Permit CITY OF TIGARD MECHANICAL PERMIT
Ili ^ , COMMUNITY DEVELOPMEN Permit #: MEC2011 -00079
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/23/2011
Parcel: 1 S134CB12101
Jurisdiction: Tigard
Site address: 11305 SW 121ST AVE
Project: WILLIAMS Subdivision: MILL VIEW Lot: 21
Project Description: Furnace replacement.
Contractor: MORRISON HEATING & COOLING LLC Owner: FANNIE MAE
16409 SE DIVISION ST # 216 3900 WISCONSIN AVENUE, N.W.
PORTLAND, OR 97236 WASHINGTON, DC 20016
PHONE: 503 - 760 -6455 PHONE: 800- 732 -6455
FAX: 503 - 760 -6577
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/23/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/23/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/23/2011 $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 g 5
to OUNC by calling .3
Issued By: /' Permittee Signature:
Call 503. • • .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.
Feb 22 11 05:05p Morrison Heating 5037606577 p.
Mechanical Permit Application F OR 01 t If l: 1 SE ON I.)
City of Tigar Received
Plan f 7 �w�� p�*m;tNo.: --� ° / )._<-.06 i
I N .
13125 SW W Hall Blvd., Tigard, OR 97223 y Review
= Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
T } _ n Inspection Line: 503.639.4175 Date Ready/By: ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Mr Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Addition/alteration/r eP lacement Mechanical permit fees° are based on the value of the work
❑ N ew construction
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit -
Value: $
CATEGORY OF CONSTRUCTION
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
Inr I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. , Total
JOB SITE INFORMATION AND LOCATION Heating/cooling .
Air conditioning
Job site address: / / 3 O S 5 i:) / ) //J A v a - (requires site plan showing placement) 46.75
City/State/ZIP: 7 t 9 a r ;-, C Ps,... 7 7 2 - -2 - 3 Furnace 100,000 BTU (ductsrvents) I 46.75 , 4 7 S
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: /, J, J 1, o Heat p 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
Flue/vent for any of above 2332
Subdivision: Lot no.: Other: 23.32
Tax tap /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
nn Gas fireplace 33.39
�C z j 0 u a C C t �� �► t /l c e i.� y ►� e^ ! Flue vent for water heater or gas
fireplace 23.32
Log liter (gas) 23.32
Wood/pellet stove 33.39 .
Wood fireplace/insert 23.32
Chimney /liner /flue/vent 2332
[t PROPERTY OWNER ❑ TENANT Other: 23.32
Name: Fa/1n I e a, \ a Environmental exhaust and ventilation _
Range hood/other kitchen
Address: 3 1 o J W , s C er./SA"- '7HAdti• 4. AL i.J. equipment _ 33.39
City/State/ZIP: (A )' , I Nll � t + J✓ . r ` 3-o0 r ( l Clothes dr exhaust , 33.39
Single -duct exhaust (bathrooms,
Phi; ( SF r ) — n).-' f(.,(.0-'1 ) ( Fax: ) toilet compartments, utility rooms) 23.32
APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
/ 1 ,-1 C., Other: _ 23.32
Business name: 7 � fu . IN/42 ' Ci i / tt , v ( ` tic / t / / Fret piping
Contact name: ! , ` 0 c; � ,•t / ]/ (`i c f' / s c,,—r---, $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address: /L `} U 9 S 6 T)/ U t S r o-,-i j ui7'z_ . C' Gas heat pump
City/ State/ZIP: .Th; f 72 ea r d CA_ 5 7-3 L, Wail/suspended/unit heater _
Phone: 6D3 7 C t - > < , v S -) - - Fax : :.f€,3 ) 7 6 0 - 6 c 7 7 Water healer
Fireplace
L
E-mail: r l y//k-[-g CO MCaz-St 11 i Range
CONTRACTOR Barbecue
Clothes dryer (gas)
,� /
Business name: /10 C f 15 c / 't P l._1 r in X <.: G i. et 4/ L C C- Other I
Address: i 0 k 6 9 S E b: li , s u ,c,,,1 , S t 1- t t 0 -/ I. I MECHANICAL PERMIT FEES*
City/State/ZlP: ' Po ,r z ,.t_ 0 P._ 7 '- 3 C Subtotal ,4/ 7 s'
Minimum permit ftx ($90.00) i'lt . C` 0
Phone:403 ' - (r, y S "S' Fax: 6 : 3) G LS 7 Plan review (25% of permit fee)
CCB li . / O • J ?// �/ State surcharge (12 %of permit fee) /(„ O
I TOTAL PERM FEE � �, c - 3
This permit application expires if a permit is not obtained within 180
Authori� i ' days after it has been accepted as complete.
1 P";^t ". "'" / ) C( c f / ` ,- , c. 1 r.- - -,l /Z 7-/ , / I . Fee methodology set by Tri -County Building Industry Service Board