Permit CITY OF TIGARD MECHANICAL PERMIT
4
±' = COMMUNITY DEVELOPMENT Permit #: MEC2009 -00492
•
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/22/2009
TIGARD 13125 2S112CB10500
Jurisdiction: Tigard
Site address: 15436 SW KENTON DR
Subdivision: Lot: 0
Project: Smith
Project Description: Replace existing furnace.
Owner: FEES
SMITH, ERIC & KAY Description Date Amount
15436 SW KENTON DR Furnaces < 100K BTU 09/22/2009 $14.00
TIGARD, OR 97224 12% State Surcharge - Mechanical 09/22/2009 $8.70
PHONE: 503 - 968 - 2602 Minimum Fee Adjustment - Mechanical 09/22/2009 $58.50
Contractor:
A -TEMP HEATING & COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 -9519
PHONE: 503 - 650 -5014
FAX: 503- 557 -2990
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: g 44"r 4 l�l _ Permittee Signature: or--Ac / / Z i, -77
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.
09/17/2009 12:26 5035572990 A-TEMP HEATING PAGE 01/02
t.-
.. Mechanical Permit Ajaplica.tioiEcENE
'
I It Cit of Tigard
cto atc/By: 7 ivcd ,2 ,01
D
I 7 /4 Fern 009' - DO VciX.,
g . : . 13125 SW Hall Blvcl„ Tigard, OR 97223 SEP 1 7 2009 PlAn Review
- ° • • - Phone: 503.639.4171 Fax: 503.398.1960 : Other Pc nit: • Pntc/By
TI6ARD Inspection Line! 503.639.4175
--
JUri 21' See Page 2 rnr
Internet: www.ligard-or,gov CITY OF TIGARD N l e, Supplemental Information
_
BUILDING DIVISION
.,,,,,,:::„.:„.,,,,:„.,::: .,, . CO. ERciAl; FEt scHEir.g,E. :to,ditektiot,
;;:4..5,..,,,::,:.::';7!",,!„..., ,
,; . .!,..-T. . . . ..,
0 New construction id! AdditionAlterationfrepiacern ont ivlitehanical permit lees* are bailed nn he value or the work
performed. Indicate the value (rounded to the nearest dollar) of ail
0 :Demolition 0 Other:
rnechAnical Innterial,,sailipment labor, overhead rind roftt,
// :
'.. ;; II A: .; ;; : : ::;': i0 . #00 . 0* , 00t§ditP,•,I , O,..l Value S
t.: ,. '',, •:'::::;.; ... . !.1 ' , ,:,.,: :... ., - , , .., ' . . ; • , •./.. 6,fi 7 3 : ,;::,
14,•' - ' ' • ' • - • •
1 • • ." ' -- . . :•;::•:ii •PM ,',.. ?..
;.;'•.- and.2-family dwelling n Conn U Accessory building.
For special itaformarlon use checklist
0 Multi-family 0 Master builder 0 Other:
Description , Qty. Ea. Total
:;:':•.: ' g : : :.',. : 1: . : ;: i : ,•; " ,:., :A .' ' , ; i: 'P; ' • : .i' :; .kiii400//t ,, , , :0,0*;''4 ,4 1:;';* 7777 :00.,0'40,„ ;;../::,' ,•;: tleatin koolin:
Job site address: n-j I to.
n3.11itat nii Ion showin lacement 14,00 MI
_ , .1.;■,,...,.
Ciry/State/ZIP7179111\a/Ae D C rl /9 g -1- 1 ' „ FtIfilACe 100 000 BTU ducts/vents 14,00 FE"
PUIMACe 1 BTU (ductliventr.) 17.90
Suitc/bIdt.t /apt. no,: ".-" Project natne: -rn r - ii -
em
,Ges Itmp 14.00
Cross street/directions to job site: Duct work _ 14.00
----- ----
H dronle hot water u ME 14,00 Mil
Residential boiler (radiator or
I ,dronic 14,00 II=
Unit seaters (fitel-type, not oieclric),
in-wall in-duct, sus.endcd etc. 10.00
Subdivision: IIIII
--___
-_-.
