Permit CITY OF TIGARD MECHANICAL PERMIT
II I o COMMUNITY DEVELOPMENT Permit #: MEC2010 -00566
T [GAR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/05/2010
Parcel: 2S 111 CA01600
Jurisdiction: Tigard
Site address: 9585 SW SUMMERFIELD DR
Subdivision: Lot: 0
Project: Gruggen
Project Description: Furnace replacement
Owner: FEES
GRUGGEN, ROBERT C & KIRSTEN TRS Description Date Amount
9585 SW SUMMERFIELD DR
TIGARD, OR 97224 Furnaces < 100K BTU 11/05/2010 $46.75
12% State Surcharge - Mechanical 11/05/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 11/05/2010 $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 503.246.66• • • :1 r .4
Issued By 4 i Permittee Signature:
•
CaII 503 .6 . • 75 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.
NOV-4-2010 03:18P FROM: TO:5035981960 P.1 Mechanical Permit A t .1i . ;F` t., . ' _ CEI VED • 1 „i, „I 1 i, i 1 .I ,1 \ I I
City of Tigard Receive
13125 SW Hall Blvd.. Tigard, OR l�telB ' �� 7
Phone: 503.639.41.71 Fax: 503.598.1 V 4 2010 Plan Re
view Other Permit
Inspection Line: 503.639.4175
Internet www.tigard or.gav Date Ready/By: , , IF See Page 1 for
CITY OF TIGARD N if ed/Method: G' Supplemensii lotormadoe
TYPE
BUILDING DIVISION
COMMERCIAL FEE' SCHEDULE —.USE OIEQUdS1'
0 New construction ® Addition/alteration/replacement Mechanical permit fees• are based on the value of the work
In Demolition performed. Indicate the value (rounded to the nearest dollar) of all ,
❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value:;
® 1- and 2- family dwelling ❑ Com U
merciandustrial 0 Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
1:3 Multi - family [3 Master builder 13 Other:
. For special I /ortnatlop ass checklist.
Description I Qty. 1 Ea. 1 Total
• J08 SITE INFORMATION AND LOCATION Head oeHot
lob site address: q efts SU
5w mmcir-te d Mr conditioning -
� Q - LZ4 (requires she plan showing placement) 46.75
City/Stale/EP: T.CW rV l Furnace 100,000 BTU (ducts/vents) 1 46.75 ;,,f n ..
Suite/bldg./apt. no.: I Project name: Furnace 100,000+ BTU (dttcWvents) 54.91 Y,
Heat pump 61.06 _
Cross street/directions to job site: Duct work 23.32
Hydraulic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric), '
Inman, induct, suspended, etc. 46.75
Subdivision: I no.: Flue/vent for any of above , ,. 23.32
Other 23.32
Tax map/pared no.: Other Nei appliances
DESCRIPTION OF WORK Water heater, 23.32
� I I`�,�f
r Gas fireplace 33.39
I Flue vent tier water heater or gas
fireplace ,
Log lighter 23.32
Wood/pellet stove 33.39
Wood frepiace/insert 23.32
r4 PROPERTY OWNER 1 0 TENANT Chinmey /ll er/fluelvent 23.32
Enter. = 23.32
Nwne: Environmental exhaust and veogladoa
Address: e.., Range hood/other kitchen
equipment 33
City/State/ZIP: Clothes dryer exhaust 33.39
Phone: 6029 6214,-(AID Fax: ( ) toile rooms) , 23.32
,
® APPLICANT 0 CONTACT PERSON Attic/crawlspace fans , 23.32
Business name: Sae u contractor Other 23.32
Same
Fuel piping
Contact name,: Diane Mason $14.15 for fleet four; 54.03 for eat* sddidoosl
Address: Furnace, etc.
Gas heart pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
Fireplace
E-mail: Range
CONTRACTOR Barbecue
Business name: Tr* 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 permit fee ($90•00) 4i) _c/O
I one: (503) 557.2220 l Fax: (503) 357.0919 Plan review (25% of permit fee)
i CCB Iic.: 72623 State surcharge (12%ofpermit foe) I
TOTAL PERMIT FEE 6ObS Q
`s „ "4WD 714s permit appikstion mints If a permit b eot obtained within Ia0
Authorized si fly: CMG � — " " ' days after u ban been accepted se complete.
Print name: j (O.fl . aeon I Date: [ I/41 1O I • Fee methodology set by Tri.Cotmty Building Industry Service Board
440.4617T (11/O2 COM/w ®)
IilditApp.doe 10/0I/e9
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