Permit CITY OF TIGARD MECHANICAL PERMIT
1111 COMMUNITY DEVELOPMENT Permit #: MEC2009 -00530
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/07/2009
Parcel: 2S114BB10000
Jurisdiction: Tigard
Site address: 10352 SW PICKS WAY
Subdivision: Lot: 0
Project: LaGrange
Project Description: Replace gas furnace
Owner: FEES
LAGRANGE, MARYLIN J Description Date Amount
10352 SW PICKS WAY Furnaces < 100K BTU 10/07/2009 $46.75
TIGARD, OR 97224 12% State Surcharge - Mechanical 10/07/2009 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 10/07/2009 $43.25
Contractor:
SUNSET HEATING & COOLING
0607 SW IDAHO ST
PORTLAND, OR 97239
PHONE: 503 - 234 -0611
FAX: 503- 234 -0439
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
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 -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: jittd d/f Permittee Signature: c p� j
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.
., 7 -
£ -- .10'/07/2009 07:24 5032340439 SUNSET HEATING _ PAGE 02/02
' M e-
Permit Apnlicati . I OR uI II( I.: I til O \I.1
City ofTigard ECEIUED Ditte/By: PcmitNo.JJG L i - (JUs30
13125 SW Hall Btvd,, Tigard, OR 972 /"tt/
Phone: 503.639.4171 Fax: 503.598.1960 D R lBy; Other Permit:
I Ir ; A I: t) inspection LinC; ;43.639.4175 OCT 0 7 2009 Date Re'dyf3y: curia: ® se< Page 2 for
Internet: www.tigard- or.gov Notl &cd/Method: 9appkmento tatbrmatten
� • CITY OF TIGARD - ,
h ,: r )99 r� � `a ,Z ilk"' Yv;4 r , tr ued $7 . 7 . c GG , v7 a I X<<C• :, p }' f ., �7 `i n'i + .1,77; 1,71777,717:477.17;,7; : � , -y
I c .:,:dd ` �. .!.G:';".- l, .:l1n"-[.Vei !:' {{ ^L } ,, ! i ; m✓, A S 1, ; I i i l l
1�k , A.- , : , .X,F.'- 3,4 r .....,.1 .)W.,�as. 3.c sI .,1.fi:', ci � � � .. ., . .
0 New construction %Addition/alteration /replacement
Mechanical permit fees* are based o the value of t work
[] Demolition Other; performed. Indicate the value (rounded to the neatest dollar) of all
1't Ey Demolition
arr }[," r" - r -r s ...r r [ry er + �r r mechanical materials equipment, Overhead, profit.
Il,rn : X ".,9� 17, la i �ey {0 • yt l any. r tr. 1 .iC i Value $ iBbOr r0
p 7 � 4 D, o and
- �0. .,. 1;_ SYiL. ,J.. .s,'6 . r- i..i t"$11 4�^1 .�. stR4t.._ �4..r+M .�r c k� P 5 ,3x- - .... ,L'il∎': r •1! /1 + rVS-7 . - 7 ' - �. L7^
till 1- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building
special i
❑ Multi -fmil For nformation use checklist
Y ❑ Master builder ❑ Other -
jr Description T
, :� li } , ri i , ro - + ;� 1 f".-r"P?' ✓r, :m,r„•er . - Ffi p L e°l o ?. t y19s s { I I , 7 . 7 p Qty. E. I Total
lit 1'.�:,:i n PR' .. .t ,iL " r) Fes• rlia.. _ :: i t a b 7t re
ylic R "- 11� l 1 wA. x ! .. i M t - u `
�� }e.!+•,nt1 .r•+ • � ..+ �rM; Af- dr�ycdJ .,lwlm trrMkct•,t�r+mi r i m '.e� �t„ �.1 ,,. ; , :t)14r�2:? HeaBeit�rooling
Job silo address: 0351 �+ Air conditioning or heat pump
