Permit CITY OF TIGARD MECHANICAL PERMIT
sz COMMUNITY DEVELOPMENT Permit #: MEC2010 -00513
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/21/2010
Parcel: 1 S133DD07400
Jurisdiction: Tigard
Site address: 12739 SW DANBUSH CT
Subdivision: VILLAGE AT SUMMER LAKE NO. 3 Lot: 113
Project: Munro
Project Description: Furnace replacement.
Owner: FEES
MUNRO, JUDY E Description Date Amount
12739 SW DANBUSH CT Furnaces < 100K BTU 10/21/2010 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 10/21/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 10/21/2010 $43.25
Contractor:
TRI COUNTY TEMP CONTROL INC
13150 S CLACKAMAS RIVER DR
OREGON CITY, OR 97045
PHONE: 503 - 557 -2220
FAX: 503 - 557 -0919
Type of Use: SF
Class of Work: ALT 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 1.81
Issued By:
Permittee Signature:
Call 03. • •.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.
OCT -20 -2010 12:25P FROM: TO:5035981960 P.1
Mechanical Permit Application , , „ , „ , ,, 1 , 1
City of Tigard Rewind
13125 SW Hall Blvd., Tigard, OR 9 DerolA : 1 G , 0 .wet e ,
. • . _7 pas Review
Phone: 503.639.4171 Fax: 51
Inspection Lino; 503.639.4175 ' J }41' Oeda Other
Internet www.tigard-or. v `a / , _.. °i te ll� 0 8a (rage :for
g p O _.� ... t, 1 1 Nmifled led: , S ppkmcetel brat ease
TYPE OF. We OF TIGARD COMMERCIAL FEE* SCHEDULE --USE CHECKLIST
®
❑ New construction Addition/attergtl�� +►ioPulcemrtr8 ���I/�+ glIV Mechanical permit fees' are based on the value of the work
a1SI0N peribrn,ed• Indicate the value (rounded to the nearest dollar) 81'101
❑ Demolition ❑ Other:
mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: S
®
1- and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES'
y g ❑ Commercial /industrial ❑ Accessory building
❑ Multi - fluidly ❑ Master builder ❑ Other: FO7 special iaj0"asale°r sae checklist
DcsaiPUrm I Qty. I Ea. I Total
JOY SITE INFORMATION AND LOCATION Heagag/eeeNag
Job site affirm: I2 -3q JJa ebUSln a. Air conditioning
(requires are plan drawing ptocemem) 46.75
City/State/ZIP: ' I a arl� Furnace 100,000 BTU (duc&vema) 46.75
Suite/bldgJslx no.: u"`���"' 111���+ Pmjedlnema: Furnace 100,000+ BTU (ducts/.am) __ 54.91
� �() Heat pump 61.06
Cross street/directions to job rite: Duct work 23.32
Hydronic hot water syatem 23.32
Residential boiler (radiator or
hydronie) 23.32
Unit heaters (fttel• type, not electric).
in-•we1l, in =duct, suspended, etc. 46.75
Subdivision: no.: Flue/veu for any of above 23.32
Otter. 23.32
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Weer heater _ 23.32
Gas fireplace 33.39
Flue vent for water heater or gas
R pl/� c fireplace 23.32
Wt lyw LoR lighter (tuts) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Yi\ PROPERTY ��/+ 0 TENANT
Chimney/liner/flue/vent 23.32
i I 1 � ►IAAJ 23.32
Name: Emvlroatmeatal exhaust and veafllattotr
Address: Bayne) + I V Range hood/other kitchen
equipment 33.39
City/Sta1c/Z1P: Clothes dryer CAMS' 33.39
Singuct exhaust (bathrooms.
Phone: () vet .1 (€41 Fax: ( ) toi d
� compartments, utility rooms) 23.32
® APPLICANT 0 CONTACT PERSON Attickrawlepace fans 2332 ,
Other: 23.32
Business name: Same u contractor Fuel piping
Contact name: D Mason $14.13 for first fear 54.03 for each additions! .
Address:
Furnace. eta
Oas heat pwnp
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) Wes heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: Trl County Temp Control
Clothes dryer (gas)
Other.
Address: 13150 S Clackamas River Drive MECHANICAL PERMIT FEES*
City /State/ZIP: Oregon City, OR 97045 Subtotal
Minimum pemdt fee ($90.00) 'j () UO
Phone: (503)557.2220 I Fax: (503)557.0919 Plan review (25% of permit t
COI lie: 72623 State surcharge (12%oPpermit fee) , yj T
:�/y / �,,, n TOTAL PERMIT FEE. (J�� (J
Authorized signature: <2! (e / 1 766 perm(( da I accepted b aspires been accepted as complete w114a Ia0
I Print name: D(a nC au.son 1 Date: 10(24 to I • Fee methodology me by Tri•County Building Induaby Service Board
(:laurel doe 10 01/00 4404617T(1 1N220M/WES)
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