Permit CITY OF TIGARD MECHANICAL PERMIT
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', COMMUNITY DEVELOPMENT Permit #: MEC2009 -00503
13 125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/23/2009
, . R D Parcel: 2S112CB09500
Jurisdiction: Tigard
Site address: 15254 SW KENTON DR
Subdivision: Lot: 0
Project: Thomas
Project Description: Replace furnace, a/c and w /h.
Owner: FEES
THOMAS, ERIC D & DENISE E Description Date Amount
15254 SW KENTON DR
TIGARD, OR 97224 Air Conditioning or Heat Pump 09/23/2009 $14.00
Furnaces < 100K BTU 09/23/2009 $14.00
PHONE: Water Heater 09/23/2009 $10.00
12% State Surcharge - Mechanical 09/23/2009 $8.70
Contractor: Minimum Fee Adjustment - Mechanical 09/23/2009 $34.50
OWNER
PHONE:
FAX:
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
Total $81.20
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246 or 1.800.332.2344.
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Issued By: cu. J \ " o p ^ Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
— This permit card shall be kept - a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mecha-tical Permit Applicatio 1 . • FOR OFFICE USE ONLY
' Received
City of Tigard Date/By: o Permit No.: e l , G . - if
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14 .
" 13125 SW Hall Blvd., Tigard, OR 97223 y — �l V
Ph one: 503.639 Fax: 503.598.1960 S E i 2 2009 Date/By: Review
: Date/By: Other Permit:
TIGARD Inspection Line: 503.639 Date Ready /By: ® See Page 2 for
Internet: www.tigard - or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
m- -- . ,, ;, m ,4 ,:. ».E WCr$K -. 4 , _,I t �, { ; =ECO FEE *zS, t ;HEDULE : il USEC H ECKLIS T_&
111 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.
C ,� l Value $
. „. :i4 . .. ; , ° ATEGORY' OF): CONSTRUCTION 4 u t „ *; . ..� ' ---- - -
? RESIDENT4IAL. EQUIPMENT SYSTEMS /FEES
® I- and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
.s JOB, :SITEx as ;AND LOCATION P. w'^„'^-IS. He at i ng/cooling
Air conditioning or heat pump 14.00 ��•��
Job site address: 15254 SW Kenton Dr. (requires site plan showing placement)
City /State /ZIP: Tigard, OR 97224 Furnace 100,000 BTU (ducts /vents) I 14.00 14.00
' Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name:
Gas heat pump 14.00
Cross street/directions to job site: Hall to Ashford 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: Ashford Oaks No. 2 Lot no.: 109 Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
t t Water heater 10.00 0wQO
�. � � �� �� A.. �..... DESCRIPTION �O ,,. `.,...,��. E' °= ; I
,.�; Gas fireplace • 10.00
Replace furnace, air conditioner and water heater 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
t Chimney /liner /flue /vent 10.00
,e , �,.� ;PROPERTI' OW NER V r e= ; ,:; '':TENANT i s '. Other: 10.00
Name: Eric Thomas Environmental exhaust and ventilation
Address: 15254 SW Kenton Dr Range hood /other kitchen
equipment 10.00
City /State /ZIP: Tigard, OR 97224 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (503)639 - 5381 Fax: ( ) toilet compartments, utility rooms) 6.80
$t?:,. . ®APPLICANT S fi W ® CONTACT PERSONrt , Attic /crawlspace tans 10.00
Other: 10.00
• Business name: Fuel piping
Contact name: same as owner $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
' r - , ::-.. >'' „, C ` �' 4;..— '' _' ` a . ” `" ,, . r ..-, _ . ".- Barbecue
Business name: owner
• Clothes dryer (gas)
Other:
Address:* �� s � .1GIECHANdC`AL?PERiV1IT'FEESih'
City /State /ZIP: Subtotal
Minimum permit fee ($72.50) .56
Phone_( )_ Fax:(_ )
— Plan review (25% of permit - - --
CCB lie.: State surcharge (12% of permit fee) z....
TOTAL PERMIT FEE 8 ( .0
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: 9 -Z,Z, — O 1 * Fee methodology set by Tri- County Building Industry Service Board
I. \nuilding \Permits \MEC- PermitApp.doc 01/19/07 440 - 46I7T (II /02 /COM /WEB)