Permit CITY OF TIGARD MECHANICAL PERMIT
rz COMMUNITY DEVELOPMENT Permit #: MEC2010 -00458
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/22/2010
Parcel: 2S102BB00830
Jurisdiction: Tigard
Site address: 10440 SW JOHNSON CT
Subdivision: Lot: 0
Project: Vinatieri
Project Description: Replace gas furnace
Owner: FEES
VINATIERI, ROBERT E Description Date Amount
PO BOX 23771 Fumaces < 100K BTU 09/22/2010 $46.75
TIGARD, OR 97281 12% State Surcharge - Mechanical 09/22/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 09/22/2010 $43.25
Contractor:
ABLE HEATING & COOLING
8900 SW BURNHAM F -5
TIGARD, OR 97223
PHONE: 503 - 579 -2250
FAX: 503 -620 -3980
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 direct questions stto/OUQNC by calling 503.246.6699 or 1.800.332.2344. /
Issued By: /((/�S)J _ Permittee Signature: 1 9A/ /f"°/°L / e / /0 N
"`---��� 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.
Mechanical Permit Annlic. fi 1 \!F l.Ol: (li rlci: Ill.: u
III City of Tigard c R ece i ved •
~ 13125 SW `' Date/By: eta /0 a Permit ' fro. Ce —
25 Hall Blvd, Tigard, OR ' : �� /i ��
Phone: 503.639.4171 71 Fare 503.598.1965 El) 2 at 1 2O I C) Dan view
y: : omen Pe:
RI , Inspection Line: 503.639.4175
Date Ready /By
Internet: www.tigerd- or. gov RI See Page 2 for
CIT OF TIGARD Notified/Method: Sapplementat information
TYPE OF ea DIVl.S
� COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction wC l Addiiion/alteration/replacement Mechanical Permit fees' are based on the value oldie work
❑ Demolition proformod. Indicate the value (rounded to the neatest dollar) of all
❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: 5
L,LJ 1 -and 2- family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
g ❑ Commercial/industrial ❑ Accessory building
Multi - family ❑ Master builder [] Other:
For special information use checklist
Description I Qty. 1 Ea. Total
JOB SITE LNFORMATTON AND LOCATION Beating/cooling
lob site address: \0440 c% - -(r.• e Air conditioning
`' l � _ (requires site plan shawin4 Placement) _ 46.75
City /State2IP7 ,
` � igi • C: 1 fl D _Furnace 100,000 BTU (ducts/vans) \ 46.75 li lac
SuitelbldgJapt 1 no.: Project n \� Furnace 100,000+ BTU (duets/vents) 54.91
I " \ h�� \E tz.:\ Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 2332
' Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, induct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 2332
Other 2332 _
Tax map/parcel no.. , Other fuel appliances
DESCRIPTION OF WORK Water heals 2332
Q 'l 1 Gas fireplace 33.39
�\ LS eX ∎iN 4'-%S S krstvA.s,� . Flue vent for water heater or gas
/ , fireplace 23.32
_ Log tighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 2332
l.+crr EIPERTY OWNER I ❑ TENANT I -ChimneydIDer/flue /vent 23.32
Name: Z V Other: 23.32
lr\khA tF-_r 1 Environmental exhaust and ventilation
Address: \ L } . u3 . rit mt , Range hood/other kitchen t _equipmen 33.39
City/State/ZIP - � ,� °V• 1 Clothes dryer exhaust 33.39
Phone: ) Single -duct exhaust (bathrooms,
( 't0 nl ( b Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON _ Altic/crawJspace fans 23.32 _
Business name: Other: 23.32
Ccmtact Fuel piping
name:. 514.15 for first four. 54.03 for each additional
Address: Furnace, etc. I
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) [ Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: -11 1 Clothes dryer (gas)
Address: OO , . tO , .‘ �_ b S Other.
O� MECHANICAL PERMIT FEES*
City/StatelZlP �� tkpe.A €�,Q - °VI I Subtotal
Phone: (C I r ` �+�J *11 c I Fax: ( a n - t�Q c Minimum permit fee ($9 fee qp
,1 Sv Plan review (25 °0 of permit fee)
fr cn Vc ' tic.: Y o l D.1 State surcharge (12% of permit fee) \0 . 4-f,6 ✓
(.4/ �� TOTAL PERMIT FEE +wjp, r
Authorized signature %fe t%/ 'l
This Permit days At expires if a permit is not plae. obtained within r after er it has been accepted as complete.
Print name: en i i t,� 1-k- f Date: C\ - v. • Fee methodology set by Tri- County Building Industry Service Board
I3Building■PermitstMEGPemi1 dx 10101/09 140.4617r(IL C/COM+WEB)
I, 'd 1 7 0 166L9£09 ONI1000 aNV ONLLV3H 3113V d9L :LO 01. 2 deS