Permit CITY OF TIGARD MECHANICAL PERMIT
`' 7 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00001
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/04/2012
Parcel: 1S 134CA04000
Jurisdiction: Tigard
Site address: 11680 SW NORTH DAKOTA ST
Project: YOUNG Subdivision: BURLWOOD NO.2 Lot: 13
Project Description: Gas furnace replacement.
Contractor: FIRST CALL INSTALLATION COMPANY Owner: YOUNG, DENNIS M & TERY NORMAN
13150 S CLACKAMAS RIVER DR 11680 SW NORTH DAKOTA ST
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503 - 231 -3311 PHONE:
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 01/04/2012 $46.75
Type of Use: SF Minimum Fee Adjustment - Mechanical 01/04/2012 $43.25
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 01/04/2012 $10.80
Occupancy Grp:
Stories:
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 questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: • Permittee Signature:
�/` ��... - mot . . _ _✓ !_ - f
Call 51 �� 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.
JAN -4 -2012 10:37A FROM: TO:5035981960 P.1
Mechanical Permit Permit Applic trl l' 1( I I ISI. °YNI.l
• City of Tigard
'.11/ R / — Received f -- V(rJ(>
1� 13125 SW Hall Blvd., Tigard, OR , l• Plan Review 1 Permit No.: j
1�G
n Phone: 503.639.4171 Fax: 503. ' . ,; r " " .,: i' " Q �P: Date/By.
tit, Other PerPermit: G A a I t Inspection Line: 503.639.4175 \V. ,c , Date Ready /By: ® See Page 2 for
w
Internet: ww.tigard or.gov J (`� ! , \ 'Sr Notified/Method: �� Supplemental Information
TYPE OF WORK \�r
COMMERCIAL FEE* SCHEDULE USE CHECKLIST
❑ New construction ® Addition /alteration/ree a 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.
CATEGORY OF' CONSTRUCTION Value: $
t -and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® y g ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Muster builder ❑ Other: Description I Qty. I Ea. l Total
JOB SITE INFORMATION AND LOCATION Resting/cooling
Job site address: I L ( O 5W NO 11+1,14010.) Air conditioning
T s Y r (requires site plan showing placement) 46.75
City /State /ZIP: f 8C i c r' Furnace 100,000 BTU (ducts/vents) 1 46.75 y(,, 75 -
Furnace 100,000+ BTU (ducts/vcnes) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
l y,dronic 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: Lot no.:
Flue /vent for any of above t 32
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
��
n � G� Gas fireplac e 33.39
fec s fireplace
for water heater or gas
_ fireplace 23.32
Log lighter (gas) 2332
Wood /pellet stove 33.39
Wood fireplacehnsert 23,32
X PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
n �l yours
Other: 23.32
Name: Environmental exhaust and ventilation
Address:m-e...) Range hood /other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
Q �g7 Single -duct exhaust (bathrooms,
Phone:
(9 3) 5!a w Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: Tri County Temp Control Other: 23.32
Fuel piping
Contact name: Diane Mason $14.15 for first four; $4.03 for each additional
Address: 13150 S Clackamas River Drive Furnace, etc
Gas heat pump
City/State /ZIP: Oregon City, OR 97045 Wall /suspended/unit heater
Phone: (503) 557.2220 Fax: : (503) 557.0919 Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: First Call Installation Clothes dryer (gas)
Other:
Address: 13150 S Clackamas River Drive MECHANICAL PERMIT 'FEES*
City/State /ZIP: Oregon City, OR 97045 Subtotal 1-1 (, - 75"
Phone: (503) 557.0230 Fax: (503) 557.0919 Minimum permit fee ($90.00) etorc.,10
Plan review (25% of permit fee
cell l ic.: 182714 State surcharge (12% of permit fee) ;,,„,
v ' �
TOTAL PERMIT' FEE I-
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Diane Mason Date: .1 IL * Fee methodology set by TO-County Building Industry Service Board
I \Building\Permiis \NEC- PermisApp.doe 10/01/09 440.4617T (I I /02 /COM/WEB)