Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00644
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/10/2010
Parcel: 25111 DD02000
Jurisdiction: Tigard
Site address: 8925 SW AVON CT
Project: LAMBORN Subdivision: STRATFORD Lot: 38
Project Description: Gas furnace replacement.
Contractor: ABLE HEATING & COOLING Owner: LAMBORN, PATTI K
8900 SW BURNHAM F -5 8925 SW AVON COURT 5
TIGARD, OR 97223 TIGARD, OR 97224
PHONE: 503 - 579 -2250 PHONE:
FAX: 503 - 620 -3980
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/10/2010 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/10/2010 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/10/2010 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By:/ / Permittee Signature: � l � 1'` I
• CaII 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application ,
FOR OFI WE.. ONI 1
! City of Tigard ^ + Received
' 13125 SW Hall Blvd., Tigard, OR 977 L� \� Date/By: r ' 9 jv ,i_,../ Permit No.: Z _ ,
-. ' 9 ��
Phon 50 3.639.4171 Fax: 503.59$.1960 ;+ Plan Review TT G A It p Inspection Line: 503.639.4175 �b -( P�® Date /By: other Permit:
Internet: www.tigard- ar.gov CO O `O\� Cate Ready/By: El sue, Page 2 for
w`G Notit ed/A9e[hod: Supplemental information
I ` \
TYPE OF WO
COMMERCIAL FEEi° SCHEDULE - USE CHECKLIST
❑ New construction ddition /alteratiort/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 profit.
CATEGORY OF CONSTRUCTION Value: $ -
►- and 2- family dwelling ❑ Commercial/industrial RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ Accessory building
❑ Multi - family El Master builder For special information use checklist.
❑ Other:
Description I Qty. I Ea. I Total
q
JOB SITE INFORMATION AND LOCATION Eieating;cooling
Job site address: \� Air conditioning
(��, ��n (requires site plan showirte placement) 46.75
. City /State /ZIP: VC., v-�a'��, ! 1 (�-l; `
` r �' 11 - d Furnace 100,000 B'FU (duets/vents) \ 46.75 ��
Suite/bldg./apt. no.: Project nan,� L Furnace 100.000 FiTI 1 04. ,a.ry «o,r) f 54.91
Cross street/directions to job site:
'i'` �' r Heat pump I 61.06
Duet work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
i n - te i n - duct, suspe et 46,75 .
Subdivision; Flue/vent for any of above 23.32
Lot no.:
Tax map /parcel no.: Other: j 23.32
Other fuel appliances
-
DESCRIPTION OF WORK Water heater _ 23.32
a _• _Gas fireplace 3339
a - Lea tit _ • Flue vent for water heater or gas
fireplace 23.32
Loa liehter (nag) 2n.az
Wood/pellet stove , 33.39
•
Wood fireplace /insert 23.32 _
OPERTI' OWNER J ❑ TENANT Chitnney /liner /0uelvent 23.32
Name: �.� Other:
23.32
l v :r C)( (N.
cxr/ MUSE ana ventilation
Address: ` k- rr ` Range hood/other kitchen
�� :,f>, l equipment
+ 33.39
k __A J °r -IA Clothes dryer exhaust
Phone: (ham ' _ \ � r ` Fay_ t ) Singte -du exhaust rharhr,,,.,,r, 33.39
City /State /ZIP;
1, ,ii compartments. utility rooms) 23.32
❑ APPLICANT ❑ CONTACT PERSON Attic'crawlspace fans
_ 23.32
Business name: Other: 23.32
Contact name: Fuel piping
$14.15 for first four; $1.03 for each additional
Address: Furnace, etc.
City /State/ZIP: Gas heat pump
Wall/suspended/unit heater
Phone: ( )
Fax: : ( ) Water heater
E-mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: Clothes dryer (gas)
Address: C.444 �� : 1 k�
x
4 6 . . ) . .r\ _ 614...111, L.1„, (� ' r Other:
City/State/ZIP: MECHANICAL PERMIT FEES*
L ~L � Subtotal :-S�- n C
- t Fax: (-
�1V � ` L... y ) Minimum permit fee ($90.00) 0_00
Phone: (
CCB lie.: ls( C� Plan review (25% of permit fee)
U \ State surcharge (12 %ofpermit fee) \ p , g 0
TOTAL PERMIT FEE , (1r) _ c
Authorized signature: p 0 / (.64. u This permit application expires if a
Q. p' permit is not obtained within 180
Print name: days after it has been accepted as complete.
Date: lk * Fee methodology ;et by Tri - Comm Building Industry Service Board
I: 1 Ba; IdingTermits\MEC- Permio p oc IUle!!o9
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