Permit r CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00204
13125 S W Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/24/2012
TIGARD Parcel: 2S111AD14200
Jurisdiction: Tigard
Site address: 14945 SW 91ST AVE
Project: Quayle Subdivision: MALLARD LAKES Lot: 8
Project Description: Replace gas furnace.
Contractor: TRI COUNTY TEMP CONTROL INC Owner: QUAYLE, MICHAEL
13150 S CLACKAMAS RIVER DR 14945 SW 91ST AVE
OREGON CITY, OR 97045 TIGARD, OR 97224
PHONE: 503 - 557 -2220 PHONE: 503 - 684 -4382
FAX: 503 - 557 -0919
FEES .
Specifics: Description Date Amount
Furnaces < 100K BTU 04/24/2012 $46.75
Type of Use: SF FlueNent For Any of Above 04/24/2012 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 04/24/2012 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 04/24/2012 $19.93
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
•
Total $100.80
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: 047 6
•
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
APR 09:51A FROM: TO: 5035981960 P . 1
Mechanical Permit ApPlicad IECEIVED - I (m mil( 1 liNI (m 1
City of Tigard Rec 9EtTAL-Prr p..„,No. „„ - &2O
.7 • 13125 SW Hall Blvd., Tigard, OR 97223
- Phone: 503.639.4171. Fax:..503.598.196A PR 2 3 2012 Plan Ravi
Date/By Other Permit
I RiAt I) Inspection Line: 503.639.4175 Date Ready/By: MI El See Page 2 for
Internet www.tigard-or.gov CITY OF TIGARD Notifled/lvfetbod: Supplemental Information
B I III DINfi DIVISION
i' •:;- .-...-:' . -..•:. TIVE`'OF'WORK ',' . - -, :., , - •,..`-f‘ 'F; . '!' ,-,- : .-,:;. : PF.0,FROEII44*4*(30.40.4ST';
El New construction 1:8:1 Addition/alteration/replacement Mechanical pennit fees' are based on the value of the work
perfonned.Indicate the value (rounded toil= nearest dollar).olall
CI Demolition 0 Other mechanical materials, equipment, labor, overhead, and profit
Value $
S JA ' rr / SiSTgNIS*4$
(81 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building . RE040 gOV
For special Wortnallost use cher
El Multi-family 0 Master builder 0 Other:
Description I Qty. I Ea. I Total
. .•
JOB -SITE INFORMATION NO. LOCATION .. ; , - ., . . : Heatitrajeneling
Job site address: 1 vg 410-Avenue) Air conditioning
, (requires aite Man showina placement) 4675 ,
City/Slate/ZIP: 8 412. 2 _4 Furnace 100,000 BTU (duns/vents) i 44.75
Furnace 100,000+ BTU (ducts/vents) 54.91
SuitetildgJapt. no.: Project name:
Heat pump 61,06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fiiel-type not electric),
inmalt suspended, etc. 46.75
Flue/vent for any of above I 23.32
Subdivision: I Lot no.:
Other. " 23.32
Tax map/parcel no.: Other fuel appliances
DESCRIPTION -OF WPF " , • • • , -• ' ' ' -2332
...,
Gas fireplace 33.39
Flue vent for water heater or gas
Rfplaco gm fumao fireplace
Log lighter(gas) 23.32
, 23.32
Wood/pellet stove 33.39
Wood fireplace/mutt - 23.32
Chimney/liner/flue/vent 23.32
;.:, '• XL PROPERTY . OWNER •.-. -,. - ' I. 's '. , .•,:..,
• Other 2332 i
Name: WIZ 0 uatil e, Environmental exhaust and ventilation _
- Range hood/other kitchen
Address: &WIC, equipment . 33.39
• City/State/ZIP: . Clothes.dryerexhaust 33,39
,. . Single-duct exhaust (bathrooms,
Phone: (28) (164-geg. Fax: ( ) toilet compartments, utility rooms) 23.32
ArkiCANT: 1 .,: :..'.. : '''. z: :, CONTACT : Sii-40 4 -';' • ', AnickrawisPac4 fans
. Other. 2332
_ 23.32
• Business name: Same as contractor Fuel piping
. ,
Contact name: Diane Mason $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address:
(las heat pump
City/State/ZIP: Wall/suspended/unit heater ,
Phone: ( ) I Fax: : ( ) Woo:theater . ..
'
Fireplace
E-mail:
- -- . - •
, ... , • , . CONTRACTOR Bartecue
Clothes-dryer (gas)
Business name: Tri County Temp Control
Other: .
. Address: 13150 S Clackamas River Drive ftliC144IC41:!PEIWITI*A . . ; ? •
City/State/ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee ($90.00)
. Phone: (503) 557.2220 I Fax: (503) 557.0919 Plan review (25% of perndt fee)
CCB lic.:12623 State surcharge (12% of pennit fee)
. ectio
t TOTAL PERMIT FEE 11J
Authoried signature: .)22414 61 This permit applleadon expires If a permit Is not obtabsed Within ISO
days after It tura been accepted as complete.
I Print name: vianc, moon I Date: 4/14g- • Fee metbodnlog set by Tri-County Building industry Service Board
INkilldIngWermitAMEC-PannliApp.doe 10101/09 440-4617T (11/07/COMATED)