Permit r >2- CITY OF TIGARD MECHANICAL PERMIT
<.'' COMMUNITY DEVELOPMENT Permit #: MEC2009-00380
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/24/2009
Parcel: 2S112AC01700
Jurisdiction: Tigard
Site address: 15065 SW 74TH AVE
Subdivision: FANNO CREEK ACRE TRACTS Lot: 16
Project: Interstate Roofing
Project Description: Install gas furnace and ground mounted a /c.
Owner: FEES
INTERSTATE DEVELOPMENT LLC Description Date Amount
15065 SW 74TH AVE
PORTLAND, OR 97224 Permit Fee 07/24/2009 $148.70
12% State Surcharge - Mechanical 07/24/2009 $17.84
PHONE:
Contractor:
FIRST CALL HEATING & COOLING CO
1650 NE LOMBARD ST
PORTLAND, OR 97211
PHONE: 503 - 231 -3311
FAX: 503- 286 -5194
Type of Use: COM
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 1 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning: 1
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $166.54
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
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 • suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility t 'cation Cente . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or dir -ct questions to OUN1/4 • alli •. 503.246.6699 or 1.800.332.2344.
Iss -d By: Permittee Signatu �I /
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.
FROM : F I R S T CALL HEAT I NG & COOLING FAX NO. :53-286-5194 Jul. 22 2009 09 42AM P1
..._____,,,,a •
Mechanical Permit Application .i: - : ...„ ., : • ••• , ONLY ' • • •-• • •:-.., : ..,•,- 1
; .,
. ,!•: City of Tigard , ,
, , Received •
Data/Hy: 7 A , 09 Pi nNo.:
ni( iteA,,Y.4Z38tC)
l ' 41 11125 W I Bi d T' 7?t , 1 --, , Pe , .. .._
- Flan RevIew
,. I • Phone: • 503.639.4171 Fa : . 11751,1960 - ''''''' ...- Othot: Parma; • Dinci/11y;
, Inspection Line- 503 639 4175 --
11.6 Ky.' r). • -, " - . . JUL 2 2 2009 Date Ready/By: FI7 r■ ,et: Page
■•;:4' _ - ' Internet: www,tigarcl-or,gov Milt nediMethorf AO, Supplementai Intnrtnotjon
1 I
1 ) g 7':',. ':'/13 ‘VI I IHMENtial i ii t Abl it 112 W §. 74 71100411 . : li i6rit r - i•Y• I `:::1"1:i , . II' i
. .., :„ ...,.. ..,.4. !!!•,- ,.. : X. 1., . )!t ',.t 4t.f.i At? ..1;' a ,D ,. , ,,o, m ,•.,,,, , . .,..• )..., .:,. •,!,-, • ‘,. : aiL ili ..,(..,., ,,r. T6p yylipt y;..' 71 ,,.0i, ‘,,,/, .i..:6jimatil6a
Mechanical permit fen are ascd on the value of the work
0 NCIV ConStructiOn • r. ri ton alteration/replacement
performed. Indicate thc value (rounded to the nearest dollar) of all
0 Don.iitiun Ell Other; mechanical materials, equipment, labor, overhead, and profit.
-... . ,
, firTellirt.MI,V TVIONEarmanro lie •
r i1 Value: $ (.. is • dp 0
L.1 A .. 1 .Y.., ,,,,;,... t:.' 4 4 L7, 1 ' , it 4 .., ' '. tit • It 1 1,S '', '' A ',. 4* -..'' 6'' :.,1 '.' e , Xi:A.. k; " g MI' CI' .. .''' rift ii 'T. irf:-.. • iv ......74:t !: • :0, ..,
0 1_ and 2-family dwelling MCommercial/industrial 0 Accessory building a :,, to f :1151, .; L . ,, :,,. amp,v,,,,,, cm.:4
POI' special information use clierkfLa
iii Multi-family 0 Master builder 0 Other;
Destription 1 I Qty, I Ea, I TWA'
LAH Fill74 fW .1." r '' ' '. (4' 1 ' ' ' ''' PA 411 1,■ . ' 1\ '■ : 0 FiCatiOlg/t0Ohltg __. — 1 , .... ... __._..._
Air conditioning or heat 1 71'111.1 P -.... ' -- —
Job site address: ts i, 5 1 ■4 4 c - .1. 6-----e (regents site plan FilOWilet plUthY1.!10) ,.. , , ... ..... , 14-00
City/State/7.1P: R. L I 1 2-.2--•".1 Furnace 100 000 BTU (dnet
es
■ 14,00
.-if
.,_. ,_ _T F,,,.
,,e 100,0001- BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project . c_?. name: —___................ .... ..._
Gat; heat pump 14,00
,----_,
Cross street/directions to ,job site: Duct work 10.00
. .. . .„ .
- - - - - 1-1ydronie hot water system 14.00
1 (ioller (radiator or
. ......, ....
