Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00550
„- 13125 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/6/2005
PARCEL: 2S 103CA -00603
SITE ADDRESS: 13400 SW 121ST AVE ZONING: R - 4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Furnace replacement.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
LPG 3 - 15 HP: COMML.INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
PETITT, THOMAS J Description Date Amount
13400 SW 121ST AVE [MECH] Permit Fee 9/6/2005 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 9/6/2005 $5.80
Phone: 503 -590 -0673 Total $78.30
Contractor:
PERFORMANCE MECHANICAL
1915 SW 25TH ST REQUIRED ITEMS AND REPORTS
GRESHAM, OR 97080
Phone: 503 762 - 2474
Reg #: LIC 147003
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and
all other applicable laws. 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 than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By: Permittee Signature: 2 1 a
Call 503 - 639 -4175 by 7:00 a.m. for inspections 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.
FRnM :PERFORMANCE MECANICAL HOAC FAX NO. :503- 762 -3872 Nov. 05 2005 05:39AM P3
Mechanical Permit Av lication I ()it <)1 l l(,: t �t <) "I ,
City of Tigard B q G D'f i Fenian No. ;1 „ -0 0 S�-2
13125 SW Hail Blvd., Tigard, OR 97223 Plan Revile per Permit:
Phone: 503.639.4171 Fax: 503,598,1960 inn * ' ;i ?d ( , Date/By:
Inspection Line: 503. 639.4175 . •1 '- 'pate Ready/By; B See Page 2 for
Internet: www.ci.tigard.or.us - Notified/Method: riles Supplemental Information
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Mechimioal permit fees" are based on the value of the work
❑ New construction 'ddition /alteration/rcplaccment
performed. Indicate the value (munded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
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and 2-family dwellin Commercial /industrial Accessor y building
For special information use checklist,
❑ Multi-family 0 Master builder [] Other: Description I Qty. Ea, I Tots! -a
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a�" 1'!,. x 1111 ' h p t ! ` a' Ir I u1 : a ,, ryry . ;" '� ,� rmiu ryh: � r ,t 1 u l , 1u + Heatin coolin
, `:' , 21 r,,�y,,..t .� , • tll3i�, p ydiini1ai di �«Mll +i 1 ` I, 1 , H 1!fi tea 1nI I : fmII M 111i0PJad . '�' `
lob site address: • . J ■ 1.. , . Air conditioning Or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: , • :,<• 3/ Cf a a 3 Furnace 100,000 BTU (ducts/vents) I 14.00 i y . .
Furnace 100,000+ BTU (ducts/vents) 17.90
Suitc/bldg. /apt. no.: Project name:
Oita heat pump 14.00
Cross street/directions to job site: but work 14.00
--.'_. - Hydronic hot water system 14.00
Residential boiler (radiator or
hydronie) 14.00
Unit heaters (fuel -type, not electric),
in - watt, in -duct, suspended, etc. 10.00
Fluc/vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
: ' ;Y 'i U ' y 7r. , --7 '� , r �+ "r r•r v yy e ; , �t i
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14 -Yp^+. " • ,. � �_ :.• , ... r '.4A1 "?, Milne` �4 i r rpin r u„rh r P,eg...o a'"Alt U ^.,th.4 Z e' s, r .
rp $rt n Water' heater lU10,00 fi ' - r� n 1r , .,,o; i7 Gus fireplace ,._ 10.00
I ir - • dr, / . Q Flue vont for water heater or gas '
fireplace 10.00
i Ag lighter (gas) 10,00
Wood/pellet stove 10,00
},, Wood fireplace/insert 10.00
M =. ,
> •. Rf. r av, t . R Jp��1 (n T AST , ,z/' 2`' �r�s' r- I: � - .uv t Chimney/liner/flue/vent 10.00
Vin_. z..?k4x:a l a ;?c � 1 a {W�U 1 d 4 l:uur. 6tl ¢ aJ ° a a " r�nti
Other:
10.00
Environmental exhaust and ventilation _,: .
Address: SC4-) i r=1./ 5 a 6 Range hood /other kitchen
equipment 1 0.00
City/State /ZIP: 77 0441 ()i_ _ 3 Cl dryer exhaust 10.00 .. .
Single -duct exhaust (bathrooms,
Phone: (503 590.- 04 Fax: ( ) toilet compartments, utility rooms) 6.80
r . 4 -. " A '1 , -1 �� ' as r p11f 11 ` � 1 ai r s �•: a � uwi l
G �� Iwt..• r, Jn� A• r i 1 11 i we 1 ,,i 1 l Attic erawlspace fans 10.00
, . :. !: ., 111 # ;r 1 " '1" 1 . sf- +R' x Gr %11111111113�a.. "..att : ,
Business note: Performance Mechanical Heating & Confine, Inc Other: _ 10.00 n
Fuel piping
Contact name: Brian Vanderpool $5.40 for first four; $1.00 for each additional
Address: 1915 SW 25 Street Furnace, etc.
Gas heat pump
City /State /ZIP: Gresham, OR 97080 Wall /suspended/unit heater ,
Phone: (503 -) 762 -2474 Fax: : (503) 667 -8823 Water heater
Fireplace
E-mail: sales atperformancemechanfcal com -
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,xrn s:r +rn as^ C I 1M t v v C 1P17 ,P i� ri w M},'W u 1 �:�J I�
`.a 'a». N , `K!. _� .:..: R•. "" »c. ,'. �n':m :ila"��.,.:..:",C1C:� �I� 1r" � �,•n I •u � Barbecue
Business name; Performance Mechanical Heating & Cooling, Inc Clothes di er (_as
Other:
Address; 1915 SW 25
Street �� 7° rs � ra , M 'f " ,' � '� 9 ^^n�* - ^i 11 ��u wy. '? ii1 91 sz ^a
1de m ilt � i 'i', t.r LL J ' llf :, t+ q oP1 " ; ' ) I 'uJ 14 ) i` ,
City /Staiel7.TP: Gresham, OR 97080 Subtotal /L.r .
-
Phone: (503) 762 -2474 Fax: (503 -) 667 -8823 Minimum permit fee ($72.50) A . 54)
Plan review (25% of permit fee)
CCB lie.: 147003 State surcharge (8% UI'permit tee) S, g 0
, / �jQ_,/! TOTAL PERMIT FEE tl S ` 3 .0
Authorized si f ).4,. -ei 1 Liga ' This permit application expires if a permit is not obtained within 1. go
a days after It has been accepted as complete.
Print name: ' • VfP a - / ` i Date: q__ 5 ...0 s • Fee tnethodnlogy set by Tri- County Building Industry Service Board
is \nulIeing \Permits \MFG.PcrnrirApp.don 12/03 440.4517T /o2/COM/WEB)