Permit q CITY OF TIGARD MECHANICAL PERMIT
'! I COMMUNITY DEVELOPMENT Permit #: MEC2009 -00347
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/16/2009
Parcel: 2S102CCO3301
Jurisdiction: Tigard
Site address: 13950 SW 104TH AVE
Subdivision: FRELEON HEIGHTS Lot: 0
Project: Specialized Housing
Project Description: Replace furnace and heat pump with like kind.
Owner: FEES
SPECIALIZED HOUSING, INC Description Date Amount
4140 SW 109TH AVE Air Conditioning or Heat Pump 07/16/2009 $14.00
BEAVERTON, OR 97005 Furnaces < 100K BTU 07/16/2009 $14.00
PHONE: 503 - 469 -9248 12% State Surcharge - Mechanical 07/16/2009 $8.70
Minimum Fee Adjustment - Mechanical 07/16/2009 $44.50
Contractor:
A -TEMP HEATING & COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 -9519
PHONE: 503 - 650 -5014
FAX: 503 - 557 -2990
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 quectinns to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature:
v i
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.
4 . Q47/14/2009 06:38 50355 *' Cal ED A -TEMP HEATING PAGE H2 / e4
Mll �h Permit A,DAlica l on '14 2 O 09 FOR OFFICE USE ONLY
U - Received
City of Tigard Permit No.. „ „
I I I ' 13125 SW Hall Blvd., Tigard, OR 97223 SIGAR PInnR.cvitW
0 Phone: 303,639.4171 Fax: 503.598.1-9 DI1' D, DIVISIO DetelEY othOY Perm'
TI G RT? (nspoction Line: 503.639.4175 BUILDING Date RcadyB ?'; lurk. F1 See rage 2 for
Internet: www.tignrd- or.gov Notifie41/Method: a supplemental Info rmntion
r "---,=71.1.7,"' ...:... ••... • :g•:: °: ;.:,. E" 9 —
DUL TSFCH..CKL
... ..... , , .. . • .... .:....:.. <'.Q� RK; ":;; .,,','.,` .... OivhITRC1rtL FEE* E J, , �
7 i Mechanical permit fees" are based on the value of tits work Now construction ,r Addition /3lteratial l i y performed. Indic-au, Mc value (rounded to the nearest dollar) of all
0 Demolition Q Other: mechanical materials, e•ui. mat labor overhead, and -olit.
— .. • ; a : A1 E'+' 1 "; 4Pr.50. !LS1'13m. - ).1'7• '!. . • .
Value: .
.. .FNT / S1.'S`T1rM
..,.,:.,.• .: : ::: : . :::. ..... •; NTi� \L.EOCtII'i4T � . ,, .
1- and 2- family dwelling ❑ C otnmctclal/industt•ial 0 Accessory building
For special information irse alteckliM.
Multi- family 0 Master buildur ❑ Other: Description Qty. Ea. Total
: JO '• #00 Heaths /coolin p
i;e:= :slrir•�ir � :jrlvraz��tir�rx�si���ri` .
.: • • ..�
::..:::..:.. .......::.,. .. Heat cond'tio ' orb n amp
, -4 ,r t tang � t p
Jab site nddrcas: f 5 P I:31 - eh v-42 Ai r c u plan &bowie; but lacemcnt 1111 14.00
City /State /71P: 4 „� � Fu 1.00,000 BTU (ducta/verm V 14.00 i
• r � F u mace 100.0001 BTU duets /vents) 17,90
Suite/bldg./apt- no.: Prole amc' _ Gas heat. pump 14.00
Cross street/directions to job site: • Duct work 14,00
.•., H drone lion water a .dent _1400
Residential boiler (radiator or
__ hydronic) 14.00
Unit heaters (fool-type, not electric),
in-wall, in•ducl. suspended, etc. . 10.00
- - -- — Fhto /vont for any of above 10,00
Subdivision: Lot 1to.:
Other: 1 10.00
Tax map/parent no.: , lances
OIiltii, � "'. Water heater
Gas
" :,::P_Lt T Fitts vent for water heater or gas 10.00
fireplace 10.00
— Ina j- A r + ::-
Wood fireplace /insert 10.00
t
Chimney/liner/flue/vent 10.00 •
O :Lt frl R`i!i ' ; ' : /� ':: NAi41' _ O 10,00
€ it•SC. . �J :'
....::..... i : .:. :• • .. :. ,,.. Usher:
Name: < V^ F,nskrnnmcntal exhaust and ventilation
Range hoodUother kitchen
Adore ` 1.4 �` r cfC uipmcnl 10.00
City /State/ZII': 1,. 'r 4 41 Clothes dryer exhaust 10.00
Phone: (At 5 ca ,'�a- Fax: ( ) toilet partMents(utility t r ooms) J 6.R0
: , ,.,,;.,.. , .. ,.,:.,:;;.... erabv g Lana 10.00
/' '.;•..:....,.; ,,;..•:..,,:•::- J.— .
C+ther' 10 00
$ugincss name: I!!01 piptnq
Contact name: . HEATING AND COOLING, IN'.. 55.40 for tirt4 four; 51.00 for each additional
furnace, etc.
Address: L""Ic,rk: Ui ,QJ,S,,,, r..• Gas heat .um
City /State/IIP: 503 -650 -5014 Walt /stispcndcdfunit honer
( ) 5 9 3 .C ' ^a (} e i- 0 Water heater
Phone: rttx:: `��r,1�.i �•? 4� l '"" C�
Firepl
E -mail: Range
.. ..,•,..:..•:. ...•. .. ;•.;,� . ..; *: ;',:;.: Barb . � : ;..,:.....: ttis
: 131r1
l)usincss nenic: +1�, t A( t CQ�(a}a I .0 _ Clothes dryer ( as
Other:
Address: 16000 SE Evelyn St --
t i -91015 bTl?CF�r[t�iCA r>rTtiV1IThF ESw
City/State/ZIP: ,,, „• ,5(1.5014 _ Smbtabtl
M inimum permit fee ($72.50)
Phone: ( ) Fax: ( ) • _ Plan review (25% of permit fcc) r ,�
CC13 lie.: r 7 f p - state surcharge (12% of permit foe)
-- ( TOT :\1.. PERMIT FEE 7
S.
This permit application expires It • permit k not obtaine. thin ISO
' Authorized , ' atur *„ ` , _ day after it hnx been accepted as complete.
Print nom • . A * ” Date: .• * Fee methodology set by rri•County Building Industry Service Board
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