Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00672
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2010
Parcel: 2S104CCO2500
Jurisdiction: Tigard
Site address: 13969 SW HILLSHIRE DR
Project: NIGAM Subdivision: HILLSHIRE ESTATES NO. 2 Lot: 131
Project Description: Gas furnace installation.
Contractor: GRESHAM HEATING & AIR CONDITIONING Owner: NIGAM, INDRA B & NEELIMA
1560 NW 3RD ST 13969 SW HILLSHIRE DR
GRESHAM, OR 97030 TIGARD, OR 97223
PHONE: 503 - 667 -7594 PHONE:
FAX: 503 -667 -3769
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
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 1.800.3 32.2344.
Issued By: / Permittee Signature:
Call 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 Applicatio CEWED IOK E USE ONLY
City of Tigard Dale " l,�, Permit No.:
° 13125 SW Hall Blvd, Tigard, OR 97223 r ��
Phone: 503.639.4171 Fax 503.598.1960 D L C 2 1 2010 Plan Review
Datc113y Other permit:
TIGARD Inspection Line: 503.639.4175 • Date Ready/By: is,n
r.
Ii,te,uet: www.igard -or.gov CITY OF TIGARD Notifiedui trtaod: •
IU III.DING DIVISION
TYPE OF WORK.. • .. COMMERCIAL FEE* SCIIEDULE — USE CIIECKLIST
❑ New construction r Additionialter - dtion/replaoemtnt Mechanical permit fermi 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: $
�1 and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial/industrial CI Accessory b uilding
For special information use checklist.
❑ Multi - family ❑Master builder ❑ Other:
Description I Qty. j Ea. Total
108 SITE INFORMATION AND LOCATION Ilcatinglcooling
Job site address } 3q 5 i `� � r Air conditioning epa bo heat pump
(requires siteplaas6owiagptacxmeat) 14.00
� r _( 7 Z 9
City/State/ZIP: -1) Furnace 100,000 BTU (driers/writs) 14.00
C
Furnace 100,000+ BTU (duets/vents) 17.90
Suite/bldg./apt no.: Project name N I ( 1 Gas heat pump 14.00 — ____
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
. hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision Lot no.: Flue/vent for any of above 6.80
Other: 10.00 _
Tax map/parcel no.: I Other fuel appliances
DESCRIPTION. OF WORK Water heater 10.00
(� Gas fireplace 10.00
` 5td-L ( ()C1 5 ! () ri.cia C -t ' I Flue vent for wafer heater or gas ,
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
! Wood fireplace/insert 10.00 .
j Chimney/liner/flue/vent 10.00
XpROPERTY hood/other kitchen
R an Rage
OWNER 0 TETENANT i Other. 10.00 ,
Name: � 0 e ri "`���JJJ M I Environmental exhaust and ventilation
ho
Address: 1 # /� ..Si'() , tfi� h 1 rf Birt ye- R n ge h o t 10.00
City /State/ZIP: y ' a, q 7 9 Clothes dryer exhaust 10.00
Single-duct (bathrooms,
Phone: 513) 5 q -1 / J� Fax: ( ) I toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: _ 10.00
Business name: Fuel t ,
P�P ng
Contact name: j $5.40 for first four; 51.00 for each additional
Furnace, etc. L
Address: Gas heat pwnp
City /State/LIP: j Wall/suspended/unit heater
Phone: ( ) I Fax :: ( ) I Water heater
Fireplace _
&snail: Range
CONT,RACFOR Barbecue
Business name: a L .y y�p u .- i .�./ � "1 1
Address: Eat at 111 V V 3 _ 1 } 1 �1C� MECHANICAL PERMIT FEES"
City /State/ZIP: ei Wf i 0,2 61105 Sebtutal
Phone: ( d D (101_1504 Fax: ( ap-1.3-/t
ew w P lan revie (2 permit fee) c1 d _ ✓U
CCB tic.: f i ll - l 1 Q State surcharge (12% of permit fee) Q / p,---0
• t TOTAL PERMIT FEE r,: 10 O c "e
This permit
Authorized signature: a days after it Ins been accepted t
epted as complete_ ISO
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