Permit CITY OF TIGARD MECHANICAL PERMIT
1111111 ' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00315
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/30/2009
Parcel: 1 S135CD02702
Jurisdiction: Tigard
Site address: 11715 SW 95TH AVE
Subdivision: BOETCHERS ADDITION Lot: 6
Project: Jones
Project Description: 80 -90 gas furnace change out
Owner: FEES
JONES, DREW Description Date Amount
11715 SW 95TH AVE Furnaces < 100K BTU 06/30/2009 $14.00
TIGARD, OR 97223 FlueNent For Any of Above 06/30/2009 $6.80
PHONE: 503 - 432 -9565 12% State Surcharge - Mechanical 06/30/2009 $8.70
Minimum Fee Adjustment - Mechanical 06/30/2009 $51.70
Contractor:
PARALLAX CONTRACTING INC
2738 SE 98TH AVE
PORTLAND, OR 97266
PHONE: 503 - 760 -3427
FAX: 503 - 760 -7183
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $81.20
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: ditt Permittee Signature: -� i7 nin�" �/�(-
Call 503.639.4175 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.
I - ,aan, 28 09 02:32p Parallax Contracting Inc 5037607183 p.2
Mechanical Permit APJ on VED FOR OFFICE USE OtiLY
City of Tigard Received .
Plan Re remit No.: - 69 : 47,00 3 i S
13125 SW Hall Blvd., Tigard, OR 97223 JUN 2 9 2009 aloft Review Other Pe nu ;: vvV
Phone: 503.639.4171 Fax: 503.598.1960 i `W „ Datts°ay;
Date Ready,By:
Inspection Line: 503.639.4175 e. � l Jurist RI Scc Page 2 for
CITY OF TIGA „al _ ,
Internet: www.ci.tigard.or.us BUILDING DIVISION _ Noti6edNiethod: _ Supplemental Information
TYPE OP WORK - - CU1NMERCIAL PEE* SCHEDULE - USE CHECKLIST
• CI New construction I Addition /alteration/replacement Mechanical permit fees* are based on the toile 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: $
RESIDENTIAL EQUIPMENT/ SYSTEMS FEES*
litI 1- and 2- family dwelling ❑ Commercialindustrial ❑ Accessory building Fcr special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other Description ( Qty. I Ea. _ Total
i JOB SITE INFORMATION AND' - LOCATION Heating/cooling
Job site address: / {� I /�/'+r +" Air conditioning or heat pump
1 5 S• V ' 1 ` Ala_ t (requires site plan showing placement) 14.00
F urnace 100,000 BTU (duc ts/vents) f 14.0
City/State/ZIP: '�'_�, R,p,A) v� 01-?.3 _ PI .00
Furnace 100,000+ BTU ( ducts/vents) ' 17.90
Suite/bldgJapt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 1 4.00
Hydrottic hot water system 14 on
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric).
in -wall, in -duct, suspended, etc. 10.00
Subdivision Flue/vent for any of above I 10.00 /v. 41K7
Other: 10.00
. Tax map/parcel no.: Other fuel appliances •
DESCRIPTION OF WQRIG. Water heater 10.00
I- �,� Gas fireplace 10.00
a - �� l7t6 ,' Qt( G4 ^' V CMT Flue vent for water heater or gas
10.00
Log lighter (gas) 10.00 .
Wood/pellet stove _ ' 10.00
Wood fireplace /insert 10.00
•• Chimney/liner/flue/vent 10.00
1p PROPERTY OWNER • ❑ TED(. L • • Other. 10.00
Name: ry + _ Environmental exhaust and ventilation
Address: y r f C (W (/r nS E .-„ C M 1`+r- A , - Range hood/other kitchen
I equipment 10.00
Clothes dryer exhaust 10.00
City/StaterLIY : 3 Single -duct exhaust (bathrooms, •
Phi: 663) 43 ?_ Qp 7t0 Fax: ( ) toilet compartments, utility rooms) ` I . 6.80
' El APPLICANT •❑.CON'CACT PERSON Attic/crawlspace fans i 10.00
Other: 1 10.00
Business name: Fuel piping
Contact name: $5.40 for first four, $1.00 for each additional
Furnace, etc.
Address: Gas heat pump
City/State/ZIP: WalVsuspended /unit heater
Phone: ( ) Pax: : ( ) Water heater 1
Fireplace _
E -mail: Range
• CONTRACTOR r _Barbecue
Business name: (0 ``` 1,1 17 'I� v L Clothes dryer (gas)
�� Other: '
Address: ' ¶ 1 lP p �. a t rr..-- ,, MECHANICAL PERMIT FEES*
City/State/ZIP: hpityp O2 ill(e to Subtotal 24 .0)
+� - � Minimum permit fx (S72.50) 7� .
Phone: (G r-) -3ff?v - 31i�") Fax: ( 513) - /J g I Plan review (25% of permit fee) mi
CCB tic.: I („,9i j0 / l o q State surcharge (8% of permit fee) 47-. g,')0
TOTAL PERMIT FEE , - )11 3,g,
lure This per a pplication expires if a permit is sot obtained within ISO V I fa
Authorized orized signature! days after it has been accepted as complete.
Print n ��t/I -f FC b Date: / o /oci • Fee methodology set byTri- County Building Industry Service Board
iSeuitdinglrcrmits\MEC•PemvtApp doc 12.'0: 440 -4617r (11 /02/COM/W'ca)