Permit CITY OF TIGARD MECHANICAL PERMIT
1111 COMMUNITY DEVELOPMENT Permit #: MEC2009-00146
Date Issued: 04/03/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S133DC00900
Jurisdiction: Tigard
Site address: 13065 SW FALCON RISE DR
Subdivision: Lot: 0
Project: Bridges
Project Description: Relocate and run gas pipe to w /h, replace furnace.
Owner: FEES
BRIDGES, JON P Description Date Amount
13065 SW FALCON RISE DR Furnaces < 100K BTU 04/03/2009 $14.00
TIGARD, OR 97223 FlueNent For Any of Above 04/03/2009 $6.80
PHONE: Fuel Piping 04/03/2009 $5.40
12% State Surcharge - Mechanical 04/03/2009 $8.70
Contractor: Minimum Fee Adjustment - Mechanical 04/03/2009 $46.30
FIRST CALL INSTALLATION COMPANY
13150 S CLACKAMAS RIVER DR
OREGON CITY, OR 97045
PHONE: 503 - 231 -3311
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: l C�Q Il t( L \ v �1► /1 (► (\ Permittee Signature: Q 0 Q ld
)(
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.
.' •PPf - -2 -2009 08:038 FROM: TO:5035981960 P.1
• ►
Mechanical Permit Application - - • . i O1( 01.1;1( 1 1 till. ()NI 1 - •
Received P Permit No.:
IN ■ City of Tigard Date/By: . 2 dQ _ 11 obi • 00 (o
13125 SW Hall Blvd., Tigard, OR • Plea Rev
i Phone: 503.639.4171 Fax: 503.5 E' IL t EKED DateBy: Other Permit:
I r(3 A It D Inspection Line: 503.639.4175 Date Ready/By: NM ® See Page 2 for
Internet: www.tigard or.gov Notified/Method: Supplemental Information
APR _ 2 2009
T1(RE. OF Wp t i COMA'tERCJAL-FEE` CH
SERULF .US1: CTIECRLIST
❑ New construction ®Additio
eel + ' >y "� e S ON Mechanical permit fees* are based on the value of the work
rl
DD UU `` performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
-. CATEGORY OF CONSTRUCTION Value $
® 1 -and 2 -famil dwelling .RESIDEN'I'.:EQUJPMENT I SYSTEMS FEES"
y g ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ea. I Total
„, , , . . - JOB SITE INTORMATION AND LOCATION Heating/cooling .
Job site address: I Z 0 (QS SW F l MO 1 V 1 ,Dr. Air conditioning or hea pump
(requires site plan showing placement) 14.00
City/ State/ZIP: Tigard, OR C 72 Furnace 100,000 BTU (ducts/vents) I 14.00
Furnace 100,000+ BTU (duets/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 + 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances • '.DESCRIPTION or WORK Water heater 10.00
i. o �pj ` ` -bIr W1+ 1 ctO� Gas f 10.00
Flue vent for water heater or gas
t' '' fireplace 10.00 -
( Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
PROPER I l' OWN 1 7 ENi1I�C1' Other: 10.00 •
Name: t3Ohn ort Environmental exhaust and ventilation
n � ` "'"�� Range hood /other kitchen
Address: uh� equipment 10.00 -
City/State/ZIP: Clothes dryer exhaust 10.00
Phone:
ce � - Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.80
CONTACT-PERSON Attic/crawlspace fans 10.00
I � � 1 i Other: 10.00
Business name: �otyit Fuel piping
r- Contact name: l Diane ( p� Masonn n a ► �tp y $5.40 for first four; $1.00 for each additional
Address:
I� I V (3 S - i vV 1 V kr' Gas ace, etc.
p �7 pump
-- City/ State/ZIP: Or Oi- G1� O & £ [, Wall/suspended/unit heater
Phone: (5 CZ) 66 a22o Fax: : 50) 557 0 p) Water heater I ,
Fireplace
E -mail: Range
,..
/y,� �, C , O �j N _ T . 7t T A / C � 'C � flR - Barbecue -
u in •, fl Of all f ( Loyfai l.Wi toy) Clothes dryer (gas)
Business name:
Outer: _ .
Address: 13150 S. Clackamas River Drive : MECRA;NICAL PERMIT:FEES* '. ..
City / State/ZIP: Oregon City, 97045 Subtotal
) O Minimum permit fee ($72.50) 7 2 -�,
(
Phone: (503) 557.; Fax: (503) 557.0919 Plan review (25% of permit fee)
CCB lie.: 1%17 (4 S tate surcharge (12% of permit fee)'._ C)
t ilk% /di
. TOTAL PERMIT FEE- • �i . -•.
/y J This permit application expires If a permit is not obtained w in 181)
Authorized signature: �-4 ' 1 _ I days otter it has been accepted as complete.
Print name: Diane Mason Date: i�/�,J 0 4 ' Fee methodology set by Tri- County Building Industry Service Board
I: NB tt
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