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Permit CITY OF TIGARD MECHANICAL PERMIT ` =' COMMUNITY DEVELOPMEN Permit #: MEC2009-00172 T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/21/2009 Parcel: 2S104CA08800 Jurisdiction: Tigard Site address: 13460 SW 136TH PL Subdivision: HI�IRE Lot: 88 Project: Bauer Project Description: Install gas furnace, ductwork, and vent. Owner: FEES BAUER, SUSAN J Description Date Amount 13460 SW 136TH PL Duct Work 04/21/2009 $10.00 TIGARD, OR 97223 FlueNent For Any of Above 04/21/2009 $6.80 PHONE: 12% State Surcharge - Mechanical 04/21/2009 $8.70 Minimum Fee Adjustment - Mechanical 04/21/2009 $55.70 Contractor: D & R HEATING & AIR CONDITIONING PO BOX 1292 CANBY, OR 97013 PHONE: 503 - 678 -2517 FAX: 503- 678 -2097 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas 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 e Issued By: 7 ( 1 \ 0 W hiLL Permittee Signature: S Q Q A pp , Ca i! t d Call 503.639.4175 by 7:00 am. 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. 1 20 09 11:35a DR Heating 503- 678 -2097 p.1 .. i c y Mechanical. Permit Applica o 0 I - O R OF l ll 'FL , :0\L 209 Received City of Tigard APR 2 0 '2_() I Dee' erna ti,.: . Sy: 1.4 ~ ' © 9 �� .4 : 13125 SSW Hall Blvd.. Tigard, OR 97223 TIGA N Review Other Permit: Phonc: 503.63° 4171 Fax: 503.598.190 1 1 dF y RD t Ave s, T' I (i :: D inspection Line: 563.639,4175 ClON Date Read ∎.: H See ['age 2 for lntemet: , Dv BUILDING ,�otiied. ,ethed: ` ( () Snppkwendl )ofors upon • . . . . - . '. TYPE '.AF WORK: - l : COMMLIRCIAL ll:EE °- SCHEDULE - USE CHCCKLLST dtechanirl perait'ees* arc haled on the value of the work 0 v ti* construction E , k3ditiort '3iterationrreplaeement performed. Indicate the value (refunded to the nearest u loblam) of all ! C Demolition ❑ Other: mechanical materials. equipment. tabor. overhead. ant. profit. j . ' CATEGORY .OF :COhiSTRU41TIOTd, . Value: $ - - I • -- __.__ RESIDENmAL EQUIPMENT ) SYSTEMS $ Lt '' ' t CK 1- and 2- famils dwelling C Commercialiindustrial ❑ Accessory building i For specraf lainrmahon use checklist. 0 Multi - family C Master builder 0 Other: I Total 1 Description i Qty. Ea. 7 ' .JI - - OR SfrE.ISFOBMAi'ION,:AND L.ttC.ATION IlestingrcoollnF .lob site address: 13460 SW 136th Place I ire conditioning or burnt pump 4 i 1 ircgmrcx nm titan shooing pl:n:.ryncot; i4.00 r` e 100,000 BTU (duc s.'ver si 1 14.00 14.00 t m;stat�zlP: Tigard, OR 87,236 /��3 1 Furnace. 100.0011-t- 13711 fdamPieriusi 17.90 . Saitc/bldg lapL no,: I Project name: ""17,_....4::)u, F Gas heat pump 14.00 Coss street/directions to job site: I Duct worst • , 1 10.00 _ 10.00 4, i (igdronic hot water system 14,00 I Residential boiler (radiator or hy'dronic) 14.00 Unit heaters (fuel -type, not electrr). in -wail, in -duct. suspended. etc. 1 14.00 ! I Flueivent for any of above t 1 6.80 6.80 1 Subdivision: Lot no -: - r I Other: 10.00 Tax map.!parcel no.: Other fuel appliances DESCRIp` ON Ol? WORK Water heater 10.00 Gas tir_pace ' 10.0C Gas furnace installation with sheet metal alterations and venting. _ Flue vent for water heater or pas fireplace 10 00 Log lighter (gas? 10.00 l Wu:KA pellet stove 10.00 i € - Wood frepiace.'ntsert 10.00 - I i ChirnnevYlinerfflue,`venE 10.00 0 PROPERLY 'OWN la ITTs - .. - _.' �_ �._. _ _ _ Other: 1.0.00 Name: Peter Bauer Eavironmental exhaust and ventilation Range he oduother kitchen Address: 13460 SW 136th Place equipment l0.011� ' CitystaterLlp. Tigard, OR 93236 ?"? 7 - 2 - �j f Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone_ t 503 ) 521 - 0180 Fax: ( I toilet cornnarrments, utility rooms) 6,80 0 APPLICANT - C 03/411'' ACT P1+I7641t • ! Atticierawlspace tans 10.0u Business name: D & R Heating & Air Conditioning ! Other. t0.1}_^ ( i Feel piping Contact name: Lisa Delzer Cox S5.40 for first four; 51.00 for each addition* Furnace etc. ; f n P.O. Box 1292 eras heat pump CityiState /ZIP: Canby, OR 97013 Walisuspendedrunitheater _ Phone: ( 503 ) 678 - 2517 Fax' : ( 503) 678 - 2097 Water heater L Fireplace I j E -mail: drheataciisa @centurytel.net ]tan e ; I C ... . r 1 CONTRACTOR OR Barbecue Clothes dirt (gas) { Bnsius name: SAME { Outer. J A ddres s: I MECHANICAL PERMIT FEES*: . S CitylStaic/Z1P: t t Subtotal I 530.80 Minimum pctmit fee (572.50) $72.50 Phone:( ) Fax:( ) t Plan review (25% of permit fee) 1 CCB lic.: 84489 n I State eurcharec (12% of permit fee) $8.70 ' TOTAL PERMIT FEE j $81.20 Authorized signature i , � t r This permit d a ter tr bas been accap[ed o I within 180 T ?i name, Lisa M. Delzer Cox Date: 04/20/2009