Permit .. tr
a CITY OF TIGARD MECHANICAL PERMIT
-!` COMMUNITY DEVELOPMENT Permit #: MEC2009 -00114
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/18/2009
Parcel: 2S115AA05100
Jurisdiction: Tigard
Site address: 10925 SW CHATEAU LN
Subdivision: Lot: 0
Project: Lutz
Project Description: Replace furnace.
Owner: FEES
LUTZ, LARRY D & LIZBETH K Description Date Amount
10925 SW CHATEAU LANE Furnaces < 100K BTU 03/18/2009 $14.00
TIGARD, OR 97224 12% State Surcharge - Mechanical 03/18/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 03/18/2009 $58.50
Contractor:
TRI- COUNTY TEMP CONTROL
13150 S CLACKAMAS RIVER DR
OREGON CITY, OR 97045
PHONE: 503 - 557 -2220
FAX: 503 - 557 -0919
Type of Use:
Class of Work: 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 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
Issued By: ('fin gtti/� 7( / 0 Permittee Signature: —,' r :'� t
\�� � 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 -t 7 -2009 12:52P 52P FROM: T0: 5035981960 P. 1
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Mechanical Permit Applica ' ®I civi IOU 1/1 l( I IRO Q\1
City of Tigard i >1 Date/By: , • Q Q _ Permit No.: ZOCQ r6.
, / ` 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598. 1960M AR 1 1 ry 2009 Date/By: Other Permit,
1 I t , A It O Inspection Line: 503.639.4175 Date Ready/By: NM Hl See Page 2 for
Internet: www.dgerd- or.gov CITY OF TIGARD Notified/Method: Supplemental Information
IN eel r iiei r lVlQICTJ .. ,
Lst ty
. - .. , - _ TYPE, UF__WO)I2K COMMERCIAL 'FEE* SCHEDULE,- IJSE. 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: $
. . . - . RE SIDENTIAL,EQUI PMENT. / SYSTEMS FEES* •
►'1 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: • Description Qty. t Ea. I Total
- . ., JOB• SITE INFORMATION AND LOCATION • Heating/cooling
Job site address: } Oq V V V `a = J 1 _ r`� Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/ State/ZIP: Tigard, OR ° 7224 Furnace 100,000 BTU (ducts/vents) 1 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
Subdivision: Lot no.: Flue /vent for any of above 1 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
• fireplace 10.00
ll1 A �) Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00 ,
Chimney/liner /flue/vent 10.00
' )4 :OWNER - : - . 0 .TENANT ' • Other: 10.00
Name: I 1Z. Environmental exhaust and ventilation
Range hood /other kitchen
Address:
fi/, `} equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Phone: ( ) 1
6/Q L Single -duct exhaust (bathrooms,
Fax: ( ) toilet compartments, utility rooms) 6.80 -
APPLICANT . ' ''0 . CONTAC'1 • PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name: Same as contractor Fuel piping
Contact name: Diane Mason $5.40 for first four; $1.00 for each additional
Address: Furnace, etc. _
Gas heat pump _
City/State/ZIP: Wall /suspended/unit heater
Water heater
Phone: ( ) Fax: : ( ) .
Fireplace
E -mail: Range
;, - • • • - - ' R
- CONTOR . . Barbecue
Business name: Tri County Temp Control Clothes dryerSgas)
Other:
Address: 13150 S. Clackamas River Drive • - • • M EcRANICAL PERMIT FEES" ' : :
City/ State/ZIP: Oregon City, 97045 Subtotal _
Minimum permit fee ($72.50)
Phone: (503) 557.2220 Fax: (503) 557,0919 Plan review (25% of permit fee)
CCB lie.: 72623 State surcharge (12% of permit fee)
TOTAL PERMIT FEE in
A ,,,, This permit application expires If a permit is not obtained within 1SD
Authorized signature:' ` ° days after it has been accepted as complete.
Print name: Diane Mason Date: 310101 • Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permite\MEC- PetmitApp.doc UI /I 9/01 4-40 (11 /01/COM/WAB)