Permit CITY OF TIGARD MECHANICAL PERMIT
� 8 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00081
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/24/2011
Parcel: 1 S134CD04700
Jurisdiction: Tigard
Site address: 12040 SW SUMMER CREST DR
Project: MARTINEZ Subdivision: Lot: 0
Project Description: Furnace replacement.
Contractor: FIRST CALL INSTALLATION COMPANY Owner: MARTINEZ, JUAN & MARIA
13150 S CLACKAMAS RIVER DR 12040 SW SUMMER CREST DR
OREGON CITY, OR 97045 PORTLAND, OR 97223
PHONE: 503 - 231 -3311 PHONE:
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/24/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/24/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/24/2011 $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 to O,C by calling 503.232.1987 or 1.800.332.2344.
Issued By: ✓ '' - ,_— • ermittee Signature: <W .G1 ..
Call 503.639.4175 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 -23 -2011 02:52P FROM: T0:5035981960 P.1
1Vlechanical Permit Application I (lit Ott I(I i ,l O.l 1
2
Received
1,1 City of Tigard q y S '/ Permit No.: iI _ C�:
I ' 13125 SW Hall Blvd.. Tigard, OR 97223 FEB 3 20 11
Plan view
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
1 1 ; \ 1 i 1 inspection Line 503.639.4175 Date Ready /By: NA RI See Page 2 for
Internet: www.tigard- or.gov Notified/Method. Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE USE- CIJECKLIST
Mechanical permit fees"' are based on the value of the work
New construction
❑ ®Addition /alteration/ replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: I
RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special Information use checkllst.
❑ Multi - family ❑ Master builder ❑ Other:
Description 1 Qty. I Ea. I Total
JOB SITE E - INFORMATION AND LOCATION Heating/cooling
Job site address: , 2 4 V 18 rnC j''tj" Air conditioning g placement) �' `�� (requires site plan showin lacement 46.75
City/ State/ZIP: - fie _`IZZ■ � Furnace 100,000 BTU (ducts/vents) 1 46.75 u /4/ , 7 S ---
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump 61.06
Cross street/directions to job site: Ductwork 23.32
Hydronic hot water system 23,32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, inxeuct, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent for any of above —1---23.32-4.3-.2.1..—
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
Flue-vent for water heater or gas
R^ !A e� fireplace 23.32
•T [( �, Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32 _
PROPERTY OWNER ❑ TENANT Chimney /liner /flue/vent 23.32
R A am, Ether. 23.32 _
Name: w ► I Environmental exhaust and ventilation
Address: Range hood/other kitchen
Stint) equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
a 0155 comp
Single-duct exhaust (bathrooms,
Phone: (5q3) Fax: ( ) toilet compartments, utility rooms) oms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Other: 23.32
Business name: Tri County 'Temp Control
Fuel piping
Contact name: Diane Mason $14.15 for first four; $4.03 for each additional
Address: 13150 S Clackamas River Drive Furnace, etc.
Gas heat pump
City/State/ZIP: Oregon City, OR 97045 Wall/suspended/unit heater
Phone: (503) 557.2220 J fax: : (503) 557.0919 Water heater
Fireplace
E -mail: Range .
CONTRACTOR Barbecue
Business name: First Call Installation Clothes dryer (gas)
Other:
Address: 13150 S Clackamas River Drive MECHANICA{A ERMIT FEES"
City/ State/ZIP: Oregon City, OR 97045 ' Subtotal
Minimum permit fee (590.00)
Phone: (503) 557.0230 Fax: (503) 557.0919
Plan review (25% of permit fee)
CCB lie.: 182714 State surcharge (12% of permit fee) Itow SO
TOTAL PERMIT FEE
this permit application expires if a permit is not obtained within 150
Authorized signature: 423/1,1 days after it has been accepted as complete.
Print name: Diane Mason Date: M • Fee methodology set by Tri-County Building industry Service Board
l in,.iSAi. ,W rmitAMEC•PermitADD.doc 10/01/09 4404 617T (11 /02 /COM/WitI)