Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00525
TJ GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/18/2011
Parcel: 1 S 136ACO2900
Jurisdiction: Tigard
Site address: 10730 SW 72ND AVE
Project: Long /Gibbons Subdivision: METZGER ACRE TRACTS Lot: 4
Project Description: Install furnace.
Contractor: PYRAMID HEATING & COOLING Owner: GIBBONS, NOREEN
5699 SE INTERNATIONAL WAY STE A 10730 SW 72ND AVE
MILWAUKIE, OR 97222 PORTLAND, OR 97223
PHONE: 503 - 786 -9522
PHONE: 503 - 647 -0021
FAX: 503 - 786 -3432
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 11/18/2011 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 11/18/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/18/2011 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: L 7 /I � /��L / ( e 7O
�' ll �� 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.
11/18/2011 FRI 11:15 FAX 503 786 3432 PYRAMID HEATING a 001 /002
Mechanical Permit Application FOR OFFICE USE ONLY ��
City of Tigard L 1 Received G . Permit No.
14
- n Date/By: / /O // ira, &C .20 /� % 0 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date /By: Other Permit:
Ti CARD Inspection Line: 503.639.4175 ! r-�1 X E Date Ready /By: See Page 2 for
Internet: www.tigard- or.gov 17Dl111j1 Notified/Method Supplemental Information
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2' ss ui;• -"tr 1 t `— ,..", 8 . nm -`- . , I ° ". &;%°..__'. ..ti^ " .... ktn�r,' ,
Mechanical pennit fees* are based on the value of the work
❑ New construction Addition /alteration /replacemp� ,\� performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: •' 1O mechanical materials, equipment, labor, overhead, and profit.
�}}Ns y p Val
7!V, , 44:0Orfir ,aelfl,,• ',, g ;6 4 raiV y i ';1 ni,• - t ...,.
^c- Value:
rcn,a.r^am n t . , +�ucnrz n::,9 m � . �, ... �a.�5�� s3z�Su.''-.tu^l ■,. � .s �� �'`4: it '��y�ci s+-• P ri r on
® and 2- family dwelling ❑ Commercial /industrial ❑ Acce b ¢i : For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other l', ' 45 Description I Qty. Es. I Total
�'� -, ?,4 4.8 t ,..., ;• �, ` `u• a �.- • . a j a ; -'e ;�- . �, Heating/cooling:
- w Air conditioning
lob site address: it) 9 a ( ,V ` c) a ` • / - (requires site plan showing placement) 46.75
City/ State/ZIP: . ! . Furnace 100,000 BTU (ducts /vents) I 46.75 r s-
r :. A l& ._ ' Furnace 100,000+ BTU (ducts/vents) 54.91
Suite /bldg. /apt. no.: Project name: t i Heat pump
�� l rt. >It (requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 2332
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: I Lot no.: Flue/vent for any of above 23.32
Other. 23.32
Tax map /parcel no.: Other fuel appliances:
- ,.•:.:� ' - f 43' n� d d ` . fi n_ . ,- ' - : : . 'o r _ ° .:.wry; Water heater 23.32
I Gas fireplace 33.39
_ fe _ ' ill•.■ 1,1 r Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) _ 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
- ' :1 .. ,. Chimney/liner /flue/vent 23.32
` :,,., ��� .�.' �: •!,•` �. ":: ;, y� .:5:r�? " ',�; ��:'� O ther: 23.32
IMMIEL \ 1 �, i / ; a M E_ 1 _ ► Environmental exhaust and ventilation:
Address: S '-- Range hood/other kitchen
3 !, � q equipment 33.39
00)1/4 City /State/ZIP: 00)1/4 O.t./\C &L- ) / a a _ Clothes dryer exhaust 33.39
� ' Single -duct exhaust (bathrooms,
Phone: (t, " . -- L a Fax: ( ) toilet compartments, utility rooms) 23.32
!-. " """ �c * n e" §� . ''o F t ., o , Attic /crawlspace fans 2332 • a I . NUI!t� !MEP l . �" �_ Other: 23.32
o
' Fuel piping:
Contact name:. _, `] ` $14.15 for first four; $4.03 for each additional
Address: a) Lf d l r V f c A "
Furnace, etc.
n Gas heat pump
City / State/ZIP: W.) C ) D 1 �- . C') aa_o WaIl/suspended/unit heater
Phone: ('� • r) 8 9 Fax: : 6 ) `, ( c c - a ti A Water heater
Fireplace
E-mail: to 0 0 A „ ii t k &i i • !�A4 Range
MBE 1.- `: 7 V, ` Barbecue
Business name: Clothes dryer (gas) • Other.
Address: ,ilk 1 �rr ARRYOM ' Z - =rte ' "� :04
iv +TTm' t.+l'� 1 D G mil Gl+•4+.....r`, t 5 .u..;t+rtar s `�.:..
City/State /ZIP: �� Subtota t Ti.
Minimum permit fee ($90,00) i l
Phone:( ) Fax: ( )
Plan review (25% of pennit fee)
/ CCB lic.: 15 f 2. U � State surcharge (12% of permit fee) / t
TOTAL PERMIT FEE /t $' lJ
//� This permit application expires if a permit is not obtained within 180
Authorized signature» / ,` � / . _ days after it has been accepted as complete.
\ Date: I - f * Fee methodology set by Tri - County Building Industry Service Board
Print name: `
�A. 4 _,l ..�► — f.
L\Building\Permits\MEC -Pe mitApp.doc 09/09/10 440 -4617T (11 /02 /COM/WEB)