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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2009 -00345 Date Issued: 07/15/2009 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.639 4171 Parcel: 2S104DC06800 Jurisdiction: Site address: 13870 SW FERNRIDGE TERR Subdivision: Lot: 0 Project: REZVANI Project Description: Install furnace and a/c Owner: FEES FEIN, STEVEN Description Date Amount 13870 SW FERNRIDGE TER Air Conditioning or Heat Pump 07/15/2009 $14.00 TIGARD, OR 97223 Furnaces < 100K BTU 07/15/2009 $14.00 PHONE 12% State Surcharge - Mechanical 07/15/2009 $8 70 Minimum Fee Adjustment - Mechanical 07/15/2009 $44 50 Contractor: HEAT RELIEF CO 13122 NE DAVID CIR # 800 PORTLAND, OR 97230 PHONE 503 - 261 -9915 FAX 503 - 261 -9814 Type of Use: SF Class of Work: ALT 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 or direct questions to OUNC by calling 503 246 6699 or 1.800 332 2344. <— Issued By: . Q Permittee Signature: y` �I Q/�h 9 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. i - w �� Mechanical Permit Application _ _ • • R eceived `F OR • OFFICE USE ONLY • City of Tigard D ate /B ♦ PemutNo: I did, , � � C °� 13125 SW Hall Blvd., Tigard, OR 97223 5 Z009 y: • '' J I JUL J U L Plan Review Phone: 503.639.4171 Fax. 503.598.1960 Date /By Other Permit t ( 700 ©) • TI GARD Inspection Line: 503.639.4175 CITY OF TIGAR II Date Ready /By: ingi H See Page 2 for Internet: www.tigard or.gov ottfied/Method. Su lemental Information BUILDING DIVISI pp '..- w w•. i , . :4•:. ` i:�.._,:- >_ r ;ci = ,} k � � 7,7• .- t-r:< ' a 4 =.:.;' a ds •= .sc :s,� -.;,..1t f � zi rt-W_ "' -- . f - gk - ,x-.. us';: '<: - ` < U . y a_ , v W . ll TYP �? 1 ,"Zl � : e: ` = ''- -a a _`:_ s 'cO M1kiE R FEE EDi LE- .US 4 , - .. - ;CKI S , e z ,� «�°,5�..?, -?a:- ''.��� � d't:1=u�. - .ma aS� :aekca:;•,< !, ,?� ps /'� �yjl >.&,: , - '�'�-- s�& a'hiX' �'"� ' £- e. 4 ^".' -Y'- :�it �-^ y3�": f�. �Y• 5+. e�F¢ ga4��i', ,.�}'y`'S.<�;II;- :Y�'- "" ^T..*+"5. Cis -rR�N rr,.�::�a0.r- •_• »-c•Y.b " ❑ 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 El Demolition ❑ Other: mechanical matenals, equipment, labor, overhead, and profit. . _ F> _tea_ �n�'� ��': s(��: �'���` -� ATEGO e,@ t,_ "�';" - =��. Value:$ �,z�' 3mx ,.�.- ..�'m� -, -_r^ -. � � 'w�"�.,,, ,..,�;� -.. �,`� _ - asra�y,�^�'..: - .�:� ... ,,...w ; �:�;c�,X L °�� -sx‹ x� ' s-. u: ,.'saz�4�_;,y�•s ,� ' -_ . -; ;�- ' 1DEI IA Q l . ... (SY St T' FAA 0- ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory buildin � � ��`> -Ys For special information use checklist. ® Multi - family {�/�p ❑ Master buil ❑ Other: • Description Qty. Ea. Total • . "--,-a, :'"k+� c y a � _c it1lD� -fir .. r, , . iiltU mr . .. _._ -•� �%i_'<��`'- e �%- 4 3 �' v-- : -. `:.?�.�� .. �'.��..S� -r. . .. (y `�'� ( . t _ ' ���F' .. •R�..,��' Heating cooling - - Job site address: 3 j I y Air conditioning or heat pump `v 5 tN �HG [ / (, �I / i / /2��L�-C.� (requires site plan showing placement) / 14.00 City/State /ZIP: ' Furnace 100,000 BTU (ducts /vents) / 14.00 2 J L3 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: I Project name: . 5 . - . 0 // 3 S Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 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. 10.00 Subdivision: Lot no.: Flue/vent for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances ,E- ,-'-�'a`a „ t -;.o,Y a71 ,4;;-3.7n era-_. 1 r- Water heater 10.00 Gas fireplace 10.00 - 1' / Flue vent for water heater or gas - / i i ■ e_______ fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 f o I t Chimney/liner/flue/vent 10.00 / - Other. 10.00 Name: - l �'` ' /C_. Environmental exhaust and ventilation Address: Range hood/other kitchen � / equipment 10.00 City/ State/ZIP: 1 .0 Clothes dryer exhaust 10.00 Fax: Single -duct exhaust (bathrooms, Phone: ( ) ( ) toilet compartments, utility rooms) 6.80 a Attic /crawispace fans 10.00 Business name: HEAT RELIEF Other: 10.00 Fuel piping Contact name: MARK DEFRANCISCO $5.40 for first four; $1.00 for each additional Address: 13122 NE DAVID CIR DR # 800 Furnace, etc. _ Gas heat pump City/State/ZIP: PORTLAND, OR 97230 Wall/suspended/unit heater Water heater Phone: (503) 261 -9915 I Fax: : (503) 261 -9814 Fireplace E -mail: Range g.; W t_ Barbecue . y .. ,. ,. p - � 'r : , r ., ',? ; Clothes dryer (gas) Business name: HEAT RELIEF Other: Address: 13122 NE DAVID CIR DR # 800 a ,, `' y s Wi t City/ State/ZIP. PORTLAND, OR. 97230 Subtotal Minimum permit fee ($72.50) /7 pZ.,�() Phone: (503) 261 -9915 Fax: (503) 261 -9814 Plan review (25% of permit fee) CCB lie.: 122424 ` al 1 l 1 State surcharge (12% of permit fee) g . "/ O [ TOTAL PERMIT FEE , This permit application expires if a permit is not obtaine 180 Authonzed signature: i%24liel i„, - days after it has been accepted as complete. y Print name: MARK DEFRANCISCO Date: • Fee methodology set by Tn -County Building Industry Service Board I :\Buildmg\Pettntts \MEC- PermttApp doc 04/06 /06 440 -46t7T (i i /02 /COM /WEB) N A/C -HEAT PUMP -- -UNIT SITE PLAN FEET TO BACK OF PROPERTY LINE \-AJ - E 19P S FEET TO SIDE PROPERTY LINE FEET TO FRONT PROPERTY LINE ADDRESS: PLEASE REFAX APPLICATION! WITH SITE PLAN V, . V