.,, „ .4,......,: , ;:.,..,,,,
i fechanical Pei•ftr. J CEIVED
icati c
• , -..., ty oi Ttgat ,,.:,:„.?..:, l d OR 97223 JAN 1 9 Recebkd ' iff . AMIN" ,, • - . _
D„te/liy: / ' 0 eV, Y 14 NG Hfe ' 100/ ..f elt)Og 40
' .1 l 312,5 SW Ilan Blvd., Tigard, 2019 . ...-
Plan-Review
. .4i ,..;::;: Phone: 503.639.4171 Fax: 503.59/3.1960 pale/13y! Other Permit:
. 1'1 tid , inspectipiii.inc; 501.639.4175 CITY OF TIGARD Date Ready/11y:
' - jurk: E.1 Scc Page 2 r
: or
p.• Internet: www.tigurd-or. BUILDING DIVISION gor Natified[Nleihal: t - Supplemental latartuadon
_
Typy, WORK ,;:,,,,. .:::::-.. - „..: . ,„ ,..„ ....., •..: -. „.1onamEgclAt:•1•..E..;s.c.ripotiLh...,:pr, (.1-!!...c:KLIpT:...,
NICO1 permit fees* are based on ilic value of the work
1.1 New cuitSlroction 12 AddirionfalteratiOn/replacernent performed. Indicate h c value (rounded to the nearest dollar) of all
E fil Other: mechanical materials, equipment, labor, c■verbead, lincl prOfit.
ValUC1$
'.,'.:' . 11 . - : 1 ' . . ,1 l , .: ' :,- -..''.,..,.-.' dATEGorcY..67 CONStkl),q111)0 :? '.1:':' :•:,..,!'' ': l';''' ::•;:::". ., .. . .. , . , , . , ,,.. . , •• ' .",,, „.
' ' ' • ' ' ' ." 7.. 12ESIDElsetiAt 'EQUIrMENT...7:SYSTEMS IzEES'f.-
; . .. . .. . .
el and 2-family dwelling 0 Commereial/industrial Ell Accessory building
For .5pecial information use checklist.
0 Multi-family 0 Master builder El other: Pesci IQty. I Fa, I Total
_ .. .
:':'.'.;:'' ;:,.,"'...' :•:'..:-.:..... (j! 'SifiTii4iiit4AtIoi■i:Abii.);:.t.,60.411.61:' .•:::.":-°. ... :': Ilealingic
ii ,.._
Joh site add 25 j
ress:/4 . 3 'id „0,2 idA v
City/Stale/ZIP: Ti - 0 e (2 7 ' i
Suite/bldg./apt. no,: ' '. ' (- 1 . "roj \ Ccl na ,,. . % . - -• Air conditioning or heat pump
(requires site ntoa showing placenteat) 14.00
Fl1111ROC 100,000 E1 ((lam/vents) i 14.00 i ‘ ..`•- 1, '"
FlItna 100,000+ B
ce l LI 61ttetAivent 17.90
s) '
Gas heat purnp
14.00
Cross street/directions to job site: ).- L -1? i, rA-, :
Duet wtrk 10.00
• . Ilydronie hot water system 14.00
5 .)-1.,c;'),/::S_Z_ZL Residential boiler (radiator or
hydionio) 14,00
- .-. Unit heaters (fltel-type, nut electric),
in-wall, in-duct, suspended, etc. 14.00 ..
• ..
Flue/vent for any of above 6 tt)
. ;
Subdivision: Lot no.: -....", 10
_ ., Other: - .00
_ .
Tax map/parcel no.: Other Ate' appliances
10.00
' .' . :•. 11 : ' ..•: :•j ..A:::,-. '.7:::::., . - ! . ale
r : . • 16,00 (jus
.- . 9/) ''-.) . - V4 A-i/I C i
E ft (':z/r7e,,.,/..r
.... / i -' -- . Fluc ,-
,i,I. for water heater or gas
fireplace 10,00
... , . ... ... .. • ... - i A% lighter (gas) If) 00
Wood/pellet stove _ . 10.00
_.. „. . . - Wund fireplace/insert 10.00
10,00
. _
'.....': ::...RPURTY.,...O.WNP....P.'..,.;:..',''..'.. ......„. NANI.,........-;.,...,,,,.,..y............,... 10.00
.. .
