Permit a CITY OF TIGARD MECHANICAL PERMIT
' Is COMMUNITY DEVELOPMENT Permit #: MEC2010 -00393
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/05/2010
T{ [;:1 R. )? 9 Parcel: 2S111 CC10100
Jurisdiction: Tigard
Site address: 15790 SW GREENS WAY
Subdivision: Lot: 0
Project: Holfield
Project Description: Replacing gas furnace.
Owner: FEES
HOL.FIELD, MIKE & JUDY Description Date Amount
15790 SW GREENS WAY Furnaces < 100K BTU 08/05/2010 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 08/05/2010 $10.80
PHONE: 503 - 849 -2103 Minimum Fee Adjustment - Mechanical 08/05/2010 $43.25
Contractor:
WATTS HEATING & COOLING INC
580 PORTLAND AVE.
GLADSTONE, OR 97027
PHONE: 503 - 786 -2858
FAX: 503- 786 -2807
Type of Use:
Class of Work: Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: ......
410e> Ilir
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Aug. 3. 2010 9:36AM WATTS HEATING No. 0889 P. 1
Mechanical Permit Application ., FOR OFFICE USE ONLY
: q RECEIVED City of Tigard Received
13125 SW Hall Blvd., Tigard, 0 e/By: • P
d,, : Phone: 503.639.4171 Fax; 503.598.1960 Plan e y : Other Permit: ""'" 1 . ..f
r , n n Inspection Line: 503.639.4175 A IA' ® C 0 Date Ready/By. iens: la See Page 2 for
Internet: www.ligard or.gov Notified/Method: 'T( Supplemental Information
CITV OF TIGARD
J r NI NISI ®Td COMMERCIAL PEE* SCHEDULE - USE CHECKLIST
❑ New construction ,. ddition/alteration/replacemenl Mechanical permit fees* are based on the value of the wort:
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value:$
i and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building R SIT) ENT)(ALEQCIIpMZrNi' /S1
.
For specialIllfonnailon rise checktfsl.
❑ Multi family ❑ Master builder [] Other: Description 1 Ea. I Total
JOB. SITE INFORMATION AND LOCATION Reating/cooling
Air conditioning
Job site address: 5 -79 e, � `` --// '' 4 / 4, 1 44/7 5 - �a.��. (requires site plan showing placement) 46.75
City /Stale2lP A 0 ,, e . 47 r ,, Furnace 100,000 BTU (ductsrvenls) / 46.75 W
• SuilclbldgJapl. no.: / Project name: /' / / Furnace 100,000÷ BTU (ducts/vents) 54.91
f7'a�/r"l�fQ-
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 -duce, suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision: I Lot no.: _ Oilier; 23.32 _
_ Tax map /parcel 110.: _ Other fuel appliances
DESCRIPTION OF W ORIC Water heater 23.32
Gas fireplace 33.39
/ u�nj .e• /1" c #7.AG. 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
Chimney/liner /fluclvent 23.32
fiOPERTY OWNER I ❑ TEN, 11"1 Other: 23.32
Name: "Zee-. .4U >��� Environmental exhaust and ventilation
Address: Range hood/other kitchen
f! . � Ige.e2j. equipment 33.39
City /StalerLlf:" 7 er ere. r 7 Clothes dryer exhaust 33.39
Single - duct exhaust (bathrooms,
Phone: VA? 17 19.. yO f Fax: (' ) toilet compartments, utility rooms) 23.32
,ja APPLICANT ❑ CONTACT PERSON Aliic/crawlspace fans 23.32
I/ Other; 23.32
Business name: Z� s � , /'7Q 04 at, Fuel piping
J
Contact name: C'� Soh / S14,15 for first four; 54.03 for each additional
s� l e. Gas Furnace, p
AdAddress: v - �'•�7'
Gas heat pump
City/Stale/ZIP:. ‘741. ate., 70 2 7 Waf /supended/unit heater
Phone:, 7) 7733 - 243, � I Fax:: (5713' 719 do , �gQ 7- Water heater
`� Fireplace
E-mail: o to leis ,41 yh ,.. ea ..,-., Range
CONTRA,; I'OR Barbecue
Business name:
Clothes dryer (gas) -
/P10 / eT Other:
Address: 510 PERMIT FEES*
City /State/ZIP: Subtotal E,
Minimum permit fee ($90.00 ta,0 _u . )
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lie.: /S/Z44) State surcharge (12% of permit fee) 10,i°
TOTAL PERMIT FEE fc. 7w e
This permit application expires Ira permit Is not obiataetrivIthIn 18O
Authorized signatu , days after!! has been accepted os complete,
Print n: b: Geo -. - I Date: (f 2.44 1 • Fee methodology set by TO-County Building Industry Service Board
r. Building\➢ermitAMEC.PermitApp.doc 10/01/09 140.4617T(11 /OUCOM/wEo)
L-dreN Wc, i