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Permit
r ` c, a-d_J Lc /H VA,uz . ='. CITY OF TIGARD MECHANICAL PERMIT , �� : �' >: _' COMMUNITY DEVELOPMENT : Permit #: MEC2009-00471 1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/08/2009 - —: - . .R.- Parcel: 1S135DA00300 Jurisdiction: Tigard Site address: 11150 SW HALL BLVD Subdivision: Lot: 0 Project: Bergmann Project Description: Replace gas furnace in attic. ADDED water heater flue to permit 10/6/09. Owner: FEES BERGMANN, KENNETH & DONNA Description Date Amount 10726 SW 63RD PL Furnaces < 100K BTU 09/08/2009 $14.00 PORTLAND, OR 97219 12% State Surcharge - Mechanical 09/08/2009 $8.70 PHONE. Minimum Fee Adjustment - Mechanical 09/08/2009 $58.50 Contractor: ARROW MECHANICAL 10330 SW TUALATIN RD TUALATIN, OR 97062 PHONE: 503 - 692 -1565 FAX: 503 - 691 -1879 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: Permittee Signature: 0 c 1 crl nt L 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. CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2009 -00471 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/08/2009 Parcel: 1S135DA00300 Jurisdiction: Tigard Site address: 11150 SW HALL BLVD Subdivision: Lot: 0 Project: Bergmann Project Description: Replace gas furnace in attic. Owner: FEES BERGMANN, KENNETH & DONNA Description Date Amount 10726 SW 63RD PL Furnaces < 100K BTU 09/08/2009 $14.00 PORTLAND, OR 97219 12% State Surcharge - Mechanical 09/08/2009 $8.70 PHONE: Minimum Fee Adjustment - Mechanical 09/08/2009 $58.50 Contractor: ARROW MECHANICAL 10330 SW TUALATIN RD TUALATIN, OR 97062 PHONE: 503 - 692 -1565 FAX: 503 - 691 -1879 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. /4 Issued By: Permittee Signature: o e t9--7 /e 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. l -(,,, i 09/03/2009 13:54 5036911879 ARROW MECHANICAL PAGE 02/02 Mechanical P, put AppliCAta�'Oi R I » :'ol ► ICE l, i> l_1 NI II �' �.9 "' ! � Date/BY: .. •_ Prnml No.V &C.v2 ®0 --'00 - . City of Tigard Dece Q . / -; + 1.3125 S■ hall Blvd., Tigard, OR 97223 EP ®0 2009 Plan ltavicw ®' '. Phone: 503,639.4171 Fax 503.598.1966 DatelBy: ' Inspection Tine: 503.639.4175 Dec Randy/Ely: rd see peso 2 for TIC. A I:I� Internet: www.tigard- ar -gov CITY OF TIGARD Noti till Sapplmnentat inthrmatton .. 1 _ D .. ,. • : - .. 'T'YP.'E; bF � M b p d of o work � rlt� - t�.ii`I) :'i'<EE "�• SC}i<.E' t3�R oc anieal errri f ees" are based on the value lh 0 New construction tgr Addition/alteration/replacement perforated_ Indicate the value (rounded to the nearest dollar) of all © Demolition © Outer: mccltatt materials; i m labor ovcrhea an 5t Value: $ ;gitiOTTAtTOUIp)1kEOt l.RY3T'RSIS >ErEEEl' .' `.:" 1 - and 2-family dwelling a ComnnerciaUittdngtrtsl 0 Accessory building For specfat Information use checklist. 0 Multi - family 0 Master builder © Other: Description Qty. Ea. Total JOII SITE INFORMATION' OD •LOCATION Heating/cooling Air conditioning or heat pump Job site address: l j / k J J ii BI d.. rc tire sit I showing plocargeat) 14.00 I Furnace 100,000 BTU (duets /vents) 1 14,00 CitylStalo %IIP: "Y't9 i5 • F urnace 10 0,000. 13113 (dact./vent:) 17.90 P Suite/bldg./apt. no.: J - Project name: e r r � r� GAS heat . . 14.00 Duct work I 10.00 - Cross street/directions to job sift; IIvtlron hot water s ystem 14.00 1 Residential boiler (radistor or --- ----- " h dronic 14.00 _ Unit boaters (fuel -type, not electric), - — in all, is -duet, suspended, etc. 14.00 - Flue/vent for any of above 6.80 Subdivision: Lot no.: 14.00 Tax map /parcel no.: Other fuel a . fiances Water heater , 10.00 W DESCiuPTlx OE WORK Gas fireplace 10.00 . _ - 1.A Elft J M - Flue vent for water heater or gas fireplace 10.00 • l,og li€btc as . . 10.00 — Woad/pellet stove 10 00 _ - Wood fireplace /insert 10.00 _ •' Chimney/liner /flue/vent 10.00 PROPI[S�tTY OWNER Q i ENANT _ OGtac: 10.00 Name: 62 Environmental exhaust and ventilation - l T NT" Range hood/other kitchen Address: Sf7`7E o�ulpmont 10.00 _. - 10.00 Clothes dryer exhaust - City /Store /7..IP: ��• _ ..— Single -duct exhaust. (bathrooms, Phone: ( ) Fax: ( ) toilet compartments, utility rooms) __ 6.50 - IO.UO Q APPLICANT T 0 CONTACT „PERSON Attic /erawlspace fans Other: 10.00 Business nalnc; A c7t.+ P � � r , . Fuef piping Contact name: _ $5.40 for first four. $1.00 for each ttthink:ms�i _— � . /1/t r — Furnace. etc, Address: Jo 33o ,)t. �itaLe T l� Q. heat pump - "" � Wall /suspandcd/unit heater ,•_•, ..� Cit /State /ZIP: - 0,C 171"6'Z Water boater _ �-- - Phone: (4- ) 69r f 4 b5 Fax; : (S) 6�/ 674 �- Fireplace__ 1 - mail: _ Rangcc ,.. I• . — CONTRACTOR � -- Clothes dger (gas) _ Business Hama: A� p �� ( •�} I C A ._ Other: _ - 1` NfX 1CfIANTCAI PERMIT FEES* Address: 1iU J 7.�ie� . City/Slate/ZIP: Subtotal M i nimu n it fee ($72.50) , ._..,, Tb�M Q �7a - .,. m permit 2� Phone: (Z 03) -- 4-b." 1 Fax:( &4 /'' — / $7 . .. Plan review (25 %ofpermrt.fcc) pf I State surcharge (1.231+ of permit Cee)o . Q �J�CCIi lie,: j �Q J TONAL PERMIT FEE - — • � f b1A pernitt application mire. it n permit. is not obtnincd within 150 Authorized signature: ,, -_—' . day.e flR er it has frees accepted as complete. ' - ° "' �, � /�� O i7 1 * I ^CCair.[hoir osv set by Tri (`nutty (}uildinR Industry Se,- vice i3odrd •