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Permit r (' • CITY OF TIGARD MECHANICAL PERMIT ! ' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00220 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05121/2009 Parcel: 2S102BB01500 Jurisdiction: Tigard Site address: 9910 SW JOHNSON ST Subdivision: Lot: 0 Project: Simele Project Description: Install furnace and ductwork. Owner: FEES SIMELE, PAUL E & Description Date Amount NGUYEN, HANH T &, PHAM, MY DUNG THI, Furnaces < 100K BTU 05/21/2009 $14.00 12583 SW 116TH AVE Duct Work 05/21/2009 $10.00 PHONE: 12% State Surcharge - Mechanical 05/21/2009 $8.70 Minimum Fee Adjustment - Mechanical 05/21/2009 $48.50 Contractor: OHAC INC PO BOX 241 DUNDEE, OR 97115 PHONE: 503 - 538 -2953 FAX: 503- 691 -8556 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 Issued By: laauRfN Permittee Signature: 4 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. 05/_?9/20Fj.9 11:43 503- 691 -8556 OREGON HEATING PAGE 01/02 Mechanical Permit A plicat FOR OFFICE UsI. cmi. ,,. . City d l -' Received �' ofT.i an D../0,-. __ Permi �I _41/..• • • 0)d n " 1? 125 S W Hall Blvd., Tigard, OR 97223 y Q Plan Review Phone: 503.639.4171 Fox; 503598.1960M 1 O 2��9 Other Permit: Date fly: I' l i', ARD Inspection Line: 503.639.4175 Date Ready/By r c? El See Page 2 for Internet: www.tigard -or.gov ' CITY OF TIGARD Notified/Method: Supplemental Information 4 1 idi flit. r C a' I "8'� 1' �: t. ", �1,.�,Ifl1141101111 f i' 1P `f - ?r , i . jst; . f 1 , r y N : i p ,,,, .!, li . )„, '!`• . '1 1`id•� .',.,' ', ;t.{ A.'" •„ � !I : i tt f£ j1 '1 id "t.l • s t d i �+ .. ( Or' p f 1 P: E t t � .,; i }' YS '� d �1' 1 ,�I y y 'Y1 ?). Ilt�+; �ll���C ,l {�����d tl� rs7 I�I�t1 ,, ,,,. , 6�� �C� E� r 1 d ir��iill fll., 3 r� ` , l,{ :4�t ��r °;,.:l' � . ,.p t��j' , F�, ,- . Rt';. ,}•.;t a•a�,:"'F,•.� Addition/alteration/replacement Meobanical permit fees are based on the value of the work 0 New construction performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical osaterials equipment, labor, overhead, and Erofit i f "" i;; , t.( F:6 « 4764'§i'''''' r , �p e; S { S 4;I ° rfr,I {i 3 + Value.S l t ri 1 ,,, ,i Y 41, S S i t i ( i i1 idol 0" pr • 443-RI K'1 i(!{{ '' i srl l ' (( 1.ii ! i p i1 1IL� II � 1 4' ( 1. < I III; ,R.' 1S �£'.'„,. .i 1 {.11,., , t , 'h6d:,.. .., •: 4 33030.3 .y3 i ld4p01 il,t, ;!mil fV - ti.. f' t I i�,r t : ,, � „ , , 1 l A 'tt rt:n i i,. i i; u, j 1t . , t t �4i ;.1 r, 1$ a ! Itl cf !, ∎; � YiCE � �l ii/ +11 Ei 1- and 2- family dwelling El Commercial /industrial ❑ Accessory building li it! !di , ,, :p,,nl : f, :,�. 11. • ;a,t 1' 2 .Pt;i1,l it .ro /,.y „I p'. '_n U4d t r ¢, .y . For special information use checklist- 0 Multi - family ❑ Master builder ❑ Other: Description Qty, Ea. Total 7 i .., : ; 3 '.[ ; V` !.,€ �9lPI! ' o ` �� ”; ' 4,',7,', 1 ' .f gi .. , ' u %' 1 1 1 ,III.: ; .: ; i ff i t '' l l' ;',i7 Heating/coolira�, :l) b. �'�� fi.� , 3 Y "in ..