Permit r c-
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00316
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/30/2009
IIGa4RD g Parcel: 1 S 125DB03702
Jurisdiction: Tigard
Site address: 9520 SW 74TH AVE
Subdivision: BOULEVARD HEIGHTS Lot: 23
Project: Cole
Project Description: Install new furnace and air condtioning unit. Air conditioning unit must maintain a minimum 3 ft.
rear and side yard setback.
Owner: FEES
COLE, JAMES S Description Date Amount
9520 SW 74TH AVE Air Conditioning or Heat Pump 06/30/2009 $14.00
TIGARD, OR 97223 Furnaces < 100K BTU 06/30/2009 $14.00
PHONE: Flue/Vent For Any of Above 06/30/2009 $6.80
12% State Surcharge - Mechanical 06/30/2009 $8.70
Contractor: Minimum Fee Adjustment - Mechanical 06/30/2009 $37.70
ROBBEN & SONS HEATING INC
2214 SE 8TH AVE
PORTLAND, OR 97214
PHONE: 503 - 233 -5841
FAX: 503 - 238 -8849
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
•
Fuel
Fuel Types:
Gas Pressue:
Total $81.20
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 1.800.332.2344.
•
Issued By: A j Permittee Signature: - / „ 0
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.
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Mechanical Permit Application C E �
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I(IIt I[C
OMEiJSE'pNLIh I n
„ ic, ` R c ei v ed
y City of Tigard R e iv S
Da/By:
N.- °t 13125 SW Hall Blvd., Tigard. OR 97223 Plan Review
' � R Phone: 503.639.4171 Fes: 503.598.1960 JUN 2 9 200 Detc/By • OihorPcrmit:
T 1 ; i ( 1 ) Inspection Line: 503.639.4175 Date Ready /Bye lures: ® See Rage 2 for
Internet: wwW.tigard- or.gov CITY OF TIGARD Netifie.d/Melhod: Supplemental Information
BUILDING DIVISION • •
TYPE, OF WORK COMMERCIAL: FEE, : .SCHIDULE �- USE CHECKLIST
111 New con struction �1 ion alteration /replacement 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 .rofit.
CATEGORY OF CONSTRUCTION Value.
RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
• - a`i d 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special r »formarran use checklisr.
• Multi- family ❑ Master builder El Other: Description 1 Qty I Ea. 1 _ Total
JOB SITE: INFORMATION AND LOCATION. Heating/cooling
/-, — Air conditioning or heat pump
Job site address: • I • :-(_-' (requires site plan showing placement) 1 14.00 I
City /State /Z1P: r e . ov-. Furnace 100.000 BTU (duets/vents) i 14.00 1
1 Furnace 100,000+ BTU (ducis/ventq 17.90
Suite/bldg. /apt. no.; Project name: , 6 f CO L Gas heat pump 14.00
Cross street/directions to job site: Duct work 10
Flydronic hot water system 14.00
Residential boiler (radiator or
h (Ironic 14.00
Unit heaters (fuel -type. not electric),
in -wall in -duct. sus 'ended, etc. . 14.00
Flue/vent for any of above 6.80 r. it
Subdivision: 1 Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
`. DESGRI)P'1'ION OF WORK
Water heater 10.00
Gas fireplace 10.00
S N 4 Flue vent for water heater or gas
fireplace _ 10.00
Log lighter (gas) 10.00
Woodi.ellct stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue/vent 10.00
R01')ERTY OWNER ❑ TENANT Other: 10.00
Name: fi cc±1 _{� Environmental exhaust and ventilation
�S 10 S a r L '' `" f
Range hood/other kitchen
Address: v!L �� equipment 10.00
City /State /ZIP: 11 4 reek am e" � Clothes dryer exhaust 10.00
j JJJ Single -duct exhaust (bathrooms,
Phone: ~ a _ j S IL, Fa ) toilet com.artmcnts, utility rooms) 6.80
. APPLICANT. .. ; ❑ CONTACT. Attic /crawlspacc fans 10.00
; .
,f�., ` Other
Business name: - Ail �t a. e� i dal r ' Fuel i.in:
t
tij
Contact name: c h'n nom._ S1.00 for each additional
Address: , Furnace etc.
•••••-•.- ' -+ • r Gas heat pump
City /State /ZIP: • I e J 4. r - _ Walt /suspended/unit heater
Phone: 65? 33 .- t4 / ; : ( � Wate heater
Fire t lace
E -mail: 1 . r1S , Range
��CONTRACTDR Barbecue
Business name: 1k.. 6 A CPr eL, ca `S 1 U a I r (gas)
_ rY
1 Clothes drycr
Oth er:
Address: I .. i', MECHANICAL PERMIT FEES*
r`
City /State/Zip:
permit t
Phone: Pax: _1' ' ' ,
CCslie j S/151.1 34'1Elo State surcharge (12% of permit fee) �_,.,'
_ TOTAL PERMIT FEE 4
' 1, . . . `'j This permit application expires if a permit la not obtained • . In 1S0
Authorized signature: A n� . - / ( ( T days after it has been accepted as complete
Print name: �1W Date , —.A -- 1 • ` Feo methodology set by in- County Building Industry Service Board
Build',ne\Permit! . d ;m iiAF• 0 N : li '
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Robben & Sons, Inc.
Site Plan
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Prepared by:' it. 1—,_ Date: J.elz_1101----
Customer Name: c St4.3i ca_i___, Address: 3S0 4.J■J`1 q P
atqwk. 09 93
Customer Phone:503_ -is_3(
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