Permit .71 CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit A: MEC2010 -00469
T i c A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/28/2010
Parcel: 2S111 CC20701
Jurisdiction: Tigard
Site address: 15660 SW GREENLEAF CT
Subdivision: Lot: 0
Project: Gamelgaard
Project Description: Replace existing gas furnace with like kind.
Owner: FEES
GAMELGAARD, IRWIN L & MARILYN J Description Date Amount
15660 SW GREENLEAF CT
TIGARD, OR 97224 Furnaces < 100K BTU 09/28/2010 $46.75
12% State Surcharge - Mechanical 09/28/2010 $10.80
PHONE: 503 - 670 -1486 Minimum Fee Adjustment - Mechanical 09/28/2010 $43.25
•
Contractor:
A TEMP HEATING & COOLING INC
16000 SE EVELYN ST
CLACKAMAS, OR 97015 -9519
PHONE: 503 - 650 -5014
FAX: 503 - 557 -2990
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 s . • - I . ed for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notificati • • - enter. Those les are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct q - tions to OUNC by ca ing 503.246.6699 or 1.800.332.2344.
Issu = d By: , , / Permittee • . nature:
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.
09/26/2010 20:23 503557 C.E CEIVED A TEMP HEATING PAGE 02
Mechanical Permit Arn licatit P 2 8 2 010 For; " ' iiilY e L�
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City of Tigard n X f /e? AIR ..o. i 6 1
13125 SW Hall Blvd., Tigard, OR 9 4•� OF TIGARD nos
Phone: 503.639.4171 .Fax 503. � '• • other Permit.:
11 , ; �< i Inspection Tine: 303.639.4175 ING DIVISION Date x B sa
r See Page 2 t lra►r+oatlon
Internet. w ww.tigard- or.gov f e �
ppt
•
T PP. OF WORK QOIVIIVIBRCiCL• b jUE USEt ."I LIST •
Q New cc nstruction ddition/altetatl l8o V Mechanical permit fees• are based on the vaiue of the work
❑ Demolition ❑ Other p Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment. Mot. overhead, and profit
CATEGORIC OF CONSFR CTION • Value: 3
, ,{� 2 dwelling ��• Z1Vh i1Vr i SYYrEMB SSES"
'- and 2 Y 11mg D Commercial/industrial 0 Accessory building
❑ Multi-family ❑ Mastex builder ❑ Other For special informafron use checklist
Description 1 ttty. I Ea I Total
.tlyll SITE INFORMATION AND LOCATION. Reathatkoolinn
Air conditions
Job site addraec / ,� !.i ;1, a 6 1 • (requires airs plan Mowing placement) 46.75 I
City /State/ IP: ' � • / 0 0 C 7 3 �(�/ Furnace 100,000 BTU (dueu/vent:) 1 46.75 _ tj a --
Suite/bldg./apt no.: Project name: -d r, tax , y 1 .� C!Z gG�� Heat pu l i " l .. n .I f A Heat pu
H 1DO,000+ BI lJ (da�hcots) 54.91
mp 61.06
Cross street /directions to job site: Tint work 23.32
,Htdronic hot water spawn 23.32
Residential haler (radiator or
hvdronie) 23.32
Unit heaters (Alai -type, not electric),
in -wall, in -duct, suspended. etc. 46.75
Subdivision: I Lei no.: Flue/vent for arm of above 2332
Tax snap!
Other _ 23.32 ,
pared no.: Other Arel a
Q DESCRIPTION Q/ 0 +' WORK. Water heater 23.32
u '� I '
i � � �`� U " Fire fireplace
fbr water heater or gas 23.39
0 fireplace 23.32
• �� >. . . II► Loalighter(tess 23.32 -
i
Wood/pellet stove 3339
Wood faeplace✓iascrt 2332
. PRt PERTY OWNER I. 0 TENANT Chinuseliner/flue/venl
23.32
Other: Name: _ 23.32
4 . ...0-a Al . _ _ � i 4 P Envi rormiental mimed sand ventilation
1 C'
Address: ,L ,] r_ O _ 1 r r ' to • - ,9„,,_ dha kitchen 33.39
City/StauyZ1P: i. - r . ► i I ip. Clothes dryer exhaust 3339
/ T Single duct exhaust (bathrooms,
Phrmo
3 (10 / ' 0 t t Fax: ( ) toilet compautmenta, unity rooms) 23.32
ECIAkkitANT .. • • • 0 CONTACT' PERSON . Attidcrawlspace flats 23.32
Business name: 23.32
Contact name: AMR KW HBATING AND COOLING, INC s14.15 for that limn 14.03 for eThh additional
Fuel *dna
MO
Address: 0 SE Evelyn 9t. Furnace, etc. • Mimi" OR 9710 clan toot ammo
City /State/ZIP 503-650-5014
�
y — [� G walVsummtided/unit beater
Phone: ( ) I Fax:: R5 ,� `1 1 ( Ij /"1 Water heater .
E -mall: l ¢/ Fireplace
Rolfe
CONTRACTOR I3atbecuc
Business name: Clothes dryrr (gas)
Address: A IJ;Isr IWATING AND COOLING, INC elites-
• -
16000-SE Evelyn St. - _ ���. •
City /State/ZIP: OR Subtotal - •
Phone: ( ) 503- 5 411 0 r-� q Mininaan permit fcc(S90.o0)
n
CC}3 tic.: Pt Tia nsview (25% of permit fee)
r' r d •1►
State surcharge (12 "k of permit fps) l r) •
l 1 TOTAL PERMIT FEE r a i;. U
Authorized signature. j ' 41V+ • MI' Thin permit application aspires If a penult to net shad . : .
] accepted oi complete.
Print name a} . d ' r wf� pat. ,R (* • pre methodology act by Tri -Comuy Balding !Mushy Service Board
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