Permit ,,; CITY OF TIGARD MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT
Permit #: MEC2010 00320
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/09/2010
T E `�'J?' g Parcel: 1S136CB09300
Jurisdiction: Tigard
Site address: 11216 SW 81ST AVE
Subdivision: HERB + PEGGY'S PLACE Lot: 21
Project: Spiering .
Project Description: Replace existing electric air handler and existing heat pump.
Owner: FEES
SPIERING, COLLEEN A Description Date Amount
11216 SW 81ST AVE
TIGARD, OR 97223 Air Conditioning 07/09/2010 $46.75
Furnaces < 100K BTU 07/09/2010 $46.75
PHONE: 12% State Surcharge - Mechanical 07/09/2010 $11.22
Contractor:
PETRA HEATING
PO BOX 301205
PORTLAND, OR 97294
PHONE: 503 - 253 -3263
FAX: 503- 253 -3261
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $104.72
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.
,j20_(2 ........._....,_______ _ ID.
Issued By: Permittee Signature: tD. ,,�
CaII 503.639.4175 by 7:00 a.m. for an inspection that busines 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 Applicatio HoR,OFI IcE USE oNL .
DECEIVED
City of Tigard R eceived ,7 p /� ,j7. Permit N Per
il Date /By: / 7 / 0 •i4 C4217/17 ''''9:3.::71 � D
a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie
_: ,; Phone: 503.639.4171 Fax: 503.598.1960 JUL 0 9 2010 Date/By. Other m it:
T I G A R D; Inspection Line: 503.639 Date Ready /By: WM ® See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
. TYPE OF WORK . COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction . Addition /alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS•FEES* .
Kl- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist. _
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
.JOB SITE INFORMATION AND LOCATION Heating /cooling
1 \ ) \ r s I _ 7! s+ A _ O Air conditioning
Job site address: C ( W �J'�-
(requires site plan showing placement) 46.75
City /State /ZIP: 1" 1 uu-k gibe. 9' 1 a D • Furnace 100,000 BTU (ducts /vents) / 46.75
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: j Project name: Heat pump / 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 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
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
\Ok k O ` - Flue vent for water heater or gas
` fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 23.32
Other 23.32
Name: 60 f v S f , Q/ Environmental exhaust and ventilation
9 q Range hood /other kitchen
Address:
// S G St- equipment 33.39
City /State /ZIP: 77 Q fco( e e , 7..)...3 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 23.32
APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
■ Other: 23.32
Business name:
E 4.r'a_ E A (C Fuel piping
Contact name: / It�Tr R $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address: 30 X -s.O I d S Gas heat pump
City /State /ZIP: .,/..Cd1/4 , D 2 �7� p (f Wall /suspended/unit heater
( 95 3) �� 3 _ 3 a 6 / Water heater
Phone: (5 - 63 )._ 2s -- g _ 3 3 Fax: : Fireplace
E -maiI: A--r0. 4 f &C E e_e -C. Es /Let Range
ONTRACTOR ` Barbecue
Business name: Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Minimum permit fee ($90.00)
Phone: ( ) Fax: ( )
Plan review (25% of permit fee)
CB lic.: t 70 3 7 yi. y f ,(p State surcharge (12 %ofpermit fee) //,
.� / v a /dg, - 22,- , lk TOTAL PERMIT FEE � -22,-, 4 This permit application expires if a permit is not obtained within 180
Authorized name:/signature:
4 0i days after it has been accepted as complete. , ( • ' ' —.
Print name.1�/'�hO ��Jr / / � Date: �`� ' Fee methodology set by Tri- County Building Industry Service Board
(:\Building \Permits \MEC- PeerrmitApp. doc 10/01/09 / 440 -4617T (I I /02 /COM/WEB)
RECEIVED
JUL 0 9 2010
CITY OF TIGARD
BUILDING DIVISION
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