Permit !r .
CITY OF TIGARD MECHANICAL PERMIT
I I COMMUNITY DEVELOPMENT Permit #: MEC2009 -00094
TIGARD, 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/09/2009
Parcel: 2S103CD06600
Jurisdiction: Tigard
Site address: 11695 SW FAIRVIEW LN
Subdivision: Lot: 0
Project: Sass
Project Description: Install heat pump and replace gas furnace.
Owner: FEES
SASS, DONALD L PATRICIA J Description Date Amount
11695 SW FAIRVIEW LA
TIGARD, OR 97223 Furnaces < 100K BTU 03/09/2009 $14.00
Gas Heat Pump 03/09/2009 $14.00
PHONE. 12% State Surcharge - Mechanical 03/09/2009 $8.70
Minimum Fee Adjustment - Mechanical 03/09/2009 $44.50
Contractor:
S & J HEATING & A/C INC
1004 NE 4TH AVE
CANBY, OR 97013
PHONE: 503 - 263 -7773
FAX:
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp: R -3
Stories:
Fuel
Fuel Types: Natural Gas
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 Noti - 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 dire questions to ► NC b allin• 503.246.6699 or 1.800.332.2344.
Issu -d By: • '' ID IL i� I Permittee Signature: 1
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.
. .
_Mechanical Permit Application . FOR OFF1CL. USE ONLY
• City of Tigard Received 9 MY
Date/By: „ars O Permit No.: i it A • ..-. , e)Q,:l i q
• ° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
IN
"I Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
T I. GA K D Inspection Line: 503.639.4175 Date Ready/By: Fa See Page 2 for
Internet: www.tigard Notified/Method: IMI Supplemental Information
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Mechanical permit fees* are based on the value of the work
El New construction Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
ID Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
1441:44,74frr,'S . 4,,, i . , '"71 , 1 „. „ ,„, 1 ,,,,,,„,„,,„.„,..„„,„„,,,„,,, ,.,„, .
p... and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. I Total
Wk401, 71NINV Healing/cooling
Air conditioning or heat pump
Job site address: i 1 1 6 ,g- , F ill kvi EA) LA IQ F.:, (requires site plan showing placement) 1 14.00
City/State/ZIP: -17 6 A-R.7 () a g-7 223 Furnace 100,000 BTU (ducts/vents) 1 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name: A._ Gas heat pump ; 14.00
Cross street/directions to job site: W 1 i g" Di" 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 6.80
Subdivision: Lot no.:
Other: _ 10.00
Tax map/parcel no.: Other fuel appliances
'r:*a**e"etkrYiTEV%e*T 7 ., .: t. air40.17% Water heater 10.00
Ae.s Alefor!,;w:w.,07,,;,...,,i, L......,&, .:-',,, -0-, g :zsise
Gas fireplace 10.00
14&rr pump 1 6 P /2.4 /.1C.4 Pl4c4/ 1 91.4m_ Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
,,,,emvoz ,-:,:- Chimney/liner/flue/vent 10.00
rr: i 7 :411r411 fiA other
10.00
Name: D DI , IALF) <- 5 Environmental exhaust and ventilation ,
Range hood/other kitchen
Address: Hp q 5' ‘ A / l rz, LA E, equipment 10.00
City/State/ZIP: -- ...,,,.. O ci - 7 2-2 3 Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: (5)3 / - 0-2 1.42 Fax: ( ) toilet compartments, utility rooms) 6.80
4 , - ,1 0 1,MIIIIBMK:43/ 3 W90 57 40 Attickrawis fans 10.00
Other:
Business name: S c4 j 1+ NI 4 4 _,N 6,
Fuel piping 10.00
Contact name: D SL.. F cie-- $5.40 for first four; $1.00 for each additional
Address: I 0014 INI a • L4 TI-i- XAE; Furnace, etc. ,
Gas heat pump
City/State/ZIP: (,A...4 ¶( 0 q ---) 0 ( 3 Wall/suspended/unit heater
Phone: (303) /3.._ 777 3 Fax: : ( ) Water heater
Fireplace
E-mail: 641 0 C..4 ... /)n..../ el . Ogin/1 Range
r4SPOI10.4 Barbecue
Clothes dryer (gas)
Business name: ,; ■&ctAAAF7 A5 ikepl Other:
Address: filtalirn. t:4
City/State/ZIP: Subtotal
Minimum permit fee ($72.50) 7. SO
Phone: ( ) Fax:( )
Plan review (25% of permit fee) 6-
CCB lic.: q 6 C 7 2_ 92.q- II State surcharge (12% of permit fee) g . 7 0
TOTAL PERMIT FEE (g/ , A9
This permit application expires if a permit is not obtained within ISO
Authorized signature: days after it has been accepted as complete.
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