Permit CITY OF TAGAR® MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00372
iGAR15 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 07/29/2010
Parcel: 2S114BA01500
Jurisdiction: Tigard
Site address: 16200 SW GRIMSON CT
Subdivision: PICKS LANDING NO. 2 Lot: 124
Project: Cline
Project Description: Furnace and heat pump replacement.
Owner: FEES
CLINE, JOAN D Description Date Amount
16200 SW GRIMSON CT Furnaces < 100K BTU 07/29/2010 $46.75
TIGARD, OR 97223 Heat Pump 07/29/2010 $61.06
PHONE: 12% State Surcharge - Mechanical 07/29/2010 $12.94
Contractor:
FIRST CALL INSTALLATION COMPANY
13150 S CLACKAMAS RIVER DR
OREGON CITY, OR 97045
PHONE: 503 - 231 -3311
FAX: 503 - 557 -0919
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $120.75
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: - . - Permittee Signature:
Ca 1 503.639.4175 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.
Mechanical PermitAppli ill �] 1012{)1 I' ` +,
Cl of �1 8r I EI tl ED Received
City � Date/By: , f / Permit No.:
2 ® 13125 SW Hall Blvd., Tigard, OR 922 Plan Review
I 19
Phone: 503.639.4171 Fax: 503.5960 2 1 ( Date/By. Other Penult:
I I., ;\ I I ) Inspection Line: 503.639.4175 Date Ready/By: Arms. 61 See Page 2 for
Internet: www.tigard- or.gov CITY OF TIGARD Notifed/Mothod: Supplemental Information
RI IR nING DI\ /ISs !,,,
TYPE OF WORK COMMERCIAL FEE* SCHEDULE -. USE CHECKLIST
Mechanical permit fees* are based on the value of the work
ID New construction ® Addition /alteration/replacemenl
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, Tabor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES''
® 1- and 2- family dwelling ❑ Commerciallindustrial ❑ Accessory building For special irifornmllon use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty, L Ea. f Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 16200 VV Cdr mean Ct - Air conditioning
(requires site plan showing placement) 46.75
City /State/Z1P: 118= "1 -LL..- Furnace 100,000 BTU (ducts/vents) 1 46.75 L1( i 15
�.+ Fumace 100,000+ BTU ( ducts/vents) 54.91
Suite/bldgJapt. no.: Project name: 6: 1i °nn- Heat pump 1 61.06 101 ' V
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
Subdivision: Lot no.:
Flue/vent for any of above 23.32
Other 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 2332
1111 X1 \'�* t _ _ t_ , Gas fireplace 33.39
'n Flue/vent for water heater or gas
II �p��4. fireplace 23.32
heat �11 Log lighter (gas) 23.32
Wood/pellet stove 33.39
-Wood fireplace/insert 23.32
y . PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
Other. 23.32
Name: V Dan 011110 Environmental exhaust and vcndlation
Range hood /other kitchen
Address: as
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
W { - 1 Single-duct (bathrooms,
Phone: ) t Fax: ( ) toilet t compartments, utility lity rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Other: 23.32
Business name: Tri County Temp Control Fuel piping
Contact name: Diane Mason 514.15 for first four; 54.03 for each additional
Address: 13150 S Clackamas River Drive Furnace, etc.
• Gas heat pump
City/Statc/ZIP: Oregon City, OR 97045 Wall /suspended/unit heater
Phone: (503) 557.2220 I fax: : (503) 557.0919 Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: First Call Installation Clothes dryer (gas)
Other:
Address: 13150 S Clackamas River Drive MECHANICAL 1'ERMITFEES*
City /State/ZIP: Oregon City, OR 97045 Subtotal
Phone: (503) 557.0230 Fax: (503) 557.0919 Minimum permit fat ($90.00) 7, j'
Plan review (25% of permit fee)
CCB lic.: 182714 State surcharge (12% of permit fee) ( 1 „
\ TOTAL PERMIT FEE 2.1).• 9
�IQ,Q� This permit application expires if a permit is not obtained within 180
Authorized signature: 1 days after it has been accepted as complete.
7/2,2110 Print name: Diane Mason Date: J • Fee methodology set by Tri-County Building Industry Service Board
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INSTALLATION ADDRESS
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PROPERTY LINE '
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