Name: ) . i3 \, .,,) ( \ /j
..
•- Environmental exhaust and ventilation
,
i . -- Rangs hood/other kitchen
if -c7 ‘_.
Address: „:- ,
; /____LY__ . \ „...,/ e•y 1' . ):. - .7 , kbb_,\.y_ cquipmeit 10,00
, _.......... • •,.----.,. .
, C:ity/SiaiciZIP: 1 i . ,,
,.., , ,, , ,z e:/ 7 .-, ,' t ,
7 6. clothes dryer exhaust
• 10.00
- Singlorduct exitattst (bathrooms,
Phone: (503) 61e.) , c.) 9 i Lt. Fax: ( ) toilet compartments, utility rooms) 6.80
Attic/
VtIrpticANT7‘, :.,:•:;.•:-::...•0" :;';'''': '' crowlspace fans 10,00
( 1000
Business-pamc: 1 .,1 /-it,--^ . i 0.1 (...):,.. r ,
1 It u r - t . /)//1 ..
Contact name: / IL. idA 11 i,„,,..., Fuel piping
$5,40 for flt'st four; $1.00 I r each tuldltlotta
. _
Furnace,. etc.
Address; ':j i 2, , 0 w t - A , .... . . (ins heat pump .- •
City/State/ZIP: 11 21 ,,, LA i ; D c_yR c ..,?/(,) w,m,,
u,,,,dedAmii heater _
/
Pl hee umw, Cf 'l
) *ri_i. 'i./).- _ Pax: (5e- ) 222 - (/) I
F ,
- - . - - Water atr Firtotee .
_ .
1 , LL_ A i .,, f. / / 6•1(2,1 t1 l; i /. R !Inge
''' 7. :,..;:i .,,...':; Barbecue . .
Clothes dtycr (gas)
)3usiness itaine6i (:)/./ ti,p/V i _ . . . •• - Othec
••• Address:. 1 /2) /5 fi Li i ,,, , --riri 1, , 7:: HANI.c.
1
Cy/State/ZIP: p. 117:til ,, 0, Subtotal Pi 4 .'..,. )
, ' ' Minimum permit fee
Phone: C503) 471. i &.,..5` Fax; ( CI,''p /24- ()i (•;„ Plan review (25% of permit fce)
.„ . _
CCB lic,: ( D ' 4, State surcharge (12% of permit fee) ; .... 0 . gO
,_
,,, ) fll . _..
TOTAL PERINII'',i
This permit application oNotres if a permit is not obtatricti N■aldn.180 qo
m
Authorized signature: ., 1,/, 2 / r days after II bict been accepted ics coitiplete.
L./ i ''t. /. '-' / 61°.
Print nae: -- / I c -: //,,. // li Ai ., / - - -
e •
. 1 / - / - 7 lf : - 1 • Pcc methodology sct by Tri-County Building lialtIoly Service ito,tol ,
6/ . -.1 Dal, . J ) .),
(PLP'
Ja,n.18. 2010 8:58AY Carson 0'il Co., InC. No. 9089 P. 1
iWechanicol Pei'mit~ ic~lli -EYED '
t tecefacd ~e- /J
I'eoaitNo.: ~/(o/tr~jp~
City of 'Tigard
►};,fe/uy: /O
•11 13125 SW Hall Blvd., 'Tigard, OR 97223 JAN 19 L iQ flan Review -
0 Phone: 503.639.4117E tax: 503.598.1960 ttsterl3y: OtherPennie:
Itt511eCt011 l.ino: 501.639.4475 Date Reidy/ity: hr': Gi See Pai;a 2 far
CITY OF TIGARD -
-
htlcl'uCt; www.tigaYd-or.gOV Notiftcdntelhad: Sapp)ct+tcntallldormallan
BUILDING DIVISION -
UhI4ICRCIAI irEE SCjiF,I I ~,USF('HF(KLI$T...
