Permit CITY OF TIGARD MECHANICAL PERMIT
a '- COMMUNITY DEVELOPMENT Permit #: MEC2009 -00514
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/30/2009
TIGARD Parcel: 1 S 136AA01100
Jurisdiction: Tigard
Site address: 7005 SW OAK ST
Subdivision: Lot: 0
Project: Reeb
Project Description: Install gas furnace and (1) gas outlet.
Owner: FEES
REEB, DAVID Description Date Amount
7005 SW OAK ST 12% State Surcharge - Mechanical 09/30/2009 $8.70
PORTLAND, OR 97223 (manual)
PHONE: 503 - 750 -1312 Additional Permit 09/30/2009 $72.50
Contractor:
WESTERN HEATING & COOLING INC
50618 COLUMBIA RIVER HWY
SCAPPOOSE, OR 97056
PHONE: 503 - 647 -5808
FAX: 503- 543 -3693
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 question to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: l Jam, l , J \(l u 1 .1AA Permittee Signature:
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.
.p 2.: 09 12:45p Western Heating 503 -543 -3693 p.1
;.s
Mechanical Permit Applic
4 CENED FOR OFFICE USE ONLY
City of Tigard • Received
DatelBy' \� �
11111 . • 13125 SV Hall Blvd., Ti V • �• H
O Phone: Bard, OR 7223 "one: 503.639.4171 Fax: 503. 8.196D EP 2 9 2009 Date/BY Other Permit:
T 1 G.� R D Inspection Line: 503.639
Data Ready /By: ® Pn
Internet: www.tigard CITY OF TIGARD Notified/Method: ■ Sup 2 Information
UILDING DIVISION
TYPE WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Additio elation/replacement
El Demolition [] Other performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: S
l -and 2- family dwelling ❑ Commtxcal/mdustrial RESIDENTIAL. EQUIPMENT/ SYSTEMS FEES*
❑ Accessory building
: Eder 0 Other: For special information use checklist.
❑ Multi - family ❑ Master bt
Description I_ Qty. I Ea. I Total
•
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: `7005 � G 1 O l< Si- Air conditioning or heat pump
/ l �%l (requires site plan showing placement) 14.00
City /State/ZIP: 1)01 A_ I r � 00. 9 3 _ y / 3 Furnace 100,000 BTU (dams/vents) / 14.00 , J
Suite/bldg./apt. Project r
no.: Project w n O j,,�� Furnace 100,000+ BTU (dram s/veats) 17.90
i�2� to . _Gras heat pump 14.00
Cross street/directions ections to job site: Duct work I0.00
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: Lot Flue/vent for any of above 6.80
•
Tax map/parcel no.: Other: i 10.00 .
Other fuel appliances J
DESCRIPTION OF WORK Water heater 10.00 _
Gas fireplace _ 10.00
Flue vent for water heater or gas
`4- i ? Go S Pit r ,,� v; C.e, fireplace 10.00
i Log lighter (gas) _10.00
• c '�l CGS 1p,) -+ as U nQ Wood/pellet stove 10.00
tl Wood fireplace/insert 10.00
PROPERTY OWNER o TENANT Chimney/liner /flue/vent 10.00
Name: 1 V 1) lR Q ` ,� I Other: 10.00
�/ J Environmental exhaust and ventilation
Address: 7( r' s \ �1. k S} Range hood other kitchen
f } ( 11 � Cl
equipment 10.00
Ci ty /statefLlP: o �� �7
3� 9��� clo the s t:xfiaust 10.00
Phone: ( ) 7,1 Simgle -duct exhaust (bathrooms,
0 / Fax: ) toilet compartments, utility rooms) 6.80
❑ APPLICANT I Nt CONTACT PERSON . Attic /crawlspace fans 10.00
Business name: Other:
10.00
Fuel piping;
Contact name: 51111‘1 i,I L) 55.40 for first four, S1.00 for each additional
Address: . V4 Furnace, etc. !/ 5 y i. " Gas heal pump CitylSrade/Z�:
1 , ` Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
E-mail: •
Fireplace
Range
CONTRA OR Barbecue
Business name: W .e 1-et r \` in q- `o �I 415 . . Clothes dryer (gas)
Address: 14 14 SL) .A 1t e r . A ti , ¶} D Other.
T t y'c MECHANICAL PERMIT FEES*
City/ State/ZIP: u ef4oet. Og_ q' oo 5 Subtotal re yv
Phone: ( ) 647- Fax: ( ) 5 q 3- 36g3 Minimum 702 -50
permit fee (572.50)
Plan
ge (12% of permit fa Plan review (25% of permit fee) -�-
CCB lic.: 1-16r7 O ,
State a review
1 , 70
%
�7 TOTAL PERMIT FEE �,
Authorized signature; ure: y g
This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Print name: ir'y R nit t
/ I Date: l -a-R-O y r • Fee methadotog;v set by T1'I -County Building industry Service Beard
LauildirsF4xmesIMEC-PermitApp.doc 01/1907
44o-4617r(1IN2/CODNWEB)