Permit " CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00653
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/15/2010
Parcel: 2S111 CCO5500
Jurisdiction: Tigard
Site address: 10060 SW CENTURY OAK DR
Project: Langley Subdivision: SUMMERFIELD NO. 1 Lot: 78
Project Description: Gas furnace installation with fuel piping.
Contractor: MULTNOMAH HEATING INC Owner: LANGLEY, WILLIAM G & BARBARA B
PO BOX 1830 5021 SW BANCROFT ST
GRESHAM, OR 97030 PORTLAND, OR 97221
PHONE: 503 - 665 -5656 PHONE: 503 - 665 -5656
FAX: 503 - 665 -2866
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/15/2010 $46.75
Type of Use: SF Flue/Vent For Any of Above 12/15/2010 $23.32
Class of Work: ALT Type of Const: Fuel Piping 12/15/2010 $14.15
Occupancy Grp: 12% State Surcharge - Mechanical 12/15/2010 $10.80
Stories: Minimum Fee Adjustment - Mechanical 12/15/2010 $5.78
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 at 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 • : • _ : 10,332.2344.
Or
Issued By: - Permittee Signature:
_ ! I�� —a ! 2e.4
a I 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.
Dec 15 10 08:33a Joe 503 - 665 -2866 p.l
Mechanical Permit Application El FOR OFFICE USE ONLY
City of Tigard D ate/B Pe nritNo.:
, C.
13125 SW Hall Blvd., Tigard, OR 97223 y' [� S
1 C • Phone: 503.639.4171 Fax: 503.598.1960 DEC 15 2010 Date/By: man Review tither Permit
D
TIGARD Inspection Line: 503.639.4175 Date Ready/By: fig See Page 2 for
Internet: www.tigard -or.gov CITY OF TIGARD Notiled/Method: Supplemental Information
BUILDING DIIMSION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ❑ Addition/alteration / replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment labor, overhead. and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS .FEES*
® I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
❑ Multi- famil ❑ Master builder ❑ Other:
For special injornrmion use checklist
Description I Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning
Job site address: 10060 Century Oak Dr (requires site plan showing placement) _ 46.75
City/State/ZIP: Tigard OR 97224 Furnace 100,000 BTU (ducts/vents) 1 46.75 it, =7
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: LANGLEY 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) 2.3.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Flue/vent for any of above 1 23.32 23,3) -
Subdivision: Lot no.: Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace
Install one gas furnace, one gas lint, one flue vent
Flue vent for r water heater or gas
fireplace 23.32
;tx .1-11-1..
l t L Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
® PROPERTY OWNER 1 ❑ TENANT .,_ Chimney /liner /flue/vent 23.32
Other: 23.32
Name: William Langley Environmental exhaust and ventilation
Address: 5021 SW Bancroft St Range hood/other kitchen
equipment 33.39
City/State/ZIP: Portland, OR 97221 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)970 -6445 Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT ® CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: Multnomah Heating, Inc
Fuel piping
Contact name: Joseph R. Innocenti 514.15 for first four; 54.03 for each additional
Address: PO Box 1830 Fumaoe, etc. 1 / 1�
Gas heat. pump
City /State/ZIP: Gresham, OR 97030 Wall/suspended/unit heater
Phone: (503) 665 - 5656 Fax : : (503) 665 -2866 Water heater
Fireplace
E -mail: multheatincl@aoLcom Range
CONTRACTOR Barbecue
Business name: Multnomah 'Beating, Inc Clothes d e r ac
Other:
Address: PO Box 1830 MECHANICAL PERMIT FEES*
City /State /ZIP: Gresham, OR 97030 Subtotal
Minimum permit fee (590.00)
Phone: (503) 665 - 5656 Fax: (503) 665 - 2866
Plan review (25% of permit fee)
CCB lic.: 75443 5141 State surcharge (12% of permit fee)
„7 TOTAL PERMIT FEE
Authorized signature: if 7 - I This permit application expires if a permit is not obtained within 18U
�� V� - days after it has been accepted as complete.
Print name: Pavia Dirksen Date: 12/14/10 • Fee methodology set by Tri -County Building industry Service Board
1:\Building\ Perrn4s1. MEC- PennitApp.doc 10/01/09 445-4617T(11/021COM/WEB)
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