RK
TPk;' O1• w0
IMcchanicnl pennit tees, arc based on the vattm of the wock
(1 New wnsfruetion f /ldtiitiott/alternlitm(reltlaccmcttl - performed. ludicate the value (,vended to 11te neatest dollar) urall
i)entolition Oti ur: tmchanical niam inns, m,uipntcnt, lnlx,r, ovetilcad, and pro
Value 6
I CONS'I„ttUC 1 IOI~T - -
.n
GATT GURX
. . , I `IALi,(~UIptYIk fv I J.~YSTFhNS I isI?SH
y Y Connnctctttlhndustrtai ❑/lccassotybnililinp Iii?;3IDFN`i
1- ttnd 2-tonal dwcllin ❑ ~ •
horspec.nlInformation usechecklist,
Multi-fainily ❑ Muster builder ❑ Other: i)c,cription -Qi . Fa. Total
I~T'IOP1.r1Nt). G T CS OCATIO~f`:.. Ilcntln coolintl•_
JCa SIT) 3NFU1Li4
yy Air conditioning or heat pinup
loft title address [.1. f to uires life t: ,!ntsliowin ltcrmeut I4.UU
a f
I , r Fumaoo 100,000 S"rU (ducf.lvcnts 14.00
- Fttnlacc 100,000-1. BTU (1.b Cmhcnts 17,90
$uiielltidg./apt. uo.: e Projccl name _Gas heat pu,n 14.00
Cross slrcet/directions to job Site: Duct work 10.00
Ilydronic lint water system 14.00
t.,.~(-:•~'~- G'r. _ Re,4idenlialboiler(radiatoror
hyJronic) _ 14.00..
Unit heaters (fitCl•typc, nut electric),
in-wall, in-duct, suspended, etc. 14.00
Flue/vent for any of above 6.710
Subdivision: l,ot )to.:
1 _ Other- 10.00
Tax map/parcel no.: Other [het npphances _
' Water heater
Gas fireplace 10,00
Fluc vent for water heater ur gas
- - ~ ..J( ! - r r n 1.~
_ . ,7 • . l:' y l r' l.:~ ,,:~'1
fireplace 10.00
iA ll !1tCf as 111.00
1Vood/pellct stovd 10.00
- lVuud fll'Cptacc/msecl 10.
- --T- f;himney/tincr/floc/vent 10.00
7L6PE[t51 U~V1JLl2 ❑IYAiV I _
r fllher: 10.00
Natnc: b:avivatumental exfutust and ventilation
Range houd/other kitclicn
tment 10.00
Address: C utUothwdryerexhausl - 10.00
City/stale/71P;
C:., ~ {<l) r_. 3 ~ .l ~ c - - - single-duct exhaust {bathrooms,
fhoitt : C Pax: ( ) ioilct compartments, utility ruans 6.80
6 Ark - T
~)+3
LIC [ QV I ACT rF1iON space fans l OAU
AN l , c/crnwf
} 10.00
Other,
Busines n'ttttc: "6y J ~ f t •c? ,r. t Fuel >I ing _
Contact name: $5,40 for first four; 51.00 for each addltional
n1macG, etc.
Address:
CTRS tical tllll
CityJSlttlr/7.iP:;~y. wall/suspendcdhtnit heater
i.. Water heater
llVi1G: L_``.//,, Y ! ; , ( ,L" FaX: ~C. f 1 \p) • ? 6 1:a h
E-mail:
r P L. 2 'r r E. Ezunge
t!trbecuc
-
GQN'a'ttAGxQIt
, - Clothes dl cr gas)
}iusinrs. n,uueLa? 5G.; dLl,.9... 1 01'2 I~c(~ Ottn.I.
Address: R" /`L. - MFrGf1 ?NyC',J. r171ZMi
Jrif}) ~ ll rd / - 3 IrP,ES~;
- r - LL L Gf„'::'i
}aX itmtal ~D 00
fit Zli~ (t) E
City G1li(-I] f
h~r}O Mininttun pc unit tcC
l itotlC. 1 d-- L . ) T
, - Plan review (25 io of pcnntt fee)
LI_
e)
CCB tic.: Stale su rchar w (12% of pcnnitre
41
TOTAL PERMIT r1, rl
Authoncd signature fr pcrmli applies HRn cxptres If a pcrmil IN pat obtained within 180
` f / ✓ ' days Oct- It h+1' been accepted us complete.
Print natltC; i l ' Dale: ( w Fee methndotogy set by rr7 County Building lndastry Service Own, '9
+