Permit s
CITY OF TIGARD MECHANICAL PERMIT
s: -' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00478 •
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/09/2009
Parcel: 2S 111 AB05100
Jurisdiction: Tigard
Site address: 9100 SW INEZ ST
Subdivision: Lot: 0
Project: Conder
Project Description: Replace gas furnace and install heat pump
Owner: FEES
CONDER, LAMAR Description Date Amount
9100 SW INEZ ST Air Conditioning or Heat Pump 09/09/2009 $14.00
TIGARD, OR 97224 Furnaces < 100K BTU 09/09/2009 $14.00
PHONE: 503 620 - 0448 12% State Surcharge - Mechanical 09/09/2009 $8.70
Minimum Fee Adjustment - Mechanical 09/09/2009 $44.50
Contractor:
WESTERN HEATING & COOLING INC
50618 COLUMBIA RIVER HWY
SCAPPOOSE, OR 97056
PHONE: 503 - 647 -5808
FAX: 503- 543 -3693
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: '� Permittee Signature: "N �j 1 C�I���C' �i
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.
Sep 08 09 04:20p Western Heating � , 503 -543 -3693 p.2
Mechanical Permit A. I li ', ,, FOR OFFICE USE ONLY
City of Tigard 10 49 Received
I D
r ( atc/ : I� 7 Permit No.'
= 13125 S W Hall Blvd., Tigard, O' 9721 G r79 ����Q� �Q ��
Phone: 503.639.4171 Fax: 503 98.1960 GO w` Plan Revim
TIGARD Inspection lane: 503.639.4175 F� ls�o Date Ready/
13y: Date/By:
/Ev: Other Permit:
Internet www.tigard or.gov CI D t Page „for
;kA` t11 Noti&ed/ Method: ` 729 SupptementaI Information
TYPE ■ F WORK COMMERCIAL, FEE* SCHEDULE — USE CHECKLIST I
CI New construction 11 Additio . Iteration /replacement Mechanical permit fees* are based on the value of the work
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
■ Other: mechanical materials, equipment, 8 pment, labor, overhead, and profit
CATEGORY 0 CONSTRUCTION Value $
5Z 1- and 2-family dwelling El Commer ial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
[] Other:
For tpecia! information use checklist.
❑ Multi - family ❑ Master b ilder
Description I Qty. [ Ea I Total
JOB SITE INFORMA ON AND LOCATION Heating/cooling
Job site address: e Z 1 Air conditioning or heat pump / )
i ( requ ¢essiteplanshowiugplacement) ]4 - 00 (�
City /State/ZIP: ) r + () 7a Furnace 100,000 BTU (ducts/vents) 1 _ 14.00 )t ---
Suite/bldg. /apt. no.: Project n- e: C.Ond �' Furnace 100,000+ BTU (ducts /vents) 17.90
I Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
IIME hydronic) 1 4.00
Unit heaters (fuel -type, not electric),
in-wall, in - duct suspended, etc. 14.00
Subdivision: I Lot no.: Flueivent for any of above
Other: 620
Tax map /parcel no.:
I 10.00
Other fuel appliances
DESCRIPTIO OF WORK Water heater 10.00
I IIEZ r'10 V A / S U - /I Gm fireplace 10.00
Flue vent for water heater or gas
4 4 -- 'aS UitfoG■ , 4 - i-eCA- b . fireplace 10.00
I Log lighter (gas) 10.C10-, Wood/pel let stove t0'o6
I Wood fireplace /insert 10.00' •
IIMIW PROPERTY OWNER I ❑ TENANT Chimney /liner /flue/vent
Other: I 10.00
Name: 10.00
I '�U r D fl # t,r Environmental exhaust and ventilation
Address: c go Su) r n 1 S-1- Range hood /other kitchen
equipment 10.00 •
City/State/ZIP: I a Y
t a ril 0 { - as Clothes dryer exhaust
10.00
Phone: ( ) � D_ Li id Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.80
Si APPLICANT I • ONTACT PERSON Attic /crawlspace fans 10,00
Business name: I Other: 10.00
Fuel piping
i
Contact name:
$5.40 for first four; $1.00 for each additional
Address: ` A-5. 11 p , � . Ira 4a f _Furnace, etc.
City/State/ZIP:
I ■ Gas heat pump
Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
E -mail • I Fireplace
Range
CONTRA Iti OR Barbecue
Business name: .J Qs . t", )-. r 0, Clothes dryer (gas)
Address: I . : 0I ti '' ,,t. 1\ _p_/'/ i 4 Other:
7 � MECHANICAL PERMIT FEES*
City /State/ZIP: S (.'_6 • U D o2 % � q �� C 1710 ---.L' Subtotal ----- Phone: ) 543 — 5 51 f II Fax: 6P3) 59 3 -- 3b 6/3
Minimum permit fee ($72.50) 7a - 5 t7
I Plan review (25% of permit fee)
CCS tic.: — 76 State surcharge (t2% of permit foe)
� t Y �
�} TOTAL PERMIT' FEE } i l , a 0 .
Authorized signature: �" �/ ` This permit application expires if a permit is nut obtained within 180
days :after it has been accepted as complete.
Print name: rt /�
1 i.Q I SQ 111111. Date: 9_ gc-_ Q i . Fee methodology set by Tri -County Building Industry Service Board
fA.Buif dinitPerwits\MEC- ParnitRpp doc 01/19/07 446- 4617r(I t/p7lCONJWEB)
i
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