�,ta rear t , r. 6 , .. o, on. lldu �wl —,..' .i Pdf,i1 .l.f IE4 i Job site address: 1 h Air conditioning iplan bo or ingg tpnnup ) V C3 (requires si plan showin placement) 14.00 City /State /ZIP' l ` � e , , Q 3 Furnace 100,000 BTU (duct;, /ven,z) l 14,00 1, y, 00 Furnace 100,000+)3T1 Smelts /bldg. /apt. no.: Project name: 3 (ductslvents) 17.90 G as heat pump 14.00 Cross street/directions to job site: Duct work k 10.00 VS-00 — Hydroaic hat water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duet, suspended, etc. 14,00 Subdivision: Lot 1ao : Flue/vent for y of above 6.80 .•,,,. _. Other. 10.00 Tax map /parcel no.: Other fuel appliances 1111141 1 " rl.m C � g� a _ € Water heater a l t _ ' , i ' I t Gas fireplace 10.00 ' T I \ _., „.. ufn ce. 4. avC.LJ(YFk,, Flue vent for water heater or gas fireplace 10.00 . .. • -- Log lighter (Pas) 10.00 Wood/pellet stove 10.00 ' — m Wood fireplace/insert 10 • •p { ;�, f ; : , Ep a';,,i,� q , Al r,4 Yp S ! P, ,, Chutuley /liner/fltleh'ent 10.00 slid gA .fi -' . ' u � . y = , ( s � ' �, . A II' 7 iS#iiv) ,I '-il ; &sir' Other. __._ 10,00 Name: F5\ r Q % ' i PL�U1 Environmental exhaust and ventilation r nn Range hood/other kitchen Address: 5`{"' ' c�W n e 1 f 'j e q ipuzcut 10.00 City /State /ZIP: '• c ''N. Of eta_ Clothes dryer exhaust 10 -00 1 Single -duct exhaust (bathrooms, Phone: ) - • 0 _ ( )bah Fax: ( ) toilet compartments, utility rooms) 6.80 ITT, GSM a a 3 S F i f! ri1 roq x; S �: P s or.v.,... i „, �. n q� i P i yJ � i ! !' /e $'� I ' a' ,i � !f ' 8 ' � ' , ' i Y4��.i � i `l' f ! i Attic /crawlspsce fans 10. { +,� EE p qd p y ` S , g g {� g J' I� 1 � , e . , , , ,u,. Ott b -.J •riri r f1 e', a if S6 • PSt• .. 11 r ZO fir, -,1) r 8 'r : r, d � L ' ? . �R4js4: 1r Business Other 10.00 usiness name: ell' i b, It ''• 1 s t l C- Fuel p iping Contact name' %-,...6 $5.40 for first four; 51.00 for each additional Address: . e x UC4 I Furnace. etc: ..__,. Gas heat purn� • City/5 tate/ZW: 11 • _ °II 11 Wall /suspended/unitlieatex ( Q t I _ 96� ( 3 1 — U 5x5 Water heater Phone: • Fa 1.-- • -- Fireplace B- rnail: �(' (� • ) • �' . Cep Range • 1 i i * i � k •Y I , Al IP et n l i r� u•r ei { R ' ! r : l�E ?9�.8 { 9 d ,tai u i . B arUecue �� �� :��� ;���e!sleE�a��`�: =�i�+�� ��, , �. � ��$ , € �1�, � �. � � a�18�������tt1���i; ����9��l ���t� ' ��s�?��� ;���� .r, • — Business name: µ • t. * \N I r A L ^� Clothes dryer (gas) w —N" Other. Address: f ' �;t ,{ ty • , , i I „ h .. i,. .,.,,v cc^^�� [� y i i }, li i ',!° 1 ' I; tl }�! ���}Itt Q t 1 4,, ,�, : C. ).. [, 1 •,s r�, r,.,:,� ay. A - -, • r ! 1 f• ray/, n r � rilr1 railii � ! @ I° f it 1 - „ ^-7 r r,� City /Sta /,ZI nac�ie,f' Il 5._ S ubtotal oa CJ Phone: ( Cp l - t 6qQ Fax: (5©5 4 C\ 1- a S ` :) - w_ n Minimum peamzt fee ($72.50) , Plan review (25% of permit fee) CCB 11x,: t'- ' (r �— State surcharge (12°0 of permit fee) 4 6.1 0 TOTAL PERMIT FEE l , ,Q Authorized signature: - Timis permit application expires if a permit is not obtain rvlthln 180 . _ • _ a days after it has been accepted as complete. L Print Waffle: Rer5v,y_it,e, }sate: • Fee methodology set by Tn-County Building industry Service Board