Permit CITY OF TIGARD MECHANICAL PERMIT
!PI 4 ' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00561
Date Issued: 10/22/2009
'TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S104AB12100
Jurisdiction: TIGARD
Site address: 13234 SW BENISH ST
Subdivision: MORNING HILL NO. 6 Lot: 150
Project: Johnson
Project Description: Install gas furnace, w /h, and a/c within setbacks.
Owner: FEES
JOHNSON, STEVEN Description Date Amount
13234 SW BENISH ST
TIGARD, OR 97223 Air Conditioning 10/22/2009 $46.75
Furnaces < 100K BTU 10/22/2009 $46.75
PHONE: Water Heater 10/22/2009 $23.32
12% State Surcharge - Mechanical 10/22/2009 $14.02
Contractor:
THERMAL FLO INC
7236 SW DURHAM RD 100
PORTLAND, OR 97224
PHONE: 503 - 670 -8343
FAX: 503 - 598 -6746
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
Total $130.84
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 questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: Permittee Signature: JA/ efi
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.
- 2 Mechanical Permit Application RECEIVED' . • - '... • • r • 1 . ' : f ° 4 6 ■ 04 iirsE ,- .:".... '.:'.', '. , .,,.;,,;.
-:.- '. City of Tigard litsiv%td
It ' ," 13125 SW Hall Blvd., Tigard, OR 97223 OCT 2 1 2009 Dafe/By:
- Permit No.: NtQCjecq
' - :: . . Phone: 503.639.4171 Fax: 503.59&1960 ' — Plan Ro
Date/By: Oilier Nrmit:
Ty . ;, x; kri Inspection Line: 503.639.4175
Juris: B 5 rage 2 for
CITY OF TIGAIID Dat li-"adYli3Y,
' Internet! www.tigard-or.sov
Nonfied/Method: -ar, Supplemental Information
BUILDING DIVISION
:. .e..,)5,;rjiii , .;!:.:::,.f,,,:.: : ii9:: : ::y; : .:tbiwuiiidi 1§3,
Mechanical permit tees* arc based on the value of the work
0 Ncw construction yAddition/aJteration/replacement
performed, indicate the value (rounded to the ne-arest dollar) of an
0 Demolition 0 Other: mechanical materials, equipment labor. overhead. and profit.
''''nz:'V.;:'"I'.::;:.'''.;,:;.:,:.: •:•• ''''' s 'I' : '. .t:''''''t''' , ,,;, .... _ . , ...,.. , V . allie . ..,.. .
- " Y ' . ' • . — ' - .. ' '.TrtiiaiiIVIENT/*;SY.Mli)*;4*..1
.•...,, •-• ... - • • • ............. •••
x_ and 2-family dwelling ID Commercial/industrial 0 Accessory building
For Special information USE checkliv.
0 Multi 0 Master builder 0 Other:
Description Qty. Ea. Total
-' ' ' "' . ''' :•:',:•F.46 ii : :'srxt . wtNizbizrviit, ---:' 44 . 0N.:XSAi.:Y,i0c . A;Ti .. ..ci:NH . E . :'':;.':' - :'..• , •: ,., .. , •:' , E' ; :': . , : :: Heatin./coolin.
