Permit •, CITY OF TIGARD MECHANICAL PERMIT
w ' COMMUNITY DEVELOPMENT Permit #: MEC2009-00130
T ! GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/26/2009
Parcel: 2S114AB05200
Jurisdiction: Tigard
Site address: 9405 SW MILLEN DR
Subdivision: Lot: 0
Project: Witham
Project Description: Install gas furnace.
Owner: FEES
WITHAM, ELLEN Description Date Amount
9405 SW MILLEN DR Furnaces < 100K BTU 03/26/2009 $14.00
TIGARD, OR 97224 12% State Surcharge - Mechanical 03/26/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 03/26/2009 $58.50
Contractor:
THERMAL FLO INC
7236 SW DURHAM RD 100
PORTLAND, OR 97224
PHONE: 503 - 670 -8343
FAX: 503 - 598 -6746
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 • ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili■ otification Ce Those rules rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules
Is ued By: k ` / /� Permittee Signatur
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.
111111L '
03/25/2009 14:19 5035988746 THERMALFLO #0130 P.002/002
. /.•-• :pp 41
"Wfechanical Permit A licatio EcovE I . FOR OFFICE USE ONLY
City of Tigard . Received
Date/By: .. $ e7 4 PtiLAi1NO."fled107...ee/,_50 .
' 11 1 4 NI 13125 SW Han Blvd., Tigard, OR 072 MAR 2 5 2009 Plan Review
• g . . Phone 503.639.4171 Fax: 503.598J:960 ' Date/By:
Inspection Line: 505.639.4175 ' , .0ther Permit:
TIGARD CITY OF TIGARD • Dat ReadY1BY: h _ BUILDING DIVISION Supplemental Fi See Pagc 2 for
• internet: www.timird-or,gov Notified/Method: i 0.4 Informatitm
t*itt'.:bi,' :. ::-.... '.. '' '!'.gtEtkOiffl; '-':IISE
... -. . ...... ....
.....
Mechanical permit fees arc based on the value of the work
• 0 New construction XAdd ition/alteration/replacemerit oerfOnned. Indicate (he value (rounded to the nearest dollar) of all
Demolition 0 Other: mechanical materials. equipment, labor, overhead. and profit.
Value: S
' . ....';'..:: ] .REgf)}:i6iiiL , E0101V1EisiT!,.,./.'41" - kiviSOE§ : : . •:‘• :. ::,' .,. .,1 .
. ....
X T- and 2-family dwelling 0 Commercial/industrial 0 Accessory building For zpeciai information uS _ ;., e checklist.
0 multi-family D Master builder 0 Other: Description Lqty. I La. 1
.,..
:-....,,.::., '.'.'.'•.•:...:'...: ..; ::::••••::: :,::.:,!. '., -,. '...:. ::.::::„.: Heating/cooling • Air conditioning or heat puinp
Job site address: ft 4 d , - . t 40 • (mqvir ,±,; Nita: plan EllOmnir iimement) 14.00
Clity/StUterZIP: Mard., 0' , 12. A Furnace 100,000 BTU (duasivents)
14.00
Furnace 100.000+ BTU (ducts/vents) I 17.90
Suite/bldg./apt. no.: 4
Project name: i i, +15/ 1 Gas heapump 14.00
Cross street/directions to job site: • Duct work ... 10.00
Hydrunic hot water system 14.00 . .
• Residential boiler (radiator or
• hvdronic) 14.00
- Unit heaters (fuel-type, not electric),
in-wall. in-duet. suspended. etc, 14.00
flue/vent for any of shove 6.81)
Subdivision: J Lot no..
1. . Other 10.00
Tax map/parcel no Other fuel appliances -
,.::: ; . Water heater I 10.00
1
. Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
1111,1_ ' . J 1 al .4 i r - ,, e..../ , Los liFhter (gas) - 10.00 . ...__I
Wood/pellet stove . . 10.00
. 1 Wood fireplace/insert 30.00
- , Chimney/liner/flue/vent 10.00
1■•.; T.ROP,ERTI.,.OWN.ER..;,: ...- '.....,1; .... •..';D:,:.fIENANT.: , -,' - •:'.7.?..;...:,.1. 10.00 other -
Name: 1 eft. - II airt----- • Environmental exhaust and yentas ion
_ -
Ranee hood/other kitchen
Address: • . . equipment 10.00 •
1
City/State/Z.1P: If .1 I ' , a .H., i Clothes dryer exhattht 10.00
Single-duct exhaust (bathrooms,
rthcInc: 5 ._.-. 1�1 --- 81 -- ---‘zPc: ( )
-77. .. .
4777 toilet compartments. utility rOoMS)
.,.,...,,I,,,:.,.....,....... . :..1::.:.!..0.A „..• ::: :: .li' . .i . : ( 6 1 ; : et'A c ...r, T , ERb - iw,•:z . .:.:::• . ;!,,,, . Attic/crawispacc fans . 10.00
Other . 10.00 1
_
Business name! I Fuel i ping
' 4"
Contact name: S5.40 for first four; S1.00 for each additional
.
r f - 1 . f ." . 1 etc.
AdelreSS! _..a _
•
. -
Gas heal porno
..,
City/State/Z11"; ' Wall/suspended/unit heater 1
- , Water heater - I i
Phone: ( ) Fax: : ( ) i._
. ,, • FireplaCe
... .
'.::::::. :,..,....,......:::',:::..:.:::•••••.: .: ."....::::,,:::: :••.'::i . : :.:•'•::::::: ::...::•:::::::. . . •,. ..:'.: . .,„ Barbeelle i
. . . !
Clothes dryer (.,.F-s) .
Business name! 7/,',77, / 2 _1C • 7
1.! . ,
.0 '• 40 . te; . .
.. . . . , .
Address: 4 1 .i./ 10 ,. ".. ' ••••• -.:MECHANIcALTERMITTEES* • ,-: 46 ..'"
I i firz elifi- . Sub 1
total ..
.+ 1
Minimum pernut fee (S72.50) iz.ifp
MY 0,.-004P 1 F 0, Plan review (25% of permit fee)
CCB lie.: L6Z19_4-1/.-v . State surcharge (12% of permit fee) 4 100 -
. '-
TOTAL PERMIT FEE . 1.)
Th6 !writ applictition expires if a permit is not obtained within 1110
Authorized signatureef days After 11 has been accepted as complete. . 1
ie Date: •j715:,01,---1, Fe, mathodotogy set by )r-Cont" BUildini: intim:try Service Board
•
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