Permit CITY OF TIGARD MECHANICAL PERMIT
m, COMMUNITY DEVELOPMENT Permit #: MEC2010 -00691
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/29/2010
TIGARD Parcel: 2S 104AB04200
Jurisdiction: Tigard
Site address: 13314 SW SCOTTS BRIDGE DR
Project: Lathrop Subdivision: MORNING HILL NO. 3 Lot: 75
Project Description: Replace furnace.
Contractor: TRI COUNTY TEMP CONTROL INC Owner: LATHROP, JANICE & LARRY
13150 S CLACKAMAS RIVER DR 13314 SW SCOTTSBRIDGE DR
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503 - 557 -2220 PHONE: 503 - 590 -1769
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/29/2010 $46.75
Type of Use: SF FlueNent For Any of Above 12/29/2010 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/29/2010 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 12/29/2010 $19.93
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 = ; • is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utilit otification Cente . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or . irect questions to OUN . ' ca 'n! 503.232.1987 or 1.800.332.2344.
f �
Issued By: / Permittee Si; 090 / l i
Call 503.639.4175 by 7:00 a.m. for the next available insp on 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.
r
DEC -28 -2010 03:28P FROM: TO:5035981960 P.
Mechanical Permit Application , ,,,; i 1 I I( , I „ ,,\, ,
.,
City of Tigard 1 ' � D Revived
13125 SW !tall Blvd., Tigard, OR 97223 � ` , i ti LJi Tel /% Panoit No.: A/ " • • /
0 Phone: 503.639.4171 Fax: 5D3.5911.1960 Dina icw
i , Inspection Line: 503.639.4175 DEC g ��� Date/By: Other Permit:
2 Data RQedy /Reedy/By UM 0 See Page 2 for
Internet: www.tigard -or.gov N milled/Method: Supplemental Informed**
r if o f IIGAR
TYPE OF wop �D4N('� )WtS COMMERCIAL FEE* SCHEDULE -.USE CHECKLIST
❑ New construction ® Addition /altera)f�'o Mechanical permit fees* 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: S
IAL
® I - and 2-family dwelling ❑Commercial/industrial 0 Accessory building RESIDENT EQUIPMENT / SYSTEMS FEES*
❑ Multi- family ❑ Master builder 0 Other:
For special bq(oraeattoa use checklist.
Description I Qty. I Ea. I Total
MD SITE INFORMATION AND LOCATION HcaNemleeeNaR
% lob site address: 18314 6w b yidgc_ r . Air conditioning
" � (requires site plan sbowinx plate u:et) 46.75
City /State/ZIP: fl 4 Furnace 100,000 BTU (dumavenu) I 46.75
Furnace 100,000+ BTU (ductr/vala) 54.91
Suite/bldg./apt. no.: I Project name: Heat pump pu • _ 61.06
Cross street/directions to job site: Duct 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. . ,
Subdivision: (� no.: Flue/vent for any of above 23.32
1 Other: , 23.32
Tax nmp/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32 -
Gas fireplace 33.39
• Flue vent for water heater or gas
o Qet7 I ( /gyp -�a a fireplace 23.32
1 ` w��. 1 l`��A) Log lighter (Ras) 23.32
Wood/pellet stove 33.39
Wood firepiacce insert 23.32
14PROPFIITY OWNER I 0 TENANT Chim /liner /flue/vent_ 23.32
d m o p
Other: _ 23.32
Name: Envlreemeotal a =boast and veatltatlon
Address: C yyl j Range hood/other kitchen
equipment 33.39 ,
City /State/ZIP: Clothes dryer exhaust ; 33.39 _
Single-duct exhaust (bathrooms.
Phone (5b3) SL C) (te q Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 2332
Other: 2332
Business name: Same as contractor
Fuel piping
Contact name: Diane Mason S14.15 for first four 54.03 for cacti additional
Address: Furnace, etc.
- Gas heat pump
City/State/UP: WalVsuspended/unitheater
Phone: ( ) I Fax:: ( ) Water heater •
Fireplace
E -mail: Range -
CONTRACTOR Barbecue
Business name: Tri County Temp Control
Clothes dryer (Ras)
- Other:
Address: 13150 S Clackamas River Drive MECHANICAL PERMIT FEES*
City/State/ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee ($90.00)
Phone: (503)517.2220 I Fax: (503) 557.0919 Plan review (25% of permit fee)
CCU lie.: 72623 State surcharge (12% of permit fec) l �4/
TOTAL PERMIT FEE V
Authorized signature: 'A 7Lh penult a� after I t M been permit se eo�b plet.. wllhlu 1.110 l Print name: D (Q� moon I Date: 1242,811 0 I ' Fee methodology set by Tri- County Building Industry Service Board
440.1
I:lauildlnalParsion 1EC-P rmltAppdoc 110/01/09 6 O2ICOM1W ®)
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