.......--
hydronic) 14,00
..,... I'lnit beaters (filet-type, not electric),
in-wall, in-duct, suspended, etc, 14.00
......... ......_
-- - - Flue/vent for any of above 0.1f0
Subd ivision: 1 Lot no,: _____,._ .. . _
___ _ _ ..,.. Other: 10.00
Tax map/parcel no.: Other hod appliances
......„..,—,..-. .„: ,
, i , •,, iiiif:, 1: 0: :, ,i3 ,,,!,,,,,,,,.. 4q, A .7 1 0ayar-4431 04 ,,,, , ,, towroriri na niel nu alwaump aro x „v. , Water heater 10,00
01.1433 . ,„ l 7
..Y...'.. ' : .. '. ' 14:kYli di !■.:, ,i t .j. . . 1 .6 .4 : ' l'J, i . : .1. .. . .4 : ,,, , ....,. Gas firepiaue 10.00
(r--, - ' or gas •
.. fireplace 10,00
( rx. et) CS c., k ■ ",-12- ) Log lighter (gas) 10.00
_..... ,
Wood/pollet stove 10.00
.......
Wood fireplace/insert 10.0(3
t 6 , 4 . i , tvTwomoo .pr.F 5 ;,,,, T„,,t9wili, or..,7cliy 2. Chimney/liner/lbw/vent 10,00
..l, l '' l l ."‘ ,l■;,' .'t 1 ; b .?:b' i' '':'`..':0;:,..‘;‘ oiher, 10.00
Narric: A i.,.,_ •,-. -4-ct-it -4 2 9 _4 9 ..C7. !7...`!,! . Environmental exhaust and ventilation
.
Range hood/other kitchen
Address: 5 G 1 %.,( A-1, A - ,.....-e equipment 10.00
___ ..... .... _. .... ...-......_ .. .....
City/State/ZIP: T ,,,,, 4.,,_e,A, i - 2 27-2-4 Clothes dryer exhaust 10.00
- Single-duct exhaust (1;a1.171poins,
Phonc: (5 e 6,, g _ 5 iv , N k Fax ( ) toilet compartments, utility rooms) 6.80
, . .
iV'qqrg,Vtoit*atrkAtavfoEyfgcSiFg Atlic/crawlspace fans 10,00
4; :lt.!t:Pt.::;: A..,k,tetiit:,,,l,mst.t.„2m,,,t.Lail:.,,,,,,,,,,,t:Y,',,l^7.:•:1‹,EL. 0 th ci 10,00
Business name;
Fuel piping
.,_ ..,.._
- • • ''
Contact name: $5.40 for first four; $1.00 fur cacti additional
- ----. v Furnace, ete.
ArICITC5a: ' , *--
kras neat pump
City/State/ZIP: Wall/suspended/unit heater
.,,.,.,....._____......_____„. .....____......_
..._....... ,. . . ..... . .. . ........
...__.. -.-
Phone: ( ) Fax: : ( ) Wate,c beater
.... Fireplace
4
E-mail: : Ran .... ...
. A tt91 ' . , t ' r i'■ I. i1k.9. ..,."'
Ty ,ivi‘ , , i'. ro NfiNtOkrp iligtors .0. r
1 .
,.. ,,,N,i,,, • h:..., k MY, \ 't 0 )•.a„',.i If ,,, y..4 ' ',, ; . A.. i ._. 2 , . A 91 Babe cue
Clotho dryer (gas) ._.
Business name: r i r 5 , J __ c „ vi 1-- co c coo it,.._., Other: ___
.... _.. ..
..., ..
Address: to 5 13 c...1 L ,,, \ op 1 ._ crk- S 7- ' ''' ?-i'V :M774 • ,'. 1 ,Atf •• 'AV63 tit
.:''' 07. '.! . ' Inditttadrasotstottni.; gAllst ".:^:.ct.ta
City/State/ZIP: Q( A 0 (2_ e - 2\ )
.,... _,. ..., ,, Subtotal
.. ..._ ..... .
r Minimum pormil lee ($72.50) • - 7"
Photie:s03 2, (... ( k l 'aA: tO4 .2 eC, - S t G I,`4 Plan review (25% of permit feet
__
C(14 1 i c.: 1 _ 'a,c7 State surcliargc (12% of permit fee)
...... .. -
.__ ...... .... „
-•-• - • "---- TOTAL PERMIT FEE ' 1 (0 (0 5( .
Thlr nuntlt oppliontinn nNioirox it openult IT not obtained within LBO
Authorized signature: , 4...44. atrytt after it Ilea boon accepted as complete,
Print name:
LOU 3 vac s ElP S I 11 e '
it • --( I et, en.thodology set by Tri-County Budding Industry Serviun Board
...
Ltn 01/19/07 .110-1617T (11/02/COM/WEB)
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