Lot no.: Floc/vent for an ' of of above 10,00 EMI
I
Other: 10.00 OM
Tax map/parcel no.;
Other fuel a , litmus •
,--
•':;•?:',:1,••:',1.:•:';?. i • : .' • Water heater E 1000
';`••:''•',•!•,•; , :0? , i'4' , t::ii'•• ; ,• ; u •k ;:;•:..;!:,,• •:.1,1 •,•• . ••. .• l• ,• •i • • •
Gin fire lace 10.00
a : '& _pt_lis":•.. t .1,4)(Aiht,c--- Flue vent for water hoofer or gas
,f.e.plrica 10.00
• - Lol li:Mer 1 ts 10.00
Wood stove E 10.00
Wood fire -lacc/inscrt
me /liner/flue/vent 10.00 ME
.:•'' ;; .'':'..:!. '0./4.0 AtA i hOW ' StiWi ! ::65.'::•; .1 ..'N1' : 4A. 1 . : ,: i : :::li. l '::lgtl*NT , * Chin
other
111111 10 Mill
Name:
_ ILA It ..' - fA „..,_D ONMENgten
- Range hood/other kitehen
Address: MN 10.00 ME
--
City/State/ZIP; . .1b • ' -e--- Clothes dr er exhaust 10.00 NMI
. Single-duct exhaust (bathrooms,
Phone 6, /A_. Fax: ( ) toilet corn a:Intents utilit , rooms 6,80
.. '"*X4tOtitAif ii ' ' '' :::: ' . "''' r l'?' : ; /.:. :: . :•' ; 1 *ONgt:afAk•ii'Cikp::.:);:,.;' Attickr.Ivnco fans 10.00 11.11
Other: ME 10.00 MI
f3 u s i n e g s name:
- . .
- ' . . - Fuel t in
Contact name: ATENEP HEATING AND COOLING, •IN ".
55.40 for first four. $1.00 n en ni id m
--I6OGO-SETIVO711-4ST: - Furnace etc. .111111 NM
Address:
ChlrekaM24-0k.-9213-__ Gas heat .um.
----
City/Statti/ZIP: 503-650-5014 watt/me ended/unit heater . w Ea lli ll..111
Water heater
Phone : ( ) Fax,: : t3 )r7,.....
E-mail:
Rene MEM
i '''': '1:: I' ''.::;:;:;;N:%q:;•:A•';:gi.!' ,r iCiiXeekiii 6 §: : • ,: : ; n: ; 4/ , ; :• • ;; A::;':',.:•;'/•';i: : ;::, , :./.:,'•:•...5; 1.3Vecue . 11.11
, 1111111111.11=
Business name: A-TEND? HEA '1 4._ ALP It.010* L •Ix 'k INCL__ s r et m Other:
• \ Address: ' 16000 SE Evelyn St. ....
;:::,.:::
11 ;- _, l ::.:::: MECTIA.NICA•L,PE117000*i'y •:, • -., .' , :- t • •.,.-, ; '
1 City/State/ZIP: 5.03; Ivlinimum permit fee ($72.50) 6515014 Subtotal
. -v.
phone; ( ) So -._.5 Fax: (..
Plan review (2.5".ii of permit fee)
CCB lie.: 1 b 4! -.1-- State surcharge (12% of permit fcc) L
rairmi
TOTAL PERMIT FEE
' Authorized signatu A, i - , . _ This permit application exult-et it n permit It not atimin within 150
days idler It Imo been accepted as complete.
_._
Print name: . IF. e arn
e-L) D m.; qbit-7, 0 9 :i . Pen methodolc■gy ,ict by Tri•Cco Si.
ty iilding inductry Service Baird
t;\131 MSC-PennItApp.doc ONCIG L
/06 440-4417? (11 (02/COMMI3 3)
L b9-A/ -