Permit el CITY OF TIGARD MECHANICAL PERMIT
` COMMUNITY DEVELOPMENT Permit #: MEC2011 -00182
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/27/2011
Parcel: 2S105DC00101
Jurisdiction: WASCO
Site address: 15170 SW SUNRISE LN
Project: Cach Subdivision: 2001 -038 PARTITION PLAT Lot: 2
Project Description: Replace gas furnace
Contractor: TRI COUNTY TEMP CONTROL INC Owner: CACH, CHRISTOPHER J & SHERI L
13150 S CLACKAMAS RIVER DR 15170 SW SUNRISE LN
OREGON CITY, OR 97045 TIGARD, OR 97224
PHONE: 503 - 557 -2220 PHONE: 503 - 893 -0049
FAX: 503 - 557 -0919
FEES
Specifics; Description Date Amount
Furnaces < 100K BTU 04/27/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 04/27/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/27/2011 $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 is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utilit otification Cente . The = des are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or • ect questions to OUNC • calling 4 32.1987 or 1.800.332.2344.
Iss ed By:
t./ . ( � i Permittee Sign-ture: `, ( •
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 -27 -2011 11:15A FROM: TO:5035981960 P.1
Mechanical Permit Application' CEIVED
I t ,:: . ti i it I t \I (1\1 \
City of Tigard P R 2 7 ?.011 Da 7 // ,)% Permit No.: •�(� ��� DOl $
13125 SW Nall Blvd., Tigard, OR 97 Plan Review 503.639.4! 71 Fix: SD3.548, I�, OF TIGAItD Date/By: Permit:
Line 503.639.4175
Interne Date Ready/By: 0 See Page 2 for
Internet; www.tlgerd or.gov y ;UILDING DIVISION Notified/method: ® El See Supplemental rororaudea
TYPE OF WORK COMMERCIAL FEE' SCHEDULE — USE CHECKLIST
❑ New construction ® Addition /alteration/replacement Mechanical permit fees* are based on the value 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: S
®
I. • and 2- farrtil dwelling RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
y g ❑ Commercial/industrial ❑ Accessory building
For special iaforrsallaa use clrecklisl.
❑ Multi - family El Master builder
❑ Other Description Qty. l Ea. 1 Total
• JOB SITE INFORMATION AND LOCATION Heatina/eoeiing
Job site address: I S 1 9 O 1\N 6x ' Air conditioning
(requires silt plan showing placement) _ 46.75 Ci "-1 ear " /� ll� Furnace 100.000 BTU (ducts/vents) j 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Project name: Heat pump 61.06
Cross street/directions to job site: Duct work _ 23.32
tlydronie hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, nut electric),
in wall, in- duct, suspended, etc. _ 46.75
Subdivision: Flue/vent for any of above 23.32
Lot no.:
Other: _ 23.32 _
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water healer 23.32
Gas fireplace 33.39
Flue vem for water heater or gas
fireplace 23.32
t) I( I . f i ; & AR .. Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
PROPERTY OWNER ❑ TENANT Chimney/finer/flue/vent 23.32
_ r Other: 23.32
Name: i J '+ ) Environmental exhaust and ventilation
D
equipment hood/other kitchen
Address: 5 1 TL,
r
equipment 33.39
City / State/ZIP: Clothes dryer exhaust 33.39 ,
3 � Fax:
Single-duet
compartments,
Phone: ) ,
( �9q � ) O ( ) toilet corn cnb, utili rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Other: _ 23.32
Business name: Same as contractor Fuel piping
Contact name: Diane Mason $14.15 for first four; $4.03 for each additional
Address:
Furnace, etc
Gas heat pump
City / State/Z1P: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue ,
Clothes dryer (gas)
Business name: Tri County Temp Control
Other:
Address: 13150 S Clackamas River Drive MECHANICAL PERMIT FEES"
City /State/ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 557.2220 j Fax: (503) 557.0919 Plan review (25% of permit fee)
CCB lic.: 72623 State surcharge (12% of permit fee) f\y� i o n . 6 TOTAL PERMIT FEE I kA (T/ t
Authorized signature: JSt. z ) /71J t 7Ah permit days after It has been accepted as oat obtained complete. within 180
Print name: JJ ( , M.tt J''./► 1 I Date: 42X71 ` I ' Foe methodology set by Tr- County Building Industry Service Bord
I.1BuildineVermitsW.C-PwmiIApp dnc 10 440 -46177 ((11/021COM/WEtr)