Air COnciitioning
.. ....1 41:
Job site address: , e g ii,/ €..''L_— (3 n i s 1. ( .11irft site . Lan showin • oin i tment) 46,75 i
City/State/ZIP: ,7 - ,; -. 5 ,17-et._._ ,. OAF q122 Furnace 100,000 BTU (d.cts/vents) Iall 46.75 ETNA
Furnace 100,000+ BTU (dem/vents) 54.91
Suite/blt./apt. no.: Project name: RI ,211 9
Heatpurnp 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot watcr system 23,32
_.- Residential boiler (radiator or
/4 .4.- iliac-, 6 07-:-A- U n th (Mel-type, not electric), 2332
•
in-wall, in-duct, su .ended, etc. .11=111
Subdivision • Lot no.: Flue/vent for an > of above 1111=111111.11
:
Other. 2.32
Tax map/parcel no.:
Other fuel a i dim:tees •
:',4„:„1,!4'::Fi::Z.`,;L.•?e,.;!;;;:;,•,:■:•:..:•=4i...7,i'Zi.:::•i.^ii..:6E,§eiiiiii6si••:1'bk.,*15iik 0 i;;;11:::::1•1•,'4'..:::• 23.32 l 'a, 1 4 . ‘ i :
IITh :Ei: . ,4', , .. ..-.. . .. ' • ' *.. 2 .... ..... . • :. 1 ':,...;,. •;!,!.,.,.,..!..:,....,„...„..,..,
3339
a ar. Flue vent for water heater or gas
-mg 4441 itroaee, , acr eon.? /oiler" fireplace ME
Log, lighter * s)
Wood/pellet stove .3339
• Wood fireplace/insert 23.32
.071 2132 :: :::WIY:•;K:t.'. o t h er:
23.32
Na-IYe.Th„6 0 4--- Environmental exhaust and ventilation -
—
Kangc hood/other kitchen
_ . iral i i nAddress: '
equipment 33.39
C ity/State/ZIP: b a. , - 0 , Clothes d -r exhaust 33.39
- , .
Phone ) Single-duct exhaust (bathrooms
Fax: ( ) toilet compartments, utility rooms) 23.32
44.i,"42 :.:ITR,s045 Attickrfans 2332
Other: 23.32
%Sin= name: ei F e--- • F.,,
/ ii.in* —
Contact name; . , Cane ' • ite 514,1:5 for first four; S4.03 for each additional
Address: 72 6 , , sr," hall rt...106 Furnace, etc.
) Gas heat pump
City/State
fierz" 1144, 04 9ntic- , Wall/sus )ended/unit heater 1 -
Photic: 0 I Fax Oak 40040144. Water heater
Fireflace 1 IMM
E-mail: , aleindi tr ift16.•C001...- . Range
ar_ . cue
'''' .6fa 5 ':' : 7 c''PNTRA:0*:‘: ,:': ;,..:" .;::•:::;,.:.: :' .::.:.. :. ''. 7:. g he . I
Business name: Clothes dryer (gas)
- Other
Addres.s. IIIIIIIIMMI
ss: dine, e_o at I 0 ' , e, ,...,,..:::•.:• .
City/State/ZIP:
Subtotal Ofiri ,...4011
Phone: ( ) Fax: )
Minimum permit fie ($90.00 P- 4 I 1 k do
(
Plan review (25% of permit fee)
4:'CB lie.: 16 g4-i .
Stale surcharge (12% of permit f
-_______
-
TOTAL PERMIT FEE riztokn
Authorized signatur . ez i , - e / . This permit application expires it a permit is not nhtninect within ISO
7 days after it has been accepted as complete.
Print name: lir e_ , ep ie . Date: / - - 1 • Fee methodology set by Tri-County Building Indot3try Service Board
rtatalamc\PertnotsWIEC 10,10tin9 440. 5 t 11021Cotvi/W25 1 1 e ao'S Lk
E00n00 'el falt O1dlttl1t13H1 tari .,. k ._,„ Att8 el. :GO 800Z/LE/01.
SETE PLAN
PREPARED BY: 1") i ,% a I DATE: /p "/ $
CUSTOMER NAME: C:,;.dc._ , :/ar.sv-a� ADDRESS: ; ,{,j' i 4,v 1, , I
CUSTOMER PHONE:. 1 ; O' 6' 1,v _.. ,- b' /,'. ' - _
PROPERTY BOUNDARY LINE 7 ,
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Jo _______),
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HOUSE
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D ILI, v ;., ,0
STREET
600/000'd SLEI# 0131VWd3H1 9VL9869C0S CI. 80 6002/12/01.