Permit � CITY OF TIGAR
II MECHANICAL PERMIT
-1 `: ,..' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00444
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/21/2009
Parcel: 2S 111 AA00200
Jurisdiction: Tigard
Site address: 14075 SW HALL BLVD
Subdivision: Lot: 0
Project: Bozich •
Project Description: Replacing furnace and adding a/c in attic.
Owner: FEES
BOZICH, DANIEL SR & MARSHA L Description Date Amount
9860 SW HEATHER LN
BEAVERTON, OR 97006 Air Conditioning or Heat Pump 08/21/2009 $14.00
Furnaces < 100K BTU 08/21/2009 $14.00
PHONE: 12% State Surcharge - Mechanical 08/21/2009 $8.70
Minimum Fee Adjustment - Mechanical 08/21/2009 $44.50
Contractor:
EAGLETON HEATING
2916 N MAIN ST
NEWBERG, OR 97132
PHONE: 503- 710 -7803
FAX: 503 - 538 -0251
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Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1 800 332.2344.
Issued By: .A. j n is Permittee Signature: _ ....61,—
Call 503.639.4175 by 7:00 a.m. for an inspection at business day.
This permit card shall be kept in a conspicuous place on the job'site until completion of the . oject.
Approved plans are required on the job site at the time of each inspection.
I
Mechanical' Permit Application FORO.FFI ' ,
_ 0 i r 1 .
PP ,. ec eived
IIN City of Tigard Permit No.: ,
° 13125 SW Hall Blvd., Tigard, OR 97223 Date /By: 1 ` sal. 2009 Plan Review
C Phone: 503.639.4171 Fax: 503.598.1960 AUG 21 - Date/By: Other Permit.
TIGARD Inspection Line: 503.639.4175 t Date ReadyBy: 10 See Page 2 for
Internet: www.tigard- or.gov CITY T1GAR Notified/Method: Supplemental Information
01 ill MGM/61 °
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, - COIVMERGIAL FEE SC HE'DD�JI,E .., U� 'k
w
- = - a$•.. �(i �re mo o. -. 5��. -,.,. � <a�._.� ---,., m ti< as�x�,^ v.:, �... a-„ ��a�-.,. h �? r„ � .,s'�'��..a...:- .,vt�ZS�,a '. s._i.,ra_srra.�+::o.e +- n.�t ms� e,- -�".x ...._44re,Ox.vs:x
❑ 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
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
x,„'+' ; a�z;:-;..-;::.;:;€:.+ �rtrsc:: stx�; cr, ,.�.,- .N,,.:,,..,'�.ri'....:�.« _`'.,`, "�: '"'3�;p "t' -,";F Value: $
�•', GA'IIEGORY OF ;CONSTRTTCTION t?
v ..44""': -.... xL` �� 4 k Ya* , y � ffi _+ x -7t '
: -." . � «, .n ss. ._ . - ,'_ �°.=.r rc�. n.-..;,"*ati," 3sv- `aa..�um.,.�m.::c xn,..E a +. ". ". . ,..,,. ,-, ' . � q ., � , a. u� ° ..„r+.»�;- rz�.?.awr '"'.A =� �',r, = 'k'�r,�. �.s' - aa °o- +rT.»:t•�.uA �:,�,
( ^:r, RESID E,9M / SYSSTEMj,EES *-,A iii;-`:
❑ I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
Master builder For special information use checklist.
