Permit CITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00163
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/14/2011
Parcel: 25111 DD13300
Jurisdiction: Tigard
Site address: 8640 SW HAMLET ST
Project: Wright Subdivision: MILLMONT PARK Lot: 10
Project Description: Replace gas furnace.
Contractor: ROBBEN & SONS HEATING INC Owner: WRIGHT, GREG & JUDY
2214 SE 8TH AVE 8640 SW HAMLET
PORTLAND, OR 97214 TIGARD, OR 97224
PHONE: 503 - 233 -5841 PHONE: 503 - 310 -4942
FAX: 503 - 238 -8849
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 04/14/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 04/14/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/14/2011 $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 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 . - ions . OUNC�by calling 503.232.1987 or 1.800.332.2344.
Issued :y: ( J� n/� Permittee Signature:
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.
Apr. 14. 2011 10:45AM Robben & Sons Heating Inc. No. 3663 P. 1
Mechanical Permit Appliltte
I t) It I n l l (r 1 t O\ l
City of Tigard I N �a "' P
• 13125 SW Hall Blvd., Tigard, OR 97223 Datt/B � ! ��t�,
piss Review
• Phone: 503.639.4171 Fax: 503.598. 1 4 Lull Baldly: Other Permit
i t ; ; ,\ c t , Inspection Line: 503,639.4175 Date Ready/By: SI See Page 2 for
Internet: www.tigard.or,gov CITY OF TIG>' RD Notified/Method: Supplemental Information
G.DIVISInN
y S 1
4 s4 .r x . .. �C l fL SSE ,C .. . %.+a T. •
Ej Mechanical pcmtit 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
O Demolition ❑ Other: mechanical materiala labor, overhead, and profit
' `r:. CA GO''ifs OF , r. C ION ,, v ,Rtt 3t gW y. a m 0 Value: a
rA I- and 2- family dwelling ❑ Commercial/industrial El Accessary building " � / YSTEMS FEES "
[] Multi - family [ Master builder 0 Other: For special irformallon use checklist.
Description Qty. Ea. Total
r , ,, JOI(l lS1 I . 0 : ., .T l t a . - t � CFA a �%f • %y j IleatinFdcooiing
�- l Air g conditioning
Job site address:
- - -�t �[}� - (requires siroplan showing placement) 46.75
City /State /ZIP`V 0 . "- ' -];'l- Furnace 100,000 BTU (ducta/veme) \ 46.75
Furnace 100,000+ BTU (duct.ivent,) 54.
Suite/bldg. /apt. no.: Project name; at pump 61.06
Cross street/directions to job site: Duct work _____ 23.32
'- T ' 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 23.32 _
Subdivision: _ - f Lot no.: Other: 23.32
Tax map /parcel no.: Other fuel appliances _ _ _
„ ' + ` ; ��` D $ t3i I,, . l µ f *' a .t;, t ` i Water heater 23.32
Gas fireplace 33.39
V ' al_U L ° 1 i ± It _ Flue vent for water heater or gas
fireplace 23.32
- Log lighter (gas) 23.32
Woad/pellet stows 33.39
' Wood fireplace/insert 23.32
r , 4r,i dd ,, ` , i t ,t Chirriney/lincr /tlue/vent 23.32
. , l'XtIbPL.. . . -.- = . + , . + ;'4 <� ' a'k r - rf :, , : i - : ' v1 ,:. ,�iFiF
Name: ` � � y � Ocher: 23.32 •
Y - WY Environmental exhaust and ventilation
Address: • 1 Range hood/other kitchen
`.qtr r ,, .,� 1w-44 V / .. equipment 33.39
—
City /State/ZIP. ` .,
, d r 7 Clothes dryer exhaust 33.39
j Single -duct exhaust (bathrooms,
Phone: o
*" u• 2 FaX ( ) toilet compartments, utility rooms)
:
Y` k • t p " v pit h ' Attickrawls ace fans
... k , �;t4P)I!LIfaA'N')Ifr. �9 S '". <r�. ,./ ro+c�'i k.k5, ��.. ..1Y' i; s u p P m5 23,32
_ Other: 23.32
Business name: �� Fuel piping
Contact name. $14.13 for first four; $4.03 for each additional
Address: -2r"7 t 1 1 4 , � Furnace, etc.
6 -�^t"� ` + Gas heat um
City/Slate/ZIP• ,.05tAtigkeip• *` Si Wel Ususpendedtunitheater
Phone: • •
+ �. + •, .. •• • Water h
�� fer f � � .
_
Fireplace _
E-mat _AQ [4s1L =Jks.a..ADsiky. ra.∎ Range -
�
A 2 r 1 , �; r ; ' t giy,t<1j ll'1CA .,5� Y k 5 Ti ce 8 ' Ora cu ■ Business name: si w �_ - aw, "balm. \ +la>+w tit Clothes dryer (gas) w
Address: -4 �,�� Other
/Stat�Zl' ' �;f' 1 , r1�IR� '�flt
City • , Vea-a* + -
Phone • t Subtota
t -t o.
w e Minimum permit fee ($90.00) +. O �lI ma te r r� Plan review (25% of permit fee)
CCB l State surcharge (12% of permit fee)
TOTAL PERMIT FEE ,
Authorized signature; 46411,41 +�. -
O S, 1 This perao application expires if a permit fie not oht fined within I
= doe after It ha. been accepted as complete
� � r♦' A Da a Fee methodology set by Tri- County Building industry Service Board (/
I:M°itdina ctedn\MBC- Permitaenabe minim ..,,.... ... --.--- .