Permit CITY OF TIGARD MECHANICAL PERMIT
III
13 , ,r COMMUNITY DEVELOPMENT Permit #: MEC2010 -00673
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2010
Parcel: 2S114BCO5100
Jurisdiction: Tigard
Site address: 10321 SW BONANZA WAY
Project: Rodgers Subdivision: RIVERVIEW ESTATES NO. 2 Lot: 88
Project Description: Install furnace.
Contractor: OREGON HEATING & AIR CONDITIONING Owner: RODGERS, MARCUS D & HEIDI A
PO BOX 241 10321 SW BONANZA WAY
DUNDEE, OR 97115 TIGARD, OR 97224
PHONE: 503 - 691 -9699
PHONE: 971- 645 -7890
FAX: 503 - 691 -8556
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/22/2010 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/22/2010 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/22/2010 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
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
Utili o i Ica i n—Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
direct questions to OUNC calling 503.232.1987 or 1.800.332.2344.
sued By: Q� ` Permitter Signature: '11h• / �I a / ( C
Call 503.639.4175 by 7:00 a.m. for the next available - - ion 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 App1ic i � e w FOR OFFICE USE ONLY
City of Tigard ! ��'���� D ,� r .� Permit No.: t ., o Gri 6 7 3
t a 13125 SIX/ Fall Blvd., T igard , OR 97 223 „ , , ,� P1a ].Review
Phone: 503.639.4171 Pax.; 503.598.1 C 2 1 (c i' ; bat e/ By: Other Permit:
TI G A RD Inspection Line: 303.639 4I75 Date Ready/By: tans, d Sec Page 2 for
Internet: www.tigard- r.gev CITY OFTIGARD Notified/Method: Supplemental Information
� ING . DIVIS ION
T!P)E o c . CO11MLRC1AI FEB* SQf J)15$1 USE, CIIECICLILSY'.
cal perm it. fees* Machani arc based on the value of the work
❑ New cOristtuctlon Addition/altcration/repiaCement performed. indicate the value (rounded to the nearest dollar) of all
LI Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATECORY::O CONSTRUCTTON _ Value $
• -- ' • ------'------ - RESIDENTIAL EQUIPMENT I‘SYSTEi1MS FEES'
1 - and 2- family dwelling ❑ Commercial/industrial El Accessory building For special /rjormatPon use checklist. U Multifamily ❑Master builder ❑Other: Description I Qty. Ea. V Total
JOB, S1T E TNFORMATION'A.NO .LOCATION ,, Heating/cooling
Air conditioning
rob site address: $ . , _ _ 1101 S. A �. _ A. r (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46,75
City /State/ZIP; � M w
�"�� �` }�+ Furnace 100.000+ BTU (ducts /vents) 54,91
Suite/bldg. /apt. no,
µ • P roject name: _ _ Heat pump 61.06
Oots street/directions to job site: Duct work 23.32
` I-Iydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric), 1
• in - wall, in - duct, sir pended . etc, _____ 46,75
" ^� Plue/vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Tax rap /parcel no.: Other fuel appliances
Water heater 23.32
KscR>'pTIO1 • OE 'WOIK:,. 1 %u;. , i s .
, Gas fireplace 39.39
UT •Qu• _, Flue vent for water heater or gas
fireplace 23.32
_.. - Log lighter (gas) 23.32
W oo d/ pell e t stove 33.39
Wo od fircplacc/ins 23.32
-w Chim n ey/l in er /fl ns e e x t 23.32
PROPERTY OWNER ';,' �' t 'NANT ;'•' Other: 1 23,32
Name: J A. ` A R E nvironmental ex haust and ventilation
Address: 10 a P4 S, . Ta . 0 j` V Range hood /other kitchen
33,39
• City /State/Z.2: Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone 'Ct) Fax ( ) toilet compartments, utility rooms) 23.32 _
l'aC.ANT. l D colyr,iCr PER &ON Atf
t cr a wlspace tans 23.32 { . M.--
- ' -- -� Other: 23.32
Business name; 1� r
V / "i rJ �Lt� r ,�� uel t P i
Contact name: $14.15 for first four; $4 -03 for each additional
Address: Furnace etc.
l , t R +rt Oas hcai pup
City /State /ZTP: / l Wall /suspended/unit heater ,T—
Y l
Phone: s gre titCt, ( 4 (Q • CI Pax:: ,, eg , la ( : Water healer
- Fireplace ,
• E -mail: Range
CO T RP C'tOR ,' )3 ar b ecue dryer � _-
* N ' /� • Clothes dryer (t as
Business name: �. Ir � ' O
Y� '-' � , l
- _. ��ryry y rr Other
Addre [ V + %OK 94 l T.,AY
21GIA� 0 T EESA '
■ City /State/ZIP: I r , i - S .. _P : • 1 Subtotal
�
'^ /�) } Minimum permit fee ( $90.00 ) q • o
Phone: ( C Q l.><-C Fax fib CS }+j � Plan revicwv (25% of permit fcc)
CCB lie.: State surcharge (12% of permit fee) 1 D + G am ' 1J,
• TOTAL PERMIT FEE ,
1 f
Authorized signature: II I This permit application expires if a permit is not obtained within 1
I days after it has been accepted as complete.
Print name: V - I Date: triats9_,` • Pee methodology set by Tri -Cotmty Building Industry Service Board
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