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Permit CITY OF TIGARD MECHANICAL PERMIT o n Permit #: MEC2009 -00356 COMMUNITY DEVELOPMENT T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/17/2009 Parcel: 1 S133DC04100 Jurisdiction: Tigard Site address: 13050 SW FALCON RISE DR Subdivision: Lot: 0 Project: Raymond Project Description: Replace gas furnace. Owner: FEES GARY RAYMOND Description Date Amount 13050 SW FALCON RISE DR. TIGARD, OR 97223 Furnaces < 100K BTU 07/17/2009 $14.00 12% State Surcharge - Mechanical 07/17/2009 $8.70 PHONE: Minimum Fee Adjustment - Mechanical 07/17/2009 $58.50 Contractor: , , SPECIALTY HEATING & COOLING INC 7500 SW TECH CENTER DR STE 120 TIGARD, OR 97223 PHONE: 503 - 620 -5643 FAX: 503 - 681 -0793 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: 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 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: if / Permittee Signature: , / ¢ ,, / tnz 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. .y - JUL'/IF /2009 /WED 05:45 PM . FAX No, P. 002 Mechanical Permit Application RECE I FOR OFFICE USE°ONLY JUL 15 2009 Received "NMI _p e nni tNo.: City of Tigard Datc/By: 7 /T /(f 9 ,► /`7�v2C►©`� D0,3.56 '� 13125 SW Hall Blvd., Tigard, QR. Plan Retiew IN ether Permit: . Phone: 503.639.4171 Fax 5 03.598,1 9 60 DateJBy TI G ARD Inspection Line; 503.6;39 CITY OF TIGAR t} at Itcady/i Jn : &1 see Page 2 for Internet: www.tigard- or.gov BUILDING DIVISI II Ip°t'f0d shod' 7C-- Supplementallnforinnfion rr •, s.'1 - -:.. .1� -! , ,._� bt ,... } { ^ k ..� zti �• f; i.., +': '�.i. t.`..•� 4 -�. =� %. '.�..qr. III _, t .. , .,r } a } w - � - 4 i �� t � : un_i +'i3 ttYLl!F ..�. ,. ! .�.,: I,,`{.t -r..F, , ,ii . �1_ r tf . ,�.. . ;� t 11 ?, :- -�t ii I. ��{?:. , , ,�t , .r {y: 11 If .t� a alp; ti ,t� "y sl u �: .., 1 ri �u�. h�i5�� ,,�1 u � it1 _� nfita 1?.;1111i1 r 1 i �. }, iI� tt u, RICIM AI REFI lsIIII C1 i 1t :. t► , i t.t MINN ;t t;�r ❑ New constructionddition/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 0 Other: mechanical materials, equ pment labor, overhead, and profit. ,..,^ , -:,- ,, i . r r revs } t•t•- ct, ^ l , r, t ,. } 1 , .. l z, ? 1 r -t , r , ;fit, Value; $ `I i ill - _t }} - t , tt lr:: a t, i t n t " rt!i t>i rl'i � } 1 }1, } ,.. #j'I , } { }i':,. t r FEt� I f .i�I N t , i} 1 1t 1 A ' lt ' � k► , I � 111 -11 t s, ..l!:+ !I. >. } t .::}tt: e} • ,... . , R r1;..0 }!at d -�. I . !fNYtl}a1U{ .h rn. t t „- �: L > U ti n t .} y, n z �,} o{i >Ftn } , ,t t r ?z} zt � n t 1 t,1 rt .fill a i { j l t Q } t I � � .ltle w 1s.� u.��6i. ilife I a-1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building I "" i � "t ` `) For special information use checklist. ❑ Multi - family ❑Master builder ❑ Other: Description Qty. Ea. Total ' if# t l!' , t Y •! -g at 11 t t . i t tt ti i j t} e t9 a ui,4 i5. ii 1 }� , ; ter t i} h`? "' { ' t, 1 i . ;;5 4 1 l.>�� I VIrefi I W t1Elr 1,7z ° .I.i g l' Ir .,tTV ∎II D . ,I ff,,+ s ll«4 1 Heating /cooling Job site address: 13050 SW Falcon Rise Air conditioning or heat pump (requires site plan Showing placement) 14.00 City /State/ZIP: Tigard, Or. 7223 Furnace 100,000 BTU (ducts/veats) 1 14,00 Furnace 100,000+ BTU (dueta/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 , w 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 F ji'1 f^ } i . � t I I(;. t ' t q � "q'" <l ka, F #Nlfu ttI r f 1 / � �,j t + iP:Ir .{ +t , t l t { { ik lt�lf df Ir` { € t 1 I • Water heater 10.00 ''y, i i 4, 1ifEilt{ l ill -k ' 4 k. t � 'tli:flifs a , 0 ^...N Y 11� .4101 tt� - 'XL E,.i ii,,,t�,f'' 'a i Gas fireplace 10.00 replace gas furnace _ Flue vent for water heater or gas fireplace . 10.00 . - Lo: li • liter (gas 10.00 Wood /pellet stove 10.00 1Voodfiretlace /insert 10.00 1.fi ` +? :11,.� " .1.e � , ii:.s �hg: ;.is't .1,1 .11J I �: P,I .. j. #f� i. ! ; ;II. t .1 t,} i I a : • 1 • - -r Qthern /liner /flue/vent 10.00 Name: Gary Raymond Environmental exhaust and ventilation Range hood/other kitchen Address: equipment 10.00 City /State /ZIP: Clothes dryer exhaust 10.00 Single-duct exhaust (bathrooms, Phone: { (5503)524.7728 f fi, }, Fax: ( ) toilet compartments, utility rooms) _ 6.80 "� if [ ,lx i{ i f k ' t {,ial� I1 � }fp�)d .1 { r `3.1 #i. 1 ## 1 1 �I ' 14 1 }. u lit f ...1 1 }1 ' ` .. � `f ■ tt��f l . V I Attic/crawlspace fans 10.00 �, - .1 ' . � dt . . ; 1 'ti l l Other: p 10.00 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Furnace, etc. Address: - Gas heat put City /State/ZIP: Wall/sus pended /unitheater Fax: Phone: ( ) ( ) Water heater Fireplace III E-mail, Ran • e e ti ii y {•. �} }1}}ts ril e' . . 7 Jai }pr L. I 1ht }Y 7r f l �l mil: l � Illig t HEEI rr# I I lll fi r .,? ° ',�', I {� t *�� .. t J pi IT , m : i � Barbecue Business name: Specialty Heating & Cooling, Inc. Clothes d er a4s Other: Address: 7500 SW Tech Center Drive #13U }t 1 1 "# ' }r• 18 ,�c a`!`la < �' �zf { s `C t }f it t City /State /ZIT: Tigard, Or. 97223 Subtotal Minimum permit £cc ($72.50) 72.50 Phone: (503) 620 -5643 Fax: (503) 681 -0793 Plan review (25% of permit fee) ' CCB lie.: 66578 State surcharge (12% of permit fee) 8.70 tJ TOTAL PERMIT FEE _ Authorized signature: 00-1,�� Tbls permit application expire% if a permit is not obtaind within 180 days after it has beets accepted as complete. Print name: Andrea Dripps Date: 7/15/09 f * Fee methodology sot by Tri -County Building Industry Sorvicc Board IAiu1 141n#1enninu'4EC- PermitApp•dsr 01/19/07 440.4617T (I I /02 /COMME13)