Multi -famil
❑ Multi-family ❑ ❑ Other: Description Qty. Ea. Total
- D}r:°rr`:r �t: .- , s.3'^ - -F , ..:,...: , = =.e ��x;;c > �:�5; e. ��+ro.�,,::- .:°..aa� -; .:: ;,. ;a "i - �, :,: i; ` ", . x� ;,;`� > ?�� =' `�
"'• "JOB SITE' °ItVFQRfi7ATION °u "LO "CATTQ - a =4 •%01, :> " - 1 , :_ Heat /coo -in
_, x. ~i� 104,47:104,4 .--, . r..xx;.�s.+.5.,-«�z > ", z =.; ,s:.a�'- a::.v:t -=`- zc�' �: 6dr -.aa*ause2�.?�: .4tl�..`t. <. ... li. g
Air conditioning or heat pump
Job site address: t 4 -
0 t:-) J c.,-) V
HO. 1 \ (1 I 'c� (requires site plan showing placement) 14.00
City /State /ZIP: K � �� 6r pl'} / Fumace 100,000 BTU (ducts /vents) 14.00 .-
e. i1 tom Furnace 100,000+ BTU (ducts /vents) 17.90
Suite /bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: /"t(- (-\ ^ t v � Ductwork 10.00
‘J � vs 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. 14.00
Flue /vent for any of above 6.80
Subdivision: Lot no.:0 Other: 10.00
Tax map /parcel no.: Other fuel appliances
„'n' 3:. :�• ,�Rs,rx'iaamc 5 s ':5'?;5,.;'Y`$' ' . `.r, - „ - - . � yr < �"
> '� � � � � �..:" � � Water heater
, "7.'.:',441r t DES RIP OF . 1 , ; 7 " ..... ,.
.: =s tir�:����x; 'sxW,- ti- ,,.,_.�.:...d , a..a- .. °',." ���, a �.,.� at�s� a .. :.r,n u§ viw:.»s§`
Gas fireplace 10.00
w,,,, e ,,�, . �/� I /� Q � C • Flue vent for water heater or gas
` fireplace 10.00
Log lighter (gas) . 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
.; ; : ;" •.." . >Fm. -,.;_" ;;at < _ > .x t :- :,, Chimney /liner /flue /vent 10.00
, , ..< " , P120p1 RTi „ OV�'N 124, n . � � k.: � ' t T * 1, "h ..'
Other: 10.00
Name: QM s 1^c� o Environmental exhaust and ventilation
_ � t Range hood /other kitchen
Address:
`` .
`7 S (.0. / lcx ) ,ie. D equipment 10.00
City /State /ZIP: a„✓� �,1 y Clothes dryer exhaust 10.00
c.,,� idi Single -duct exhaust (bathrooms,
Phone: (S�o - ��S tit � 3 - - j c toilet compartments, utility rooms) 6.80
; : i rk, 's, =• ov:: -sn�.. :: .,,�.5 ./:' >c.:s..::«. -;k ;;:. ..r .ax�,;=~.:.:_„_:,; -:�xv
''SW' `xfa u 0.4. I"Vs,, ::E"a� (
,
t "? A l , <tz5 Attic /crawlspace fans 10.00
," .<, „ n'ARPLI A_N , ,'-` 0_, .CONTACT= PFrRSON�
. ,�.��w . � �%5�� -w -. «�S�Au�a�� "�s�� ,ii-'_ , ",� e�,r��se�.r�.t�i �s.� :; �B� ..wu' -''Y
�� Other: 10.00
Business name: E 11 b nC�
9 T � )...1 �e3G��' l.. t4, L l' Fuel piping
�C first Contact name: \ E chi - 1 c r l ` l 5 . (, $5.40 for rst four; $1.00 for each additional •
Address: L Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended /unit heater
Phone: (c 3 P , 2,,c5 - , po -3 Fax: : ( ) Water heater
Fireplace
E -mail: . Range
X " £ - "t: a a< .=~.aa : - xFzt-' a. s;a,.., °�= e ° 3Fr"_ .
.; � �. � . GONT�CTOR ' � v ". ,V f Barbecue
Business name: Clothes dryer (gas)
Other:
Address: 50in :Y *RrIV -.:;, ._∎11 cam 641 --.7_ ,.` :," . ,
__ li MECIFTANICAL PERU,, ,, ,. Mme' y +t ,
City /State /ZIP: Subtotal
Minimum permit fee ($72.50) 7 2.S O
Phone: ( ) Fax: ( )
CCB lic.: - State surcharge (12% of permit fee) B • 70
TOTAL PERMIT FEE S ' , 2 0
Authorized signatur / This permit application expires if a permit is not obtained within 180
%_.ik.` - .� :ar days after it has been accepted as complete.
Print name: ` Date: 9 * Fee methodology set by Tri- County Building Industry Service Board
I. \Building\Permits\MEC- PermitApp doe 01/19/07 440 -4617T (I I /02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
`T`ot
tim `" :01E-rev,
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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1:\ Building \Permits \MEC- PermitApp.doc 01/19/07 2