Permit CITY OF TIGARD MECHANICAL PERMIT
111 - COMMUNITY DEVELOPMENT Permit #: MEC2011 -00232
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/27/2011
Parcel: 1 S125DA00700
Jurisdiction: Tigard
Site address: 9240 SW 66TH AVE
Project: Ross Subdivision: JACKSON WOODS Lot: 6
Project Description: Replacing furnace and adding NC. NC unit must meet 3 ft. minimum rear and side yard setbacks.
Contractor: SUNSET HEATING & COOLING Owner: ROSS, DOUGLAS LYNN
0607 SW IDAHO ST 9240 SW 66TH
PORTLAND, OR 97239 TIGARD, OR 97223
PHONE: 503 - 234 -0611 PHONE:
FAX: 503 - 234 -0439
FEES
Specifics: Description Date Amount
Air Conditioning 05/27/2011 $46.75
Type of Use: SF Furnaces < 100K BTU 05/27/2011 $46.75
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 05/27/2011 $11.22
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $104.72
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / Permittee Signature:
/
Call 50 .•: •.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.
05/26/2011 13:35 5032340439 SUNSET HEATING PAGE 02/03
Mechanical Permit Apulica-tic -n ' FOR 011'1'lci: NI
USE ON � ' i Raccivcd . .
i C 13125 SW ity HTali >sgard Blvd � y a Date/By: � 26 6/ „ii �i _ I,
., 1Tigard, OR 99223
• a. n : Phone: 503.639,4171 Pax: 503,598.196_Q t i 416 ZQII Other Permit;
Inspection Line: 503.639.4175 �VI Dote Ready/By: tort to See Page 2 for
'• Internet: www.tigard.or.gov I Notified/Method: : Supplemental Information
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-- • - — Mechanical permit fees* are based on the value of the work
0 New construction Add ition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
Demolition Other: mechanical materials, c ui meat labor overhead, and •rofit.
CA - - '' " " 2 L! ' • "
. .. ...... .....:.... , .,� ... .. ".. , ., �-'��} Fps *: - =• •
• ,�fi�
1- and 2- family dwelling ID Commercial /industrial ❑ Accessory building For special information use checklist. Multi family 0 Master builder 0 Other: Description 1 Qty. I I✓a. r Total
,eon SIT'F Tii1 'O12M L1ON .. NiD I,OCAT ONo '.' Heatin_ coolie
— ° - Air conditioning
Job site address: rc uires site plan !thawing placement)" r 46.75 p
City/St ate /Z.ii`; `� `) Furnace 10000013TU dects/venrs 46.75
(-- ^ /� furnace 100,000+ BTU (ducts /Vents) 54,91
Suilc /bldit. /apt. no.: Project /m ss I"Ieatpui p 61.06
(" rns street/direr :lltms to Pt) si re: Ass Duct work - 23.32
_____ .....- ..... — - .— Hydrotic hot water system 23.32
Residential boiler (radiator or
- - - -- _...
hydronic) 23.32
-- - Unit heaters (fuel -type, not electric),
.- , - „ in-wall, in -dnct suspended, etc. 46.75
— — Flue /vent for any of above 23,32
5uhrfiviston: Lot no Other: 23,32
lax map /parcel no.: ther Fuel app anm:
- -- - - - - -- �....•.. —; Water h alt r 23 32
AT.SCRIPTiON'.OF AVORit;:;';: .:,
•
i ...........•,._•., ..-- ,.. -,�— �' ..., Clas F 33.39
DP_ y�_/d / � _ (, V\ Flue vent for water heater or gas
i T e �L ($1 fireplace 23.32
A `•.�% 0 ... k I_' IL .10. I. Iie, t .. 6 Le lighter (gas) 23.32
r
Wood /pellet stove 33.39
Wood fi place/insert 2332
Chimney /liner /floc /vent 23,32
" ritt0)P>ERTV 47Vt'IV ti + � TiraN Other: 23.32
Name: j k ' , • w c k �t� Environmental exhaust and ventilation
Range hood /other kitchen
Address: orui► - � ♦ rI' \1 C�ui -meat 33.39
City /State /ZIP:' CA (7..Z.3 W Clothes dryer exhaust 33.39
\ ( Single -duct exhaust (bathrooms,
Phone: (•1 a , „ s • k Fax: ( ) toilet com artmentg unlit rooms _ 23.32
r. •'X`:: ; bb1V iti. liti b Attic/crawls • • ace fans 23,32
tC
Other: 23.32
..�
Business name: Fuel pipit' n
Contact name: $14.1.5 for first four; $4.03 for each ndditinnal
Furnace, etc.
Address:
-- Gas hcetpum
City /State /ZIP: Wall /su tendcd /unit heater _
Phone: ( ) Fax: : ( ) Water heater
_ - Fireplace
E -mail: Range
.; I IOl4TR lcibit
Barbecue
Business name: r' ' ? + -t, 1; , r•, Clothes dryer (pas)
Other:
Address: 0110 C 5(,!) I (1 .b1 5'trr,'r;k ;' 11•[ IGiF it'A:<�' Ii11ItZ;;'tt1� $*:-:, . • ''' '..• :' • ..
1 . . • t1 :. • .., . , • , : . 1 j • 1. i . . .il • •
City /State /ZIP: Ptyc4 -ta,iu VIZ_ Cii2 -34 Subtotal . 3 .C. 7 II)
^
Minimum permit fcc (590.00)
Phone: (5b,,',!) 2 5 4-(1,0 I I Fax: (,i` O3) Z 314 .,,() y I._ r ."9 - — �'—' Plan review (25% of permit fee
CCB lie.: 1 i;ej fit j - / //CC- 7 4:-'7' State surcharge (12%ofpermit fee) j I - «
TOTAL PERMIT !. r EJQ9
✓
This perm application expire,' if a permit is not obtained within 180
Authorized signature:
after It has been accepted as complete.
Print name: ,gf , ( '• r A - I , Date: " Fee methodology art by Trt- County Building Industry Service Board
. . ._. _ _ .. AAA em em n e mannn4Axmw1
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^ HIS'
SUNSET Site Plan
F e l Company
DIRECTION
Name & Address:
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