Permit A
v CITY OF TIGARD . MECHANICAL PERMIT
' _ 1 COMMUNITY DEVELOPMENT Permit #: MEC2009 -00182
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/29/2009
I
Parcel: 2S104CA10400
Jurisdiction: Tigard
Site address: 13688 SW JENNA CT
Subdivision: Lot: 0
Project: Goetz
Project Description: Replace furnace.
Owner: FEES
GOETZ, STEPHEN F & MEGAN M Description Date Amount
13688 SW JENNA CT Furnaces < 100K BTU 04/29/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 04/29/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 04/29/2009 $58.50
Contractor:
TRI- COUNTY TEMP CONTROL
13150 S CLACKAMAS RIVER DR
OREGON CITY, OR 97045
PHONE: 503 - 557 -2220
FAX: 503- 557 -0919
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 Notific tion -Gen . Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
Issue By: /�, Permittee Signature: 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.
''R -24: -2009 02:28P FROM: TO: 5035981960 P.1
Received
Mechanical Permit Applicati a
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City of Tigard Fl t �mi ,�� 9 ` •' Y : -_ /f
1phi g Date/By: y ,q y z p Xi Permit Na : : /► Q0' ' 6017
13125 SW Hall Blvd. Tig ard, OR 97223 4 2009 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 APR
2 Date/By. Other permit
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Inspection Line: g 03 8.4175 C ITY OF TIGARD Date Ready/By: to ';' el See Page 2 for
Internet: www.ti and - or. ov Notified/Method• - /, Supplemental Information
BUILDING DIVISION
. . . TVPE.OF. WORK. ., COMMERCIAL, FEE* SCITEAULE- USFC:HEglitJ
❑ 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.
- CATEGORY OF CONSTRUCTION ' Value: $
RESIDENTIAL EQUIPMENT /,SYSTEMS. FEES* -,
® 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special iri/ormatlon use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
. JOB SITE INFORMATION AND LOCATION Heatiog/cooling
Job site address: 1 U U 0 U (, Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/ State/ZIP: Tigard, OR - '-72 Furnace 100,000 BTU (ducts/vents) ( 14.00
Furnace 100,000+ B'l'U (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name: 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
hydronic) , 14.00
Unit heaters (fuel -type, not electric),
in - wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue/vent for any of above [_ 6,80
. Other: 10.00_ .
Tax map /parcel no.: Other fuel appliances
'DESCRIPTION QV WORK Water heater 10.00
t fait-aft fiJy Gas fireplace 10.00
a
,f i v1( 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
l Chimney /liner /flue /vent 10.00
. ' PROPERTY OWNE , - I - . Q TENANT- Other: 10.00
Name: e J �' 6O j Environmental exhaust and ventilation
Address: Ear n0 1C) Range hood/other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
5 „` _ _ j Single-duct rtmen (bathrooms,
Phone: ( 1 L /7�C Fax: ( ) toilet let compartments, utility rooms) 6.80
1, PPLICAN
AT . - [] CQNTACI' ` ERSO1Y Attic/crawlspace fans 10.00
Other: 10.00
Business name: Same as contractor Fuel piping
Contact name: Diane Mason $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City / State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax: : ( )
Water heater
Fireplace -
E-mail: Range
,„ ONTRACTOR Barbecue
Business name: Tri County Temp Control Clothes dryer (gas) ,
Other:
Address: 13150 S. Clackamas River Drive ME IANCCAL PERMPP HEESt
City/ State/LIP: Oregon City, 97045 Subtotal
Minimum permit fee ($72.50)
Phone: (503) 557.2220 Fax: (503) 557.0919 Plan review (25% of permit fee)
CCB lie.: 72623 State surcharge (12% of permit fee)
TOTAL PERMIT FEE � i ��
Authorized signature: l/�,�/(/ This permit days after it has a complete. with 180
Print name: Diane Mason I Date: . 41L71 0q ' Fee methodology sat by Tri- County Building Industry Service Board
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I -U Building Permiu1MEC•PermhApp.doe 01/19/07 440.4 (I i /02JCOMIWSR)