The URL can be used to link to this page

Permit ii CITY OF TIGARD MECHANICAL PERMIT Permit #: MEC2010 -00610 s— COMMUNITY DEVELOPMENT Date Issued: 11/23/2010 +'� •TIGA ILD• 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S111 CD08500 ,a.a,',' v. Jurisdiction: Tigard Site address: 15925 SW SERENA CT Project: Sheets Subdivision: KERWOOD ESTATES Lot: 2 Project Description: Replace gas furnace. Contractor: A- ACTION HEATING Owner: SHEETS, DICK 18245 SW TV HWY 15925 SW SERENA CT ALOHA, OR 97006 TIGARD, OR 97224 P PHONE: 503 - 649 -3524 HONE: 503 - 968 -6092 FAX: 503 - 649 -6095 FEES Specifics: Description Date Amount Furnaces < 100K BTU 11/23/2010 $46.75 Type of Use: SF Fuel Piping 11/23/2010 $14.15 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 11/23/2010 $10.80 Occupancy Grp: Minimum Fee Adjustment - Mechanical 11/23/2010 $29.10 Stories: Fuel Fuel Types: Natural Gas Gas Pressure: 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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /� / Issued By: /�r' t..1-)2._� — Permittee Signature: C t f .. / ( �O /\./ Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 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. 03/10/2016 11:06 FAX Ej 001/002 Mechanical Permit Application S9 FOR OFFICE USE ONLY City of Tigard FOR Permit ,fir �, . 6 Date/By: // og,3 4) ii r ' l 6 Z� /o -Oc 6 /a 13125 SW Hall Blvd., Tigard, OR 97223 1V' ', I plan Review I ` � Phone: 503.639.4171 Fax: 503.598.196[ �� Other Permit: it: D TIGARD Inspection Line: 503.639.4175 \ tl \ V ` , a ; to ReadyfBy: IA See Page 2 for Internet: www.tigard- or.gov eS, .6 , tified/Method: Supplemental Information \TYPE OF WORK C'1 S o . COMMERCIAL FEE" SCHEDUL UIEE C'HECKL'IST • 1:1 New construction �J Ayddltlon /alteratton/rtYlaacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. • CATEGORY OF CONSTRUCTION Value: $ 1- and 2- family dwelling ❑ Commercial /industrial RESIAENIAI., E / �SSTEYI5 FEES` ❑ Accessory building Si S• • Multi - family El Master builder ❑ Other: For special information use checklist. Description I Qty. Ea. Total JOB SITE INFORMATION AND LOCATION ' • . . ' Heating/cooling �� J �-y� g /r Air conditioning Job site address: /� a S e. , ��/' —E - Ar C . / (requires site plan showing placement) 46.75 City /State/ZIP: Furnace 100,000 BTU ( ducts/vents) j 46.75 L1 t p �i Furnace 100,000+ BTU (ducts/vents) 54.91 • Suite/bldg. /apt. no.: Project name: Heat pump 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46,75 ' Flue/vent for any of above 23.32 Subdivision: Lot no.: Other: 23.32 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 23.32 `1,42.n10 Gas fireplace 33.39 c Rep [ Q. ��' Q Flue vent for 23.32 r water heater or gas ( T S n a o Log lighter l lJ O_ /L Log � ghter (gas) • 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner /flue/vent 23.32 PROPERTY OWNER ❑ TENANT Other: _ 23.32 Name: C ^� eJ v Environmental exhaust and ventilation Range hood/other kitchen Address: ' `- I 1 D 14 ..1 equipment 33.39 City / State/ZIP: 1 -- `�� Clothes dryer exhaust 33.39 (3 o Siuet exhaust (bathrooms, Phone: 11� ) C_ .l `7 9 c Fax: ( ) [cite[ compartments, utility rooms) 23.32 ❑ APPLICANT ❑ .CONTACT :PERSON` Atticicrawlspace fans 23.32 Business name: Other: 23.32 A- ACTION HEATING & A/C Fuel piping Contact name: $14,15 for first four; $4.03 for each additional 18245 S.W. T.V. HWY Fumace, etc. 1 114 !_ Address: ALOHA, OREGON 97006 Gas heat pump City/State/ZIP: Wall/suspended/unit heater Phone: ( ) Fax: : ( ) Water heater Fireplace E -mail: Range CONTRACTOR ' Barbecue Business name: A- ACTION HEATING & A/C Clothes dryer (gas) 18245 S.W. IV. HWY Other: Address: ALOHA, OREGON 97006 MECIIAivicALERi llT P TEt City/State /ZIP: Subtotal Ph J�� e: ( 5a.'� (p -35 4 Fax5 (p� -6 ©9 -5 Minimum permit fee ($90.00) t. Plan review (25% of permit fee) • CCB lic.: ! t ),.3 ( o 9 O- I it i ( State surcharge (12% of permit fee) TOTAL PERMIT FEE /00V / Authorized signature: This p ermit application expires if a permit is not obtained within 180 ✓ Q days after it has been accepted as complete. Print name: 'u./I 3 eI ] f Date: I j I 0 ' Fee methodology set by Tri-County Building Industry Service Board l:\BuildinePenuil \MEC- PennilAoo.doc 10/01/09 440- 4617T(1 1/02/COM/WEB1