Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00320
-T G_ARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/30/2009
Parcel: 2S115AA02500
Jurisdiction: Tigard
Site address: 10602 SW KENT ST
Subdivision: Lot: 0
Project: Rutherford
Project Description: Install furnace
Owner: FEES
RUTHERFORD, ROBERT D & Description Date Amount
NANCY M, TRUSTEES, 10602 SW KENT Furnaces < 100K BTU 06/30/2009 $14.00
TIGARD, OR 97224 12% State Surcharge - Mechanical 06/30/2009 $8.70
PHONE: 503 - 620 -9609 Minimum Fee Adjustment - Mechanical 06/30/2009 $58.50
Contractor:
OHAC INC
PO BOX 241
DUNDEE, OR 97115
PHONE: 503 - 691 -9699
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
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
•
Issued By: 1 i L `i, Permittee Signature: n �� �e(r�
� ' � u -If
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.
„06/30/2009 13:55 503 - 691 -8556 OREGON HEATING PAGE 01/02
Mechanical Permit. Application . FOR OFFICE USE ONLY
City of Tigard ,� Rece
e iv Petur +t Nc.: /L{�(� - pp ()
w 13125 SW Hall Blvd., Tigard, 0 Plan Review
l' . Phone: 503.639.4171 Fax: 503 9 , 60 0 '1009 Datc/BY: Other Parrnit;
t FGAIZD Inspection Line: 503 4175 SUN 3 Date Ready /By. 0 See Page Z for
Internet: www,tigard- or.gov r P aC\ tfi
t ed Ttetho : Supplemental laformn
—
+,, ' , ,r, I P O v� ', ;` +` " COM MER( E S AIJ4, SSE C1 EC;.C. UU •!
v ° ;, + ! .;! ,, + "' ! ''_ t4 - ¢ e - , -,_ w M P utait fees* are based att the value of
,. - the work New construction '® Addition/alteration/r lacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other; mechanical materials, equipment, labor. overhead, and •rofit.
Value $
.' i ,•! • , t l i + r rrc, i y � I'. ( r " 1: c,
' ,h,'1,r!dt.r, r i} ;r S` :'i + v .. ,•• ,` +` ' ,Otl b lY�� 'x -• ' r „r, . + �' i , + ' +i, r
.-••••••” , . ", �� 1(1 D]E �?;]CL�L a�S� � i1 �ly`3C , 1 �' �`F'�*9�y ..
$) 1 - and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building For,gpecial infornacAfion, +se checklist.
❑ Multi-family ❑ Master builder ❑ Other: Description Qty. 1 Ea I Total
`` 1 'S+ + : ` i
x rt i ',
, ''JOB S�k` 114FO Ia\.T)O'l' , ? oe I v , . l' ' i' + i , Heating/cooling
oa `. V • 1 �� Air conditioning
Tres ite .1e s ho l wixt, pump •
Job site address: �, � K��� '5.-\ - (requires site �lsn hoin, >laeemecit 14.00 •
Cit /State /Z3P: 7 "=' a Furnace 100.000 BTU (ducts) 14.00 �,�
Furnace 100000 +BTU (ducts/vents) 17.90
Suite/bIdg. /apt. no.: Project name-; Gas heat pump 14.00
Cross street/directions to job site: Acct work r 10.00
Hydrooic hot water system _ 14,00
Residential boiler (radiator or.
-
Irydronic) 14.00
.. Unit heaters (fuel -type, not electric),
in -wall, in -duct suspended, etc. 14.00
Flue /vent fob of above 6.80
Subdivision: Lot no.: Other _ 1040
Tax Wrap /parcel no.: Other fuel appliances
ry t "4TV7�'' a'A' "h Water heater 10.00
a ' ► ;fig w n $754' C lk • i; , , j ,rwf,, rii,, ' ��; i ii
� t, i�, rte � , Cras fireplace 10.00
. \Y\ a 11 i'L» T .Q C e - Flue vent for water heater or gas
fireplace 10.00
u -- Log lighter (gas), 10.00
Wood /pellet stove 10.00
Wood f 10.00
_ z , .� ,p' ` id'C' nl� .. 4i' •,n t o 4., , ,, ' 1- , r r,, . , k e.F1.,,.. � t,N Chtmney/liner /due/vent 10.00
,,l1 1J tl# }'f g'� �nJt>b ;'Ar''' ,' 4 i 144e. ., ) >'4�:!4i11�l f ,, ! ,„,, " Other. 10.00
Name: Q ,} 'Q �,& -. > �l
Environmental tat exhaust and venCllatlOZt
rl 1 ` # e� Range hood /other kitchen
Address: 1oZ 5W } 3\ - w equipment 10.00
City /State/ZIP_ \• Q • C rl a. _
Clothes dryer exhauot 10.00
Single -duct exhaust (bathrooms,
Phone: r ) 6 DO R(;) Fax ( ) toilet compartments, utility rooms) 6.80
,, k' , ; j n � S) j d� a ? �' y �,, y i �.,.7 i ' q�` +` ., f o rs r iu -. v,,1�a, ' S ' Attic /crawls ace fans 10. G4
r 3, .. : 1 • . i' r�< ,.- ;∎. }..r.,.EI.,!; E ': filSvi4l : 14, fl �LrC011l �� k,c SOj �_, , ,' _,
„ Other: 10.00
Business name: ill • r: . \ Pn \ r fik..l Fuel piping
Contact name: ► S5.40 for first four; $1.00 for each additional
ILA. .
Furnace, etc.
Address: e'` Iwo . a Gas beat pump
City/State /ZIP: 0 ),1.--v °l1 i ‘ Walllsuspezrdedhrnithaater
Phone: (c ) � F ax.:: ( j ) 6 G U - Water treater
Fireplace „„
. • E - mail: Range
aAf. J. YF �{ } M i + 1� 1r� i ! , s } 1t ,bi l l r +� F y �, ( ! I 4, + , Barbecue
„l
,. ui„,i i .+ o ,�d + :, h r, ..1. : • •∎•• x a F k E• y x . •q• , IA + ! , . ,N • l• • Clot l' ,r.t.,, ,� . ..,
" - r E -\M 1 ∎1 A C_ s dryer _,(al_-,)
Business name: \1
Other:
Address: ? -4 i� , ,V lr'3i?r'`!�;' tyj�r EtY: *';ft7'i . LT�b°'lj'`� r; F,f;1
cc'�� ``
� �a��� ,.. tom[ . „.::� "Sa!rG....�
City /State /ZIP: - 9 , l Subtotal _
w Minimum permit fee ($72.50) �15 .50
Phone:( `D - C ' ER—t F O eP\- Ci Plan review (25 °6 ofpemitfee)
CC33 tic.: 1", ; S Q ci l ( 5, (Q s State Mule urge (12:/> of pe xiit - fee) - tfs. 1 y
- TOTAL PERMIT FEE ' , QQ
This permit application expires if a permit is met obtained within 180
Authorized signature_ _ �.. � . r t . days after it ban been accepted as complc4.
Print name: • , Date: r �'���
• Fee methodology set by Tri -County Building lnduleey Service Board