Permit �rq CITY OF TIGARD MECHANICAL PERMIT
o
• fi COMMUNITY DEVELOPMENT Permit #: MEC2009 -00511
• Date Issued: 09/30/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S125DCO3200
Jurisdiction: Tigard
Site address: 7129 SW BARBARA LN
Subdivision: THE RAZBERRY PATCH Lot: 25
Project: Fieldhouse
Project Description: Replace existing heat pump and furnace air handler.
Owner: FEES
FIELDHOUSE, MICHAEL & JOANNE Description Date Amount
7129 SW BARBARA LN Air Conditioning or Heat Pump 09/30/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 09/30/2009 $8.70
PHONE: 503 - 452 -7533 Minimum Fee Adjustment - Mechanical 09/30/2009 $58.50
Contractor:
ABLE HEATING & COOLING
12420 SW SUMMER CREST DR
TIGARD, OR 97223
PHONE: 503 - 443 -2058
FAX: 503 - 620 -3980
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 Notif -, -r. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules
or dire questions to OU b a g5 .246.6699 or 1.800.332.2344.
Is ued By: k t Permittee Signatur- • �. /' .`�S ;;S %!✓ /�!L/
Call 503.639.4175 by 7:00 a.m. for an inspection that busines- 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.
. Mechanical Permit Applicatio CEIVED FOR O FFICE USE ONLY
r City of Tigard
Received
° 13125 SW Hall Blvd.,'rigazd,OR 97223 SEP 2 9 2009 Dat&Rr: 9A &C PennitNo.. 111 A09 f/ 57./
3 ' Phone: 503.639.4171 Fax: 503.598.1960 Alan Review Date/By • Other Permit:
T t G A RD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /Bv; rur s: H See Page 2 for
Internet: www.tigard or.gov BUILDING DIVISIO : Notified/Method �/<!, Supplemental tnrwmutiun
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*
and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
\ q Air conditioning or heat pump
Job site address:
\,, \ • W • �. % `{ _r \ (=pares site plan showing placement) , 14.00 \'''k City/State/ZIP: y, t ` r� Furnace 100.000 BTU (ducts/vents) 14.00
`\ ( 1 ` �� Furnace 100,000 - BTU td cts(vcnts) _ _ 17.90
Suite/bldg. /apt. no.: `l Project name: %F .,, Gas heat pump 14.00
Cross street/directions to job site: Ductwork_ 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, induct, suspended, etc. 14.00
Subdivision: Lot no.:
Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
1 '
Gas fireplace 10.00
Pyr 1:1'6)
fir. r�rnlr . F'J MA (/N (7 /4l J 0 Flue vent for water heater or ps
fireplace 10.00
K. 1er_'_ /W i
C. I''vRRlAI./ 4» t- /AAJ1)/1° up IX )e- , 1• Log lighter (gas) 10.00
`/ + f A /// Wood/pellet stove 10.00 '
Wood fireplace/insert I 10.00 I Chimney /liner /tlueivent I 10.00
PROPERTY' OWNER ❑TENANT Other: 10.00 ,
Name: 1' `YNC -, all- , ,\n taki\lr.1 Vi=Ul.\tin ltl� -t Environmental exhaust and ventilation
Address: a _ _ !! Range lloodiother kitchen
ka \lA `4�1� 4L equipment 10.00
City /State/ZIP: ` \ . �t r r,, . t NA a Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (( --. �`'J I Fax: ( ) , toilet compartments, utility rooms) • 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Business name: Other: _ 10.00
Fuel piping
Contact name: $5.40 for first four; 51.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) F :: ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: \ + 1/_ ` • `
Clothes dryer (gas)
�` � t-' � - Other
Address: %C\ Q■,e)+ �■ 1 t MECHANICAL PERMIT FEES*
PT
CityiState/ZI\ '`L I tot,. �� � - Subtotal
Minimum permit fee ($72.50) 77 ,9)
Phone: (-lQ - Fax- ( SA \f) .10 -e�G 0 Plan review (25% of permit fee)
CCB lie.: `% ,��, i � State surcharge (12% of permit fee) 7. 70
TOTAL PERMIT FEE VI , L \
Authorized signature: This permit application expires if a permit is not obtained within 150
d ays after it has been accepted as complete.
Print name: - t, , ` ; t___4 \t ‘ ci, Date: - Q - 0 • Fee methodology sal by Tri-County Building Industry Service Board
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o - ABLE HEATING & COOLING Air Conditioning Site Plan
• j % • 8900 SW Burnham St Suite F5
▪ 1 ▪ 1-- TIGARD, OR 97223
• e • a 7 (503) 443 -2058 Fax 1503) 620 -3930
CCB #184392 Email: ablehvac2 @aol.com
Customer ANNE ft' i4 (9.,
Address 11 2-9 Sus) B A N City 4(,) Zip 71 1
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