Permit CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2010 -00567
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/05/2010
Parcel: 2S104AB11300
Jurisdiction: Tigard
Site address: 12307 SW MORNING HILL DR
Subdivision: MORNING HILL NO. 6 Lot: 142
Project: Tajipour
Project Description: Replace gas furnace.
Owner: FEES
TAJIPOUR, REZA & AHMADI, SHIDEH Description Date Amount
12307 SW MORNING HILL DR Furnaces < 100K BTU 11/05/2010 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 11/05/2010 $10.80
PHONE: 503 - 524 -0915 Minimum Fee Adjustment - Mechanical 11/05/2010 $43.25
Contractor:
HYBRID HEATING & AIR CONDITIONING CO.
PO BOX 329
CORNELIUS, OR 97113
PHONE: 503 - 357 -5663
FAX: 503- 357 -0668
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 Notifica . • -nter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direc estions to • • NC by calling 503.246.6699 or 1.800.332.2344.
Issu • By: � /. Permittee Signat 1 r < <--
i
CaII 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.
11/04/2010 11:04 50335 R E ED HYBRID HEATING PAGE 02/03
Mechanical Permit Application i t is t 1 i ( ' ' -1.w.!
City of Tigard NOV 4 2010 Received / ! %/ /o hermit No.: Eta 'ae10 ....06)5
-too Sl
N _ 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
k: phone: S03.639.4171 Fax: 503.598 OF TIGARD Date/By: Other :
inspection Lime: 503.639A175 Dace Rmd
Internet www.tigsrd -or.� BUILDING DIVISION x
11(FE OF WORK COMMERCIAL FEE* SCHEME - USE CHECKLIST
• ❑ New CopSpttction ..r. • Addition/alteration/replacement eplacement Mechanical permit foes* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) dell
❑ Demolition ❑ der: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
SIAENTIAL EQUIPMENT / SYSTEMS FEELS*
vi 1- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building
For special on user checMiat
0 Multi- family 0 Master budder ❑ Other: Description I Qty. I_ Ea. I Total
JOB SITE INFORMATION AND LOCATION Healing/coolie
Air conditioning or feat pump
Job site add I Ll t h -
address:
(ratites site Plan shOw Pte) 14.00
City/State/ZIP: , , , i 6 . 3 Furnace 100,000 BTU (ducu/vo ss) 1 14.00 /5 --
• Faunas 100,0004-137U (dam/vents) 17.90
SuitabldgJapt no.: Project name: Cl.... j , O Gas heat pump 14 -00
Cross street/directions to job site: Duct work 14.00
Hydronic bot water system 14.00
Residential boiler (radiator or
hydrvnic) 14.00
— Unit heaters (f td -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Lot �.:
Flue/Vent for any of above 10.00
Subdivision I Odter 10.00
Tax map/parcel no.: Other iael appliances -
• DFSGRIPTIOIN OF WORK Water beater 10.00
Gas fireplace 10.00
4,ir ( r / Flue for water beater or gas
fireplace 10.00
LOS lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/ insert 10.00
0'4 PROPERTY OWNER ❑ TENANT Other
Chimney/lima/flue/vent 10.00
Other. 10.00
Name: . ? ,., -a t y., Environmental exhaust and ventilation
• `� Range hood /other kitchen
Address: • I j • t•' • MUM= 10.00 ,
City/State/Z P: • 1 U • MIIIIIMI Clothes dryer exhaust 10.00
s S exhaust (bathrooms
Phone: (3 DD 3) 54, 3 - 0q1.5 Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attidvrawispacc fans 10.00
Other 10.00
Business name: Fuel piping
Contact name. _ $5.40 for first Ibur; 81.00 for ene>b additional
Address:
Fan ace. etc.
- Gas heat pump
Cit wall/saspendedhmit heater
—
Pi ( ) Fact :: ( ) Water beater
_ Fireplace
E-mad: -
CONTRACTOR Barbecue
Business name J Clothes dryer (rtes)
mi!. • .. • Other:
Address: Pia q MECHANICAL PERMIT FREE' QQ
City/State/ZIP: Cm/1(0_11 u S /� *' Minimum permit roe sn a � s D a)
(51 3) - ` Fax: �) 3c�! ` L/ 6P Phut review (25% of permit fee) 1 -
V CCB lie.: / , ' lib q// Stato surcharge (12% of permit fee) r v *
TOTAL PERMIT FEE o 819 Authorized signature: This permit apnea ii a Permit is not obtained . •, 150 o 0
gnatwe: dins after it has been accepted as complete. t V
Print rtantv: T Date: q .. • Fa methodology set by Th- Coenty Budding Industry Service Board
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