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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2009 -00091 Date Issued: 03/05/2009 { 13125 SW Hall Blvd . Tigard OR 97223 503 639.4171 TLCrARD Parcel: 2S102AB00202 Jurisdiction: Tigard Site address: 9455 SW CENTER ST Subdivision: Lot: 0 Project: Nutial Project Description: Replace furnace. Owner: FEES NUTIAL, KAREN E Description Date Amount 9455 SW CENTER ST Furnaces < 100K BTU 03/05/2009 $14.00 TIGARD, OR 97223 12% State Surcharge - Mechanical 03/05/2009 $8.70 PHONE: 503 - 332 -6969 Minimum Fee Adjustment - Mechanical 03/05/2009 $58.50 Flue/Vent For Any of Above 03/05/2009 $6 80 Contractor: FIRST CALL INSTALLATION COMPANY 1650 NE LOMBARD ST PORTLAND, OR 97211 PHONE: 503 - 231 -3311 FAX: Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Fuel Fuel Types Gas Pressue Total $88 00 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 503.246.669 or 1 800 332.2344. Issued By: A, Permittee Signature: Se% ....5 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. MAR - +3 -2009 10:29A FROM: ( T0: 503598196© P.1 .. - ' It Tr (N\ F Iv F Mechanical Permit Application k FOR 011 1( 1. t SI. i /NI,, City of Tigard MAR 0 3 2 Received Permit No.: 009 Date/3y. _ • • q Atka • • • e t • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Phone: 503.639.4171 Fax: 503.598.1960 OF O F T IGPRD Date/By: OtherPernit: I I( k 1) Inspection Line: s U1'ILDING DivISIO�� Date Ready/By: ® See Page 2 for Internet: www,ti g d or. g ov I7V Notified/Method: In Supplemental Information TYPE..OF ,WORIG . ' COMMERCIAL FEL* S CHEDULE,- USE CHECKLIST • Mechanical permit fees* are based on the value of the work ❑ New construction ® Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. ' CATEGORY' OF CONSTRUCTION Value: $ RESIDENT1A EQUJPM'ENT /. SYSTEMS FEES* ® 1- and 2- family dwelling 0 Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family 0 Master builder ❑ Other: Description ] Qty. 1 Ea. ( Total JOB SITE INFORMATION AND LOCATION- Heating,/cooling . . . Job site address: ' A S Y , 1W ^ ,�+, _ l j ®w Air conditioning or heat pump (requires site plan showing placement) 14.00 City/ State/ZIP: Tigard, OR Furnace 100,000 BTU (ducts/vents) I 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg./apt. no.: Project name: ' Gas heat pump _ 14.00 Cross street/directions to job site: Duct work 10.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Flue/vent for any of above J 6.80 Subdivision: Lot no.: Other: i 10.00 Tax map /parcel no.: Other fuel appliances ' ' • ' DESCRIPTION OF- WORK Water heater 10.00 Gas fireplace 10.00 ° Rep 1 ,.. 1Ct (rn j Flue vent for water heater or gas J "'' fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 _ . - Wood fireplace /insert 10 00 - Chimney/liner /flue/vent 10.00 . PROPERTY' OWNER' ❑ TENANT � Other: 1 10.00 Name: 1.yf , t at Environmental exhaust and ventilation Range hood/other kitchen Address: equipment _ 10.00 City/State/ZIP: Clothes dryer exhaust 10.00 f{�� Single -duct exhaust (bathrooms, 6.80 Phone: t J 0') } �J/J� 4 6 Fax: ( } toilet compartments, utility rooms) ' Attic/crawlspace fans 10.00 .-• .APPLICANT : ❑CONTACT 'PERSON 10.00 _ •' ^� �/�.}-��' f Other: t Business name: i r W (� a T c t 1-6 I Fuel piping F Contact name: Diane Mason f $5.40 for first four; $1.00 fo r each additional � 31S S. g1Y �,,,�:, r t ,p Gas heat etc. Address: Y �� � V V Les heat t pump i Phone: �J t % City/State /ZIP: (rf OYI G cooks Wal /suspended/unit beater , (50�) r S1 22n J I 'CJ"b 1 Fax, , F cJM.�CJ ) / ,n/1I l -1 Q� Water heater Fireplace E -mail: Range 1 , < - _ CONTRACT.' Barbecue • coil I }-� Clothes dryer (gas) Business name rot co il 1 I (. �t I d ► O Other: .. . Address: 13150 S. Clackamas River Drive MECHANICAL PERMIT .F ' EES*, Subtotal City/State21P: Oregon City, 97045 Minimum permit fee ($72.50) Phone: (503) 5574 120 000 I Fax: (503) 557.0919 Plan review (25% of permit fee) CCB lie.: 1 714 State surcharge (12% of permit fee) TOTAL PERMIT FEE` L1.J Authorized signature: t � �r `�� This permit application expires If a permit u not obtained within 180 1 days after it has been accepted as complete. Print name: Diane Mason Date: 4*//A a Fee methodology set by Tri -County Building Industry Service Board I:\ BuildingWermite\MEC- PermitApp.doc 01/19/07 440 -46i7T (I11021COM/WEB)