Permit CITY OF TIGARD MECHANICAL PERMIT
III
■ COMMUNITY DEVELOPMENT Permit #: MEC2012 -00223
TI G A.p. f? 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 05/08/2012
Parcel: 1 S134DD00400
Jurisdiction: Tigard
Site address: 10805 SW TIGARD ST
Project: Bob /Chris Fitzgerald Subdivision: 2004 -050 PARTITION PLAT Lot: 2
Project Description: Replace old 80% furnace with new 95% gas furnace
Contractor: RELIANT PLUMBING & MECHANICAL Owner: FITZGERALD, CHRISTINE ANN
11575 SW PACIFIC HWY SUITE 219 BURGHARDT, JOSEPH WILLIAM JR
TIGARD, OR 97223 BURGHARDT, THOMAS JOHN ET AL
10835 SW TIGARD ST
TIGARD, OR 97223
PHONE: 503 - 246 -1201 PHONE:
FAX: 503 - 246 -1205
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 05/08/2012 $46.75
Type of Use: SF FlueNent For Any of Above 05/08/2012 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 05/08/2012 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 05/08/2012 $19.93
Stories:
Fuel
Fuel Types:
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: Ji Q Permittee Signature: b A PPu all 1)ik)
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.
May. 4. 2012 7:34AM Rel ient Plumbing and Mechanical No. 5368 P. 1
Mechanical Permit ApplicaVECEIVED FOR OFFIC:E USE ONLY
City of Tigard Received
if fcs P. i. 1 .: • '' 00 2-3•3
I " 13125 SW Hall Blvd., Tigard, OR 97223 i A A 4 2012 Plan DaDate/BY: Review
' 1 ' Phone: 503.718.2439 Fax: 503.598.1960 - - - Other Permit:
DarefBy:
I 'AJAR')
Inspection Line: 503.639.4175
Ell RI see Page 2 for
rn
Inteet: www.tigard CITY OF TIGARD Nol Supplemental Information
BUILDING DIVISION . . .. ..... ...... . .
. . . • ; • • : : ; . . : . TYPE . OF WORk . :: . ::::: !. .. ::. ;.: : ..:. : . . L:".: .:: ,••• :: ,. : 1.::.c.Or.40Eftr44: PEE* •S(*.#4::iNAPICUIS1'....
. .: .
Mechanical permit fees' arc based on the value of the work
0 New construction 0 Additi n/alteration/r lacement performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition I:1 Other: mechanical materials, equipment, labor over ead and profit.
Value: $ f
. : CATEGORY OF CONSTRUCTION • . • . . .• . . • • ..
• • • • • • :.: • . agS . q : $0 FIEF
Fa 1- and 2-family dwelling 0 corrimerciavindustrial El Accessory building For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description I Qty. I Ea. j Total
-
1013 SITE INFORMATION'AND:loapioN' .:i ::',' : ';' •::: , .f: • :::,: ii!Rtiow 01 DR:
• Air conditioning
Job site address: 10805 SW Tigard Street (requires site plan showing placement) 46.75
Furnace 100,000 BTU (duets/vents) 1 46.75
City/State/ZIP: Tigard Oregon 97223
Furnace 100,000-r BTU (ducts/vents) 54.91
Suite/bids/apt. no.: Project name: Bob/Chris Fitzgerald Heat pump
. (requires site plan showing placement) 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 (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 46.75
Subdivision: Lot no.:
Flue/vent for any of above I 23.32
Other: 23.32
Tax map/parcel no.: Other inel appliances:
. . . ; ' ' : , .:; ' . ... • DESCRIPTIOKOP. WOR1C:• : • . ::: .„:::'.:. .::::.'::: : ..;:: , Water heater 23.32
Gas fireplace/isert 33.39
Replace old 80% furnace with new 95% gas fuance Plue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood keplacc/insert 23.32
. .. .. Chimney/liner/flue/vent 23.32
:' El: PROPERTY OWNER . • • j : •• ' Li Itonn .".:: ••• . :': :
. .. . . . .. . .. Other: 23.32
Name: Bob Fitzgerald Environmental exhaust and ventilation:
Address: 10805 SW Tigard Street Range hood/other kitchen
equipment 33.39
City/State/ZIP: Tigard Oregon 97223 Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: (503)901-0973 Fax: ( ) toilet compartments, utility rooms) 23.32
. . . - .. la,C01!rfACT.:pg4oN. ... ,. Attic/crawlspace fans 23.32
Other: 23.32
Business name: Reliant Plumbing and Mechanical
Fuel piping:
Contact name: Ryan Hambleton $14.15 for first four; 54.03 for each additions!!
Address: 11575 SW Pacific Hwy Furnace, etc.
. Gas heat pump
City/State/ZIP: Tigard Oregon 97223 Wall/suspended/unit heater
Phone: (503) 246-1201 Fax: : ( ) Water heater
- Fireplace
E-mail: ryan®reliantplumbing.com Range
... . •: : : ' r :':• . :• E ::.: ' '::: E. 01q*AOr.011:i ::: !: ;: ;s :: ::: : .::: '. 1 : ..:.;:; '1c, .::: Barbecue
Business name: Reliant Plumbing and Mechanical Clothes dryer (gas)
Other:
Address: 11575 SW Pacific Hwy :::::.::: ;:::.:.:;;' .:. i :: : : : .1 q0 1 ,APAC4. 1 *-01.r. 1 r0.0 ; !`::•! •.. ... .. '. .
City/State/ZIP: Tigard Oregon 97223 Subtotal 70.07
Minimum permit fee (590.00) 90.00
,Phone: (503) 246-1201 i Fax: ( )
Plan review (25% of permit fee)
/ CCB lie.: 169844 4kkki-11,
State surcharge (12% of pcnnit fcc)
TOTAL PERMIT FEE 10.80
Thb permit application expires it a permit is not obtained with tV
Authorized signatu d' Amor days after it has been accepted as
Print name: name: Ryan ' 'n . ,/on 1 Date: 5/3/2012 4 Vac methodology set by Tritounty Building Industry Service Board
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