Permit CITY OF TIGARD MECHANICAL PERMIT
' - COMMUNITY DEVELOPMENT Permit #: MEC2010 -00670
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/22/2010
Parcel: 2S111DB06800
Jurisdiction: Tigard
Site address: 15400 SW ALDERBROOK DR
Project: SNYDER Subdivision: SUMMERFIELD NO.7 Lot: 393
Project Description: Furnace replacement.
Contractor: TRI COUNTY TEMP CONTROL INC Owner: SNYDER, OWEN & GAIL
13150 S CLACKAMAS RIVER DR 15400 SW ALDERBROOK DR
OREGON CITY, OR 97045 TIGARD, OR 97224
PHONE: 503 - 557 -2220
PHONE: 503 - 620 -0999
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Air Conditioning 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 $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law.. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC b calling 503.232.1987 or 1.800.332/344.
Issued By: / r Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
DEC -21 -2010 11:57A FROM: TO:5035981960 P.1
Mechanical Permit AD .!), ti • i UM( tit n l I t t, I' i t 1 \, ,
City of Tigard Received
13125 SW Hall Blvd., Tigard, ORr,9.7223c� Dat y ' V �,( O
II Phone: 503.639.41.71 Fax: 503.5$&.1961P 1 2O �O Plan Review near Permit:
„ 1; Inspection Line: 503.6394175 DatelBy'
Date Ready/By: 61 See Page 2 Ibr
Internet www.tigtvd- or.gov cr ry O F TIGARD Notitied/Mothod:
Eg
Old DIVISION Supplemental Information
WORK • COMMERCIAL FEE* SCHEDULE —.USE CHECKLIST
0 New construction Addition/alteration/replacement Mechanical permit fees' arc 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: $
® m
I- and 2- family dwelling 0 Comercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ Multi - family 0 Master builder ❑ Other: For special (q(or7aultoa use checklist
Description I Qly. I Ea. 1 Total
• .10/2 SITE INFORMATION AND LOCATION Ileatlryrit/eoeHn)t
• Job site address: I Ei 0O 6 W A Air conditioning '
t f Y (requires site plan showing placomeer) 46.75
City/State/ZIP; 1 O Ord 4124 Furnace 100,000 BTU (ducts/vents) 1 46.75
Suite/bldgJapt no.: K Project name: Furnace 100,000+ BTU (duetdvents) 54.91
Heat pump 61.06
Cross street/directions to job site: Duet work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric).
in -wall, in -duct, suspended, etc, 46.75
Subdivision: Lot no.:
Flue/vent for any of above 23.32
Other 23.32
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
Flue vent for water heater or gas
• Red) f Q e —('/ i rY La fireplace 23.32
Y v- "��' 4 U'^
Log lighter (gas) _ 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
PROPERTY OWNER I ❑ TENANT Chimney/liner /flue/vent 23.32
tad Q{.�� I pE Other: 23.32 _
Name: 9 1 5• t V �I Environmental exhaust and ventilation
Address: bbb Range hood/other kitchen -
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
yy�,�� Single duct exhaust (bathrooms,
Phone: (� ) (�-,� Fax:
( ) toilet compartments, utility rooms) 23.32
0 APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Other: _
Business name: Same as contractor
Fuel piping
Contact name: Diane Mason $14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: _ Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: Tri County Temp Control Clothes dryer (gas)
Other:
Address: 13150 3 Clackamas River Drive MECHANICAL PERMIT FEES*
-
City/State/ZIP: Oregon City, OR 97045 Subtotal ,
Phone: (503) 557.2220 Fax: (503) 557.0919 Minimum permit fee ( $90.00) ti()
Plan review (25% of permit fee)
CCB lie.: 72623 State surcharge (12% of permit fee) rI'�
L (2/ t t
' 92749.41) TOTAL PERMIT FEE
Authorized signature: /l 7 hta permit application noires if a permit Is not obtained within I80 gll
4V)l days after It bee been accepted as complete.
Print name: V HQ{, moon I Date: I.i I * Foe methodology set by Tri- County Building Industry Service Board
I:11lui dinyiPermiuCMEC•PemhApp.doc 10/01/00 440.4617T ( 11/02/COM/WER)