Permit •
CITY OF TIGARD MECHANICAL PERMIT
1 '1 COMMUNITY DEVELOPMENT Permit #: MEC2009 -00519
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/02/2009
Parcel: 2S112BCO2000
Jurisdiction: Tigard
Site address: 14695 SW 84TH CT
Subdivision: HAMBACH PARK Lot: 4
Project: Zull
Project Description: Replace furnace.
Owner: FEES
ZULL, THEODORE W & SHARON A Description Date Amount
14695 SW 84TH CT
TIGARD, OR 97224 Furnaces < 100K BTU 10/02/2009 $46.75
12% State Surcharge - Mechanical 10/02/2009 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 10/02/2009 $43.25
Contractor:
TRI- COUNTY TEMP CONTROL
13150 S CLACKAMAS RIVER DR
OREGON CITY, OR 97045
PHONE: 503 - 557 -2220
FAX: 503- 557 -0919
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: /1 � 'n n l — Permittee Signature: n
V " U� Call 3.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
_QCT- 1-2009 02 : 01P FROM: • TO:5035981960 P . 1
-...
Mechanical Permit Application i 0R 01 1 1( 1 I \I 0\ 1 1
City of Tigard
E 5 i i iiii .wii 1 1 i 46 _
Ill • 13125 SW Hall Blvd., Tigard, OR 91[12.1E .
— — CEIVED Plan Review
Permit No.:
' I Phone: 503.639.4171 Fax: 503.598.1960 Other Permit
Datc/EY:
Inspection Lne: i 503.639.4175 0 CI 0 1 20
iti,mit) Date Ready/By: Wall RI Sec Pass 2 tar
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
I ' I
C °. ' "A !',"` ':' drAVI IOW '-' .;' ::-..', ...T7'':::r. *$(40:1 0110,$P.
i
0 New construction e Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical rustaials, equipment, labor, overhead, and profit
Ilf W '. - ,,,. ,, . ..,•e7 ., '- - : ;:',! 7 .,-; --:,''' Value: $
..;.-.; ' -::.2itt/tbst-trat i ttiittlitttAtte#AiktZ :. : '
El 1- and 2-family dwelling 0 Commercial/industrial 1._; Accessory building
For special irtforrnation use checklist.
0 mum-family 0 Master builder 0 Other: Descripticm [Qty. I Ea. l Total
P4 T7-§P4L 0*.lt.01'ri.iWt: ;:'; .. ''. ...: :', -.' ,',. - Heating/cooling
Job site address: 144 g ew ri. , (Dv+ Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: Tigard, OR Cil Furnace 100,000 BTU (ductdvents) f 14.00
Furnace 100,000+ BTU (dais/yews) 17.90
Suite/bldgJapt. no.: 1 Project name:
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.
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 14.00
Flue/vent for any of above , i 6.80
Subdivision: Lot no.:
, Other: 10.00
Tax map/parcel no.: Other fuel appliances
Water heater 10.00
Kti)latt. ItinrKtM Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chinmey/liner/fluetvent 10.00
i?,..Mt`„*.".1.fV '? : ,,k;..v.,P.'t '. ' . ,.. :1. i;.-..:... other lo,o0
,
Name: =ail Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: (ft) utility rooms) 6.80
Fax: ) s,
64- 14 ( toilet compartment
. , . ,. , , • — • ,,, ,,• , 4.';' ''.- ,f ickrawlspace falls
P■S'i.ii.;;Ni 'i,.:.44107,7:",,,ifli -.50 Att
. 41E21! , ;- , : -:: ::.:: 10.00
- Other: , 10.00
Business name: Same as contractor Fuel piping
Contact name: Diane Mason $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump _
City/State/7JF: Wall/suspended/unit heater ,
Phone: ( ) 1 Fax: : ( ) Water heater
Fireplace
E-mail; Range ,
...:.
:„.":',;,......-:;;edf,,i,. 4&FOR :...-..., '.., -.., . . i..... i: . -,!. ,...:;,-. i..,;P:.'.,'.' '.:..- -' 1 , Barbecue
IckV...C:,:‘•-::;,:-.X;;..4.4...43,11..-.4.-.$1.,;.,?,-:',.,.;cx,-:.,.aA,-.,i0..e...-.,.-.4; ".,..;,; . „..; : :-... . ; ... ..v..,:-.: : : .. . .
Business name: Tri County Temp Control Clothes dryer (gas)
Other:
Address: 13150 S. Clackamas River Drive '.' ".....:-.4.Wei:AtiKOZ4R:Ailti..0:4•:'''.::''-:-.; --:',''
City/State/ZIP: Oregon City, 97045 . Subtotal
Minimum permit fee ($72.50) Li 0 00
Phone: (503) 557.2220 1 Fax: (503) 557.0919 Plan review (25% of permit fee)
Cal lie.: 72623 State surcharge (12% of permit fee) iggo
TOTAL PERMIT FEE
Authorized signature:
•Argill A
This permit application expires If s permit ts not obtained within 180
days after ft baa been accepted as complete.
1 Print name: Diane Mason 1 Dateiqf /0 1 • Fee methodology set by Tri-County Building Industry Service Board
I , us..ax—Ao.....NAUFfe-Porml*Ann &In 01119/07 44114617T (1 It02/COM/WEB) ( 00.