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Permit I - it ! CITY OF TIGARD MECHANICAL PERMIT '!. = COMMUNITY DEVELOPMENT Permit #: MEC2011 -00266 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/10/2011 TIG• • .,. g Parcel: 2S110BA07800 Jurisdiction: Tigard Site address: 11571 SW COLE LN . Project: Truax Subdivision: EVERGREEN SPRINGS Lot: 3 Project Description: Replace furnace. Contractor: TRI COUNTY TEMP CONTROL INC Owner: TRUAX, TAMI L & HERB M 13150 S CLACKAMAS RIVER DR 11571 SW COLE LN OREGON CITY, OR 97045 PORTLAND, OR 97224 PHONE: 503 - 557 -2220 PHONE: 503 - 639 -3636 FAX: 503 - 557 -0919 FEES • Specifics: Description _ Date Amount Furnaces.< 100K BTU 06/10/2011 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 06/10/2011 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 06/10/2011 $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, 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 - 009 You may obtain a copy of the rules or direct que - o OUNC by calling 503.232.1987 or 1.800.332.2344. Issued B /. Permittee Signature: � � 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. JUN- 9 -2D11 01:33P FROM: TO: 5035991960 P. n Mechanical Permit Application %it tt►R tlhll(t IiSt ON Received no �i /�- v-W' Y/ City of Tigard ! N 9 2 11 Date/By: Perm N o. ; 711 • 1 3125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 . Other Permit: I 1 t 1 , I Inspection Line: 503.639.4175 'ul i Y OF �! AFL Dat yady /By: luris, 411 See Page 2 for Internet' www.tigard- or.gov BUILDING DiVISI©N Notified/Method Supplemental Information 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: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* ® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building . For special inforrnallon use c/secfrlist. 0 Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling 1G Air conditioning Job site address: 4�J (` W �`�� (requires site plan showing placement) 46.75 City /State /ZIP: 1 604 Furnace 100,000 BTU (ducts/vents) I 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 Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, induct, suspended, etc. 46.75 Flue /vent for any of above i 23.32 Subdivision: Lot no.: Other: 23.32 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 23.32 , Rfy ft Gas fireplace - 33.39 Vitt for vent for r water heater or gas fireplace 23.32 Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace /insert 23.32 Chimney /liner /flue/vent 23.32 , PROPERTY OWNER ❑ TENANT Other: 23.32 Name: l rY Environmental exhaust and ventilation Range hood/other kitchen Address: \1.3)/P110 equipment 33.39 City/State /ZIP: Clothes. dryer exhaust 33.39 :1' ( l ^� 6 �� Single-duct exhaust (bathrooms, Phone: (� Fax: ( ) toilet compartments, artmenrtments, utility rooms) 23.32 ® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans , 23.32 Other: 23.32 Business name: Same as contractor Fuet tin PP R Contact name: Diane Mason $14.15 for first four; $4.03 for each additional Furnace, etc. Address: Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone:( ) Fax::( ) Water heater Fireplace E - mail: Range CONTRACTOR Barbecue Clothes dryer (gas) Business name: Tri County Temp Control Other: t 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 Fax: (503) 557.0919 Plan review (25% of permit fee) CCB lic.: 72623 State surcharge (12% of permit fee) TOTAL PERMIT FEE � 0� C �� 7i 4 w This permit application expires if a permit is not obtained within I80 Authorized signature: J • days after it has been accepted as complete, ( t J �� Print name: v Q moon Date: 021 ' I ' Fee methodology set by Tn.-County Building Industry Service Board :\ tt Building \ Permits UmGPermitApp.doc 10/01/09 440..461 7T (t t/02 /COM/WEB)