Permit ,, CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00507
TIGARD 13125 SW Hail Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/09/2011
Parcel: 2S111AD02800
Jurisdiction: Tigard
Site address: 14600 SW 89TH AVE
Project: Maroney Subdivision: PINEBROOK TERRACE Lot: 25
Project Description: Install new gas furnace, ductwork & gas line.
Contractor: SANDU INC Owner: MARONEY, SHARON
2101 NE 387TH AVE MURPHY, DANIEL A
WASHOUGAL, WA 98671 14070 SW HALL BLVD
TIGARD, OR 97224
PHONE: 503 - 740 -1333 PHONE: 503 - 260 -7751
FAX: 888- 340 -6548
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 11/09/2011 $46.75
Type of Use: SF Duct Work 11/09/2011 $23.32
Class of Work: ALT Type of Const: Fuel Piping 11/09/2011 $14.15
Occupancy Grp: 12% State Surcharge - Mechanical 11/09/2011 $10.80
Stories: Minimum Fee Adjustment - Mechanical 11/09/2011 $5.78
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
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 -0090. You may obtain a copy of the rules
or direct estion;e OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B at06244(-44-1 Permittee Signatur = -_c / / 7
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
Fm :Sandu Inc, Fax. 888 - 340 -6548 To:City of Tigard (15035981960) 02:22 11/09/11GMT -05 Pg 02 -02
Mechanical Permit Applica 'o FOR OFFICE: USE ONLY
IN r �� �
City Of Tigard CEIV - Permit No.: /
• 13125 SW Hall Blvd., OR 97223 ��
Plan Review ?tiler Permit:
Phone: 503.718.2439 Fax: 503.598.1
V 0 n Date /By:
TIGARD Inspection Line: 503.639.4175 i 2011 Date Ready/By: Juris HI See Page 2 for
Internet: www.tigard- or.gov Notitied/Method: Supplemental Information
�[jCikaIiT�YiAO� OF TIGARD
.. .yrdiFilitti:�.3I V:ISIO pf .. :CO1411IERCIAL SCHEDULE - .13.F. CHECKLIST: .:.
Mechanical permit fees* are based on the value of the work
❑ New construction M Additionlalteration/replacemenf
❑ Other:
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition mechanical permit
materials, equipment, labor. overhead, and profit.
Value: $
CATEGORY CONSTT2UCTION RESIDENT '1AL,EQUH'MENTJSYSTEMS.FEES *..
1 1 -and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. _ Ea. 'Total
" '.. 'JOB SITE 'INFORMATION AND .LOCATION .. ' . • � Heating/cooling:
Air conditioning
Job site address: 14 Go ? -e 4i YE- (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts /vents) l 46.75 44.7c
City / State /ZIP: 7 6■te.) l De 9 n2 Lt Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump
_ — _ site_plan showing placement) 61.06
Cross street/directions to job site: Duct work I 23.32 2 • ' 1.
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
1 ht -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.:
Flue /vent for any of above 23,32
Other: 23.32
"fax map /parcel no.: Other fuel appliances: • - : DESCRIPTION 'OF' WORK ` I Water heater 23.32
i AI 4L meet) . " 4Ct C i uo Gas fireplace 33.39
�ll f Flue vent for water heater or gas
AV) ;45 cJAf • . fireplace 23.32
Log lighter (pas) 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
i
ner /flue /vent
i. PROPERTY. OWNER ' ' . ' ❑ TENANT
Chimney/liner/flue/vent
Other: 23.32
Name: C 4 ,4 e ¢20 . 0 e• y• Environmental exhaust and ventilation:
Address: / i goo 9 s90- 4 Range hood/other kitchen
equipment 33.39
City /State /ZIP: 7 oce 9 72.2 tp I Clothes dryer exhaust 33.39
�t) F ( ) ' Single -duct exhaust (bathrooms,
(hone: ,)n
3 • ' 7 j toilet compartments, utility rooms) 23.32
4 :APPLICANT.' - 1,3 • CONT'ACT..PERSON Attic /crawlspace fans 23.32
Business name: J \,A / —` Other. 23.32
Fuel piping:
Contact name: TQWA) Ay f $14.18 for first four; $4.03 for each additional
Address: (dl ®t rti E- 3 5� /"� Furnace, etc. I 111./S-
?CJ Gas heat pump
City /State /ZIP: WA-5 ' 4t 6 4- l fa / Wall /suspended/unit heater
Phone: (532 7-1.10 -- /334 Fax:: ( f) 3 it e 6,5-c Water heater
E -mail: 5 G1. % O' M� ! . CJe�
Fireplace -- —
CON [TOR:. .
„ ... ` Barbecue
Business name: 7 1; Clothes dryer (gas)
�'” r Other:
Address: '. -. - ;MECHANICAL PERMIT FEES" • •. . i '.i • ,
City/State /ZIP: Subtotal � st(.2.
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) 90.00
/ _ Plan review (25% of permit fee) ...r
CCB lic.: `66®, � 1 t ((Dec) State surcharge (12 %ofpennitfce)_
--�"'` �°'� �! TOTAL. PERMIT' FEES.} a /W
Ant oozed signature: s �..... ``""" This permit application expires if a permit is not obtained within 180 .
_ \ days after it has been accepted as complete.
Print name: C 1- ®�8J D k,, s F t x fee methodology set by'Iri- County Building Industry Service Board
r\Building'PennitslMEC-PermitApp doc 09/09/10 440- 461 (11 /02/COMJWEB)
Fm:Sandu Inc, Fax. 888 - 340 -6548 To:City of Tigard (15035981960) 02:22 11109111GMT -05 Pg 01 -02
To: Clty of Tigard From: Sandu Inc, Fax. 888 - 340 -6548
Fax: 15035981960 Pages: 2
Re: Mechanical Permit Application Date: Nov 09, 2011
Urgent For Review Please Comment Please Reply For Information
• Comments:
Please call me and let me know how I can pay the permit fees.
Tel: 503 - 740 -1333
Email: sandu.inc @gmail.com
Fax: 888 - 340 -6548
Thank you,
John Sandu
www.myfax.com