Permit CITY OF TIGARD MECHANICAL PERMIT
"'� • COMMUNITY DEVELOPMENT Permit #: MEC2011 -00039
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/21/2011
Parcel: 2S104AB09800
Jurisdiction: Tigard
Site address: 13101 SW BENISH ST
Project: Ediger Subdivision: MORNING HILL NO. 6 Lot: 127
Project Description: Replace gas furnace.
Contractor: EASTSIDE HEATING & AIR CONDITIONING Owner: EDIGER, JON & ERICA
7200 SW JOHNSON CREEK BLVD 13101 SW BENISH ST
PORTLAND, OR 97206 TIGARD, OR 97223
PHONE: 503 - 774 -3281 PHONE: 503 - 720 -0440
FAX: 503 - 774 -3057
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 01/21/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 01/21/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/21/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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 . • . • l -wo k will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuanc-, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility otification Center. Those rules are set forth in OAR 952 - 001 - 0010th 0 a • 952 -00 ! : ° :. You may obtain a copy of the rules
or dir•ct questions to OUNC • • calli • ' : .232.1987 or 1.800.332.2344.
Iss ,•d By: � Permi • • Signature:
Call 503.639.4175 by 7:00 a.m. for the next available 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.
From: 01/21/2011 11:46 #539 P.002/002
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Mechanical Permit Application....' \ rt..\)‘. : . :. .. : ,..1.pa Oil K:v. kiSE ()NIA ' . • • • . : .•••••::'
1 ' Id Recelved • - • • •
City of Tigard P`' r „ / ,, mnirea s
• 13125 SW Hall Blvd. Tigard, OR 97223 Permit No. Wee 40 / __
r,,,.\\ k \S\C "Plan Review
I I . Phone: 503.639.4171 Fax: 503.598.1.960 .,,..1 vs ., tN\s, Date/By: Other Permit
Inspection Line, 503,639.4175 0\ A l\.\(:j. V
:TIGARD Date Ready/By. IR 0 See Page 2 for
Internet: www.tigard ki\ ' 0 \ Notified/Method: Supplemental Information
•:::'.',..: :1 ‘ :''':.' '' ',,'..:::, ::- ' ::.
TYPE OF ;:,,:•::',. ' • ':-.f- .':''-- ,' -:•-•.' .cnK4E0
0 New construction ..
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 materials, equipment, labor, overhead, and profit.
• .:" '.i , .:.;::- ''',. '•' ''.-:'::',.'..'..'-• .CA '.- -' '' 'r '' '''' . ''. . ' ,'. . Value. $
, '7;:'.18i0 FtE
gi- and 2-family dwelling ci Commercial/industrial p Accessory building
For special information use checklist.
Multi-family 0 Master builder 0 Other:
Description 1 Qty. _ Ea. Total
'': '• ' ..,';,:" .,.':' 40: '•:,: .:1'.: • : Heating/cooling
Air conditioning
Job site address: 11 i CA SW ."R,?_‘c.c-\ S" S I f - (requires site plan showing placement) 46.75
City/State/ZIP: cycz,,, ck --
c... Fumace 100,000 BTU (ducts/vents) 1 _ 46 75 lqii-15
Furnace 100,000+ BTU (duets/vents)
54.91
Suite/bldg./apt. no,: Project name: Heat pump 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. 46.75
. —
Subdivision: Lot no.:
Other: 23132 -
Tax map/parcel no.: Other fuel appliances
' .. : ..' : •••'..,,',,". ,',- .,..;-.. • ' 6664Ti -, : :r:'. .-.-; - .• . -. . , i • -:: Water heater 2332
. _
Gas fireplace 33.39
---- PN.P ?VsL .q Cyk. c LA....c Ymcx-C t_ Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32 _
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
.._./' , ...- Chimney/liner/flue/vent 23.32
J. .::''')25 i***°°*'•''''''.:.'.:.--'.f.::::::. ','; _,'1'„ :., ' .
Other: 23.32
Name: ""c v .--- N 1 , e c. Environmental exhaust and ventilation
• Range hood/other kitchen
Address: j 3 i C) k s \ ' e..v\v„, S k_
equipment 33.39
City/State/ZIP: " \ cc,....\--- c\ CR...... Ci - 1 22-S Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms.
Phone: (56) --12 0 '- 0 L b Fax: ( ) toilet compartments, utility rooms) 23.32
,.,',: •:.; ', ',...:j :••"1::[: ,,,,-':: !::, , ::: : ‘ : , : vttito i , :f i ko - Anic/crawlspace fans 23 32
— Other. 23.32
Business name: e c i v k e.c... . , k ,
Fuel piping
Contact name: -- s -- 0 V. E \ vsa ot ..... g .k ---- $14.15 for first four; $4.10 for each additional
Furnace, etc.
Address: - -1 -ao 0 sc - KcA,Ny\s6v- \ rxe_eX 1 - Gas heat pump
City/State/ZIP:? c ... \\ ckx A , c" zoL Wall/suspended/unit heater
Phone: (S 03) 1 - Lk- -32 \ Fax: : (5'03 ) ---)-)LA_ -30 Water heater S
Fireplace
E-mail: „ c Q .... c \ , \Q. 1\ c _ Ne.x).... \ \.:\ v . e... 0 ry ,... ‘
Range
.-,':''''.::,' :''''.::".: -'''.:•:.‘-:: 7 : ' ' f 03i.40406:1., '-'-''-): :.-:::-..•:,,,.. „.. :,:.i., •:. i.: ..:., , Barbecue
Clothes dryer (gas)
Business name: E cLs ‘,. si (.( \_\ „k_
Other:
Address: So A S i a V C- ' ''':A■ItIOW4i T.*.E:8, ..'--:----'',.
City/State/ZIP: Subtotal
Minimum permit fee ($90.00) ci 0. 00
Phone: ( ) ' Fax: ( )
_
Plan review (25% of permit fee)
CCB lie.: -22_s g . State surcharge (12% of permit fee) lb . pc
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature: 1 01..._- T--------)i--------- days after it has been accepted as complete.
Print name:17)0,,Nr.,:,,, '- 3 2 -\.)-e-\ -- S Date:' .. 2,.1 ••-• 11- ., Fee methodology set by Tri Building Industry Service Board
I \Building \ Permits\ MEC-Permit App doc 10/01/09 440-4617T ( t 1.'02/COMWEB)