Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00506
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/24/2009
Parcel: 2S104AB10200
Jurisdiction: Tigard
Site address: 12334 SW 132ND CT
Subdivision: MORNING HILL NO. 6 Lot: 131
Project: Williams
Project Description: Install furnace.
Owner: FEES
WILLIAMS, JOSEPH M Description Date Amount
12334 SW 132ND CT
TIGARD, OR 97223 Furnaces < 100K BTU 09/24/2009 $14.00
12% State Surcharge - Mechanical 09/24/2009 $8.70
PHONE: 503 - 747 -5205 Minimum Fee Adjustment - Mechanical 09/24/2009 $58.50
Contractor:
OREGON HEATING & AC
PO BOX 397
DUNDEE, OR 97115
PHONE: 503 - 691 -9699
FAX: 503 - 691 -8556
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 estions to . NC by calling 503.246.6699 or 1.800.332.2344.
Issu d By: / �� Permittee Signature: �� p 'srfw
A „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.
. • ..
M Perm A licatio ECEIVED FOR OFFICE USE ONI Y
Received ...
faniit No.' Q
C1 O Tigard Dateday: s e All EcofoO 40 596
N..- - 13125 SW 11x11 Blvd,. Tigard, OR 97223 ti 2 3 r, .'19 �nn Plan Review
Phone; 503.639.4171 Fax: 503.S98.1960 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Dste Ready /By: ® See Pate 2 for
Internet: www.tigard CITY OF TIGARD Not ? ;edJMrthod: Supplemental information
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BUILDING DIVISIO ' 'M� R fir. yv y yam' [�' y+ r ye
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❑ New construction � Additlori /aitcration/ Mechanical permit fees are based on the value of the work
perforrrd. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: • mechanical materials equipment, labor, overhead, and profit.
t r ue: $
`xihc; f ,, ,,. i ' ,.. "Y ,'O ( STT2II TTQI� i t . ! , ,, r, , . ' 'J r ' � tot 'ValiU MEIVT I S1EIvis,v t§'� t ,i l i
Kt- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
Forspeciat information use checkhsl.
❑ Multi - family ❑ Master builder ❑ Other: Description ..
Qty. Pa. I Total
i' iF•,. f{ K_J \ ; ,`; ;) .
.: ; ']O'B 1 "' OR)V 1I N D I LO. : r. . , 0 ' fl eatin_ coolin•
i r t.•
k � u 1 cL (b ac uire conditioning
site plat showing heat pump placement)
14,00
rob site address: 1 r� -� re rc plan hon
' City/State /21P: T a- „--6._ c4 Ci -a V . Furnace 100,000 13 ducts /vents) . t 14.
Furnact 100,000+ ETU ducts/vents 17, 90 IIMI
Suite/bldg. /apt. no.: Project name: _ Gas heat pump I4.00
Cross street/directions to job site: Duct work 10.00
l-lydronic hot waters stem IIMI 14.00
Residential boiler (radiator or
. b dronic) 14.00
- Unit heaters (fuel -type, not electric),
. in -wall. in -duct, sendcd, etc. 14.00
Plue /vent for an of above 6.80
Subdivision: Lot no O MI 10,00
Tax map /parcel no.: Other fuel appliances
A a p n l •q>A + v a , P {{ d {i� {1ie� tt , r ,' ��' � �� �yalci h ea ter 10,0
i ra � i' l //(ratio''' i � 1 ra , a° i fi 1. (L 1.- • C s.1 d7 1i
Gas f • .lace 10.00
a �+ `� Flue vent for water heater or gas
� 'v4� E.replace III -
Lo: li :liter • as - 10,00 -
Wood/pellet stove 10.00
' Wood fire lace /insert 10.00
, ,r Chimne /liner/flue/vent 10.00
{y,'V 2-t+ i�6t ti ...1 CS �:i i ; 4 t irp,, 1 14 o ,, , Otbc- 10,00
l3 }�"� ..,
Name; X, � I l 1 ,1'Y� `\ Y Environmental exhaust and ventilation
Range hood/otherkitchen
Address; Q Zai...1 I •ui.mcnt 10.00
ct7 Clothes d cr ccltaust 10.00 MOM
Single -duct exhaust (bathrooms,
Phone; l L- ax. ( toilet com. artments, uh utility ems
"ry Ira'rI :t .t''r . ,. m „ s .+ .1 %.4; +p '!1i'.'r; -' s;r PIII •r 6 80
';'a' le il'iq i =. r,;;': N7 Attic /crawls. ace. Ens
r ",( t r ,-; T'ie . I„ , u' ` �t„ X 1,„ „ =:
' ,l<i3, f, ..y, ) � ' { iF'�� i;; 9 �, �} / �''d '� , : ?if�. . +7; �•y��{ ,. „ . r.. `,M , , L'i'�
31i'Px „t.r X,� (�.., r 1 ^� .., �' : "j :l; :;'�.`6V..'Vi'f \,: In C JIJda�, .., ._
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, aF1,, ,. ..Ii..,, �s:. ..�.,. ,,ar; 10,00
- ■ Other.
Business name: (' on. ‘A er1,ii 1 - N 3 _ NC- - '
Contact name' , . $5.40 for first four. $1.00 for each additional
Furnace, etc.
w Address: L1 i as heat . m• Mil
City /State/Z 1-yie. • C 1115 . Wall/sus.ended/unit MI
s
Phone; (50 ) 9 - G.� Fax b - W. ater
a tcr er h hee
. E -mail: Ra.ge _
,
E ll"
,, ,a �c.;c..i ^,r -: , ,iu'' ;.: i'. < ^, /` / , ;f;i ? , ∎ Barbecue
't ", �r•r "d 4r) l, ii ,r l ..t f c• t , t 3 ./�� Q ' � r�,� 7 U
l u C d / 4 . :h 1� � n ;r,'
i t, L, 'fir J�`� �laV� Fd
�� M �; 1, , I ' ,!,91::1 ' !i,
Clothes d er • . s ��
Business name: a �[ Other. y •
Address 1)1 E F,,9; i;;!ji1 � 'ih" "tC',,.s, e"4 ,'. L Td , s'p /1 ,e1 ;••, it
City/State /ZIP: 9 ,>i Subtotal
1 a ' p minimum perm fee ($72.50) r
Phone: ( 'x"11 - C Epp Fax: (e5Q i 1- ' 5 S cQ _ .. Plan mica/ (25% of permit fee)
S surcharge (12 ;e, of permit fee) N1 INN
Cc» lie -: t , , \ ; t
Lk TOTAL PERMIT FEE ; 1 , ,
• e, Thi per m it application expire if a permit is not obtained within I80
' Authorized signature: a , ` days after it h. z been accepted as co> .plete.
Print name: ' i CL, 11r% Date: L'�''�l *Al Fee methodology sat by Trii -C tittty Building lndmstty Service Board
.e...a.rer-n.,,,,, ,,,,:1,,, 111/10M, C40 /i2/CON1hwaB)
z B/I ,ti..
0 39 d ONIld3H NO93e10 9998- T69 -E0S 917:TT 60EZ /EZ /60