Permit CITY OF TIGARD MECHANICAL PERMIT
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`' :'• COMMUNITY DEVELOPMENT Permit #: MEC2009 -00149
Date Issued: 04/07/2009
TIGA 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S104AA07700
Jurisdiction: Tigard
Site address: 12705 SW KATHERINE ST
Subdivision: Lot: 0
Project: Pizer
Project Description: Install gas furnace.
Owner: FEES
PIZER, KIMBERLY A Description Date Amount
12705 SW KATHERINE ST Furnaces < 100K BTU 04/07/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 04/07/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 04/07/2009 $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 $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable - . All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issu- ce, or if work • suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Ut ty Notification Cent- use les are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules •
Iss d By: 0 40 / Permittee Signatu' i � t . /l i _ZN.
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Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
04, 15:16 5035988748 THERMALFLO :0206 P.002/002
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Mechanical Permit Auplication R EC E IVL ; ,a ' ' . FOR OFFIC: E 1.SE ONLY
• i Ved .
City of Tigard APR - 6 2009 =By: iff09 , , l Pcn»it Nc.: ii,ee, do , ....... /
IN 4 13125 SW Hall Blvd.. Tiaard, OR 97223
Phone: 503.639.4171 Fax: 503.5%. I 960
CITY OF TIGARD iajiMIIIIIIII Other Permit:
Inspection Line: 503,639.4375 Rau
TI GARB Date Ready/$y: 8 See Page 2 for
Internet: www.tigard-or.gov BUILDING DIVISIO Notified/Metho0 . ' Supplemental infOrmalion
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Mechanical permit fees* are based on the value of the work
0 New conkruotiOn %Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 111 Other: mechanical materials, equipment, labor, overhead, and profit.
.-.. .... . . .-. Value: S
'''''. . ' --' • '-':: '''•::•.•:•.: ::: :: ' :.- ;. .: .- - :: 7. . :.:H . E:' : '
RESIDENTIALEQ-OWS.V
X 1- and 2-family dwelling I: Commercial/industrial 1: Accessory huiidina.
For special information use check
O Multi 0 Master builder III Other: Description Qty. 1 Ea. i Total •
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JOB SITE 1i4FORIS/LHAITIOIC • .: .:: .:: .::::. : ::'• Heating/cooling
' Air conditionin or heat pump
Job site address: / T-700 E g 14/ kezalet Z.414, % (..h.ssitc i.,,__ , shciac.iii.nt 3 4.00
City / S tate/ZIP: Tgacet__, oil? qi 2 20 . Furnace 100.000 BTU (duets/vents) Ti 14.00
— Furnace 100,000- BTU (ducts/vents) 17.90
Suitc/bIdg./apt. no.: Project name: g 1 2 Oa° 2..---
Gas heat pump .. I 14.00 .
cross street/directions to job site: ' Duct work 10.00
Ilydronic hot water vs= 14.00
Residential boiler (radiator Or i
• . .
hvdronic) e 14.00 I ,
Unit heaters (fuel-type, not electric), .
• in-wall, in-duct, suspended, etc. 14.00
r .
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• . I Flue/vent for any of above 6.80
Subdivision: • 1 Lot no.: —
Other: 10.00
Tax map/parcei no.: Other fuel appliances
7 . . . 7.'• :',;,' fliscikii - MORK . :::: • ': ' ' -:::: :::::::.::::::''::::::- ';::...:;:::':.:.:':;:'''';'.'; Water heater 10.00
- —7 .
Gas fireplace . i 10.00.
Flue vent for water heater or g.
__Thr_r4,1/ Cee_.. . fireplace 10.0(1 '
.. Log lighter (gas) !' 10.00
Wood/pellet stove 10,00 i
Wood fireplace/insert 10.00 I I
. . ...... .... . .. . li er/flue/ven • I 0.00
',..:7 ::':'.' TRCrpf ,•„, .. „ • ' •;.' ' ' .- ' ' . ' : : .11rETYA :'':::::.:.:....:. ;;.'.,... ,. ,. -.....,-..--.,_,.......-._
• ' '" ' ' . '.. '' ' %., • ' J 10-00
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Name: j6cil.," fj/3e7. _P,Mvironmental exhaust and ventilation ...„ ,
REITM hood/other kitchen
Address: I equipment 10.00 1
fP,.
City/State/ZIP: • ja OW A 0 (1-70- - b 0 Ire- Clothes dryer exhaust I 10.00
Single-duet exhaust (bathrooms, ' I' •
Phone605) m.5 40 4-7 Fax: ( ) I toilet compartments, utility rooms) ' 1 6.8()
;',;.•:' •:.: ii: •;,,.. , ... • . • :tkcorvi ,.:.,.,..,;, Attic/crawlspace fans 1 10.00
• Other: i 0,00
Business name:
Fuel piping
A
I' Cnel name: i tgi
$5.40 for first four: $1.00 for each additional
ora
V A f
1 v . . Furnace. etc. I -
Address: 1 . .
0 A, I (ins heat pump
City/State/ZIP: , it ' Wall/suspended/unit heater i •
Phone: ( • — • ) Fax: ! ( ) Water heater
- ■ , Fireplace
E-nia i i Mt , CanZ... Range • ._
.. ... .,. Barbecue i
Business name: 71,-in rip xle,, Clothes dryer (sits) • ,_
Other;
Address: // V40 (5 gz-wr--10,0 .... ..... ,
MEC
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City/5 tate/Z I l'! p „ 1 „, g. el 04- Subtotal 1 1 1:16 .
---, Minimum permit fee ($72.50) 1 72 .
Phone: irr et",..i3Pe Fa, 4 I))b 0- facof. ,
. Plan review (25% of perrnii fee) I
GCB lie,: 15494.1 . • State surcharge (12% of perrnii fee) ' e3.1
TOTAL PERMIT FIE 1;71,20
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This permit application eipiras if a permit is oat obtained within )))11
Authorized signatur days after it has been accepicit aS Complete. ,
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ilril±_f nanfiy_refie: " Fott inethodolozy s by Fri-County Building Indus Scrvicc hoard
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