Permit r y CITY OF TIGARD MECHANICAL PERMIT
1 ,/- COMMUNITY DEVELOPMENT Permit #: MEC2009 -00355
TiG ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/17/2009
Parcel: 2S112BD03800
Jurisdiction: Tigard
Site address: 14595 SW 79TH AVE
Subdivision: MARA WOODS Lot: 9
Project: Nguyen
Project Description: Replace gas furnace.
Owner: FEES
NGUYEN, FRANCIS KHAI & CHINH THI Description Date Amount
14595 SW 79TH
TIGARD, OR 97223 Furnaces < 100K BTU 07/17/2009 $14.00
12% State Surcharge - Mechanical 07/17/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 07/17/2009 $58.50
Contractor:
DAMAR HEATING INC
P.O. BOX 56327
PORTLAND, OR 97238
PHONE: 503 - 236 -6344
FAX: 503 - 236 -6552
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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: f I � Permittee Signature: dry/ � ,&G f fa.-7Q"../
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.
••JUL' -14 -2009 11:36 PM WIGGINS 3609061977 P.01
IVE Mechanical Permit Applicatio h'1►1: t►i''I I1 h 1451: t)�'I,1; ,... ,
r. City of Tigard JUL 15 2009 Reoeivcd — ` n . ,
DalelB � /7 / '� a � , Permit No • � �r� po 0 .— / '1
" 13125 SW Hall Blvd., Tigard, OR 97223
i lli
i j • Plan Review
Phone; 503.639,4171 Fax: 503398,1960 Other Permit:
Inspection Lino, 503.639.4175
i CITY OF TIGARD 17ateJe ;
it,n"' p yard BUILD DIVISIO ° � t °'� eho - See Page ltor
Internet: www.tigard-or.gov Notitted7 Supplemental Information
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0 New Construction 6 • ddition/rtltcration /replacement -- Mechanical permit fens* arc based on the value of the work
Ei Demolition 0 Other: performed. indicate the value (rounded to the nearest dollar) of all
mechanical materials, etul•ment labor, overhead, and troflt.
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1: l- and 2- family dwelling 0 Commercial /industrial 0 Accessory building (G 9si " °t °" t N °N ° " "� "'m "" d" m "` "� Nrta . " �r ''�V�IC ...due.
12 Multi - family 0 Master builder 0 Other: For specs! information use checklist,
on Qty. Descript Ea. Total
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N'J � InIVII hlnlllnlloatilN ter, I u ,I i t . Hcirtin s4olin
•
/ 1 / 5 J '"' C i4 - Air conditioning or heat pump
Job site address: % .Y re( tides site 'tan slmwin_ lacemiaat 14.00
Cit /Statc /ZTP: P � 77 ?? y _ "_ Furnace 100 000 BTU ducts/vents 1.111 14,00
Furnace 100 000+ BTU duets /vcn s Mill 17,90 _
Suite/bldg. /apt. no.: Project name:
Go heat .um. Ell 14 MI
Cross street/directions to job site: Duct work 11M1 1p.00 MI
H dronic hot water s stem 14.00 MI
Residential boiler (radiator or MI
h dronie MN 14.00
Unit heaters (fuel -type, not electric),
in - wall in - duct, suspended eta. 1111 14.00
Subdivision: Flue /vent for an of above WIC 6.80
I of no.: _ Other: MEI 10,00
Tax map/parcel nn.: Other fuel a . (lances
per ,f y p,��I p ,��.� ry $ �pp�}I�hJ'vy �� nm ,y)t rm
MII IUIIIIIIII N �IWIVi ' �tA'dA1;,'W&IV'lallulllll�u�II YB NIWNIIIIIII�NFaIPM iY1VM,I WIWIIIMIAI I FhSNIVT!ll ll y,d F 'i ' ' I 1 pINYIII' • . 4r t 'I` I "I �pipplp�'ui� 10.00 MEE
W9WIIIm , ' 10.00
6 els � S I O (2f 1 �
tire. lace , _ Flue vent for water heater or gas
11�'_..�� ! g 10,00
- ETRIEDEMEINIMIN 10.00 MI
Wood/.ellot stove ME 10.00
Wood fire .late/insert NMI 10.00
mm t; „:7 +m:pa�l `F, y' m� - Iy Chimno /liner /flue/vent 10.00
i ill t l i lD� m u a ar
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Nae: 10.0Name: / f /,t,. A p, Environmental exhaust and ventilation
Address: " �^ - .$4 Range hood /other kitchen
e* ui mcnt 1111 10.00
City /State/ZIP: / l e , I .2'.2:Y r 73 4—",?—, Clothes d er exhaust 10.00
Or
MEI
Single com exhaust (bathrooms,
Phone:
(f �O ) ,„ — 0 ' 0 Fax ( ) toilet corn artments, unlit rooms 6.80
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Business Warne. inn
IIMEIMMINIMIMIIIIMEMIE
10.00
Contact name: 55.40 for first ibur $1.00 for each additional
Address: Furnace eto. WM
Gas heat turn. MIM
City /State/ZIP: Wall /suspended /unit heater __ME
Phone: ( ) 7 Fax: : ( ) 13211111. 111..11111111=1111 - Fire, lace
E-mail: Ran �� �
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I I " r• i I Ip,. ,_ q . d d 41lEalNlulu,361.A ,d al t,� e' , � ,, �� .�i1 IBh, p � ,.'I, ta l Barbecue Business name: % �� r " IYIO Clothes d er :aa) ���
* I -.-- Other: MI
Address:
/ # / Q } > ;' , � -� a �� rF..'. r p �.l , ,'.,:,
7 Sul =� ?ennI °Mllmu m >� •I' '1 . � I ii 7"lt! l
City /State /L1 I': � ul:: ry I poet and v ,,, � w:�l tr<,5r.a rmtx5ri:' `',. -��tl •• '� +v
Pel r drfl < d k 97 y 3 g Subtotal UWE
„ Minimum permit fee ($72.50) ISPIM
Phone:
p A j, yq Fax: - ) � 4 1_
Plan review (25% of ermitfee) MIN
CCD lie.: 7 a „ 6 / E I .10. O sn
State surcharge (12% of permit fbe) ii
cj l n /� �/� iii ItM
Authorized signature: (,� • ems/ This permit dpplication expires If a permit is not obtained within ]eta
_ _ _
. day.. after It has been accepted as complete.
- Print name: I2 )9 i t 6 7 J Date: 7 / ' 7 ` Fee methodology set by 7•ri- County Building industry Service Board
1:1 aulldinglhrmtlt /IMEC•PerrmltApp,doc 01/19/07 440 -467,r (11 /02 /co v we'n)