_l t Al S 1 t.44 1/ *quirts site plan showing ptaegment) 14.00
City/State/ZIP: 1 1 - -- . Furnace 100.000 BTU (duets/vents) 14.00 14-
Suite/bldg./apt no.: Project name; 1•�. 1bl�� Furnace 100.000+ BTU (duets/vents) 17.90
J_ Gas heat pump Iq,Op
Crows strcct/directians to job site: Duct work 1000
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00 _
Unit heaters (fuel - type, not electric),
in -wall, in- duct, suspended, ctc. 14.00
Subdivision: Lot no.: Flue/vent for any of above 6.80
Other, _ _ 10.00
Tax map /parcel no.: Other fuel appliances
....,...W :_.ra -
t� y' �1��,'� r ir11 T 1 + �'+ ,1 'yf •. i ° ^ 's`. �'u+tq I � s�r•'�rl I' f a rr �rm�i °P l 1' ils� ll 4�,�u_a Water hCatef 10.00
h y 4arL °•1 �,i ,3WLr,i.r3c�r<,i � 1P. n i +N e f •�Rr e+, nua l r Di , i a d � s�� i� , n , �
Lr N, _ri,.tr.ltr�ihin..ntrc ��Yl>i�. �' -���e '+)���.! r�,Y.u.`. °�.+:.f /v. ���..,lLali.�ii9
F Gas fireplace _ 10.00
Flue vent for water heater or gas
_fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove .10,00
Wood Iiireplacciinscrt 10.00
�, L I } 59�," 70. i. .J n 1 t�,tF�r) 'f c {{�LL .SG 1.1.,,,,,,,,,,71:437, 1. r`r �; �", r, � ur .. Chimney/liner /flue/vent 10.00
.41,ri IF�ile t o n.. - 110.4 ,,. ffifd:r, a `� ,11 9f"_•i,..,,m: 1 r t , t .! ,m i.A.. i A.i.r,
Other 10.00
��(i�a -; Environmental exhaust and ventilation
Address: yl �. / ^ Range hood/other kitchen
- equipment 10.00
City /State/ZIP: Clothes'dryer exhaust 10,00
p Single -duct exhaust (bathrooms,
Phone: ( ) D- -1A • Fax; ( ) • toilet compartments, utility rooms) 6.80
OE ' � ; i4.'"ibl �ye R yfp (rF� a 1''�" ?F N i "�r' I t ty 7
,, 1u�li L ,..a. w t ^:R6.'�" �?'i'k.V`�•" � ;,,.,, r�� � ;tS�;r `{ t ',,� cy;rk`+f4a Attic /Crawlsacc fans 10.00
Other. I 0.00
_Fuel piping
Contact name: $5.40 for first four: 31.00 for each additional
Address: Furnace. etc.
-.-_ Gas heat pump
City/State/ZIP: Wall/suspended/unit heater - •
Phone: ( ) a Fax :: ( ) Water heater
E-mail: Fireplace
rr� V7 ", '�r � i' �5 S m•" - m �.•v+ m : h t 't . Range
Y ; LL1 ��IYJIG.FA' .�Lti:�ifq' yS$Y,'Fl iw$ 4» �.'s:L, � O 1 r�( g1ags �le�I 'i�vlC �'Y''� �' 7i"7f r ' din { I ., .. i Barbe
l�t'ahal.tn� .1,4a ar.:.,.. f..t, -i. � : :�h u
Business name: Sunset Renting & Cooling Clothes dryer (gas)
-
Address: 0607 Sw Idaho St Other
..),t- .1"u,St i " 7 ; 7� , �, F i.l°i t • t ri I I - i i" ` < 4 ' t
City/State/ZIP: Portland OR 97239 Subtotal IU
Phone: (503) 234 -0611 Fax: (503) 234-0439 Minimum permit fee ($72.50) a,
CCB lie.: 161085 - _ Plan review (25% of permit fee)
:� � _ - permit �
State surcharge (I2% of permit fee) - !V �(7 -
ALL. TOTAL PERMIT FEE Q O
Authorized signature: This permit application tapir's if . permit t b b obtained within. tea oil
days after it %sa•been ateepted as complete.
Print name: S11,41,4.vk1- a 11 Lo -1 Date: 1 g 0 1111111111111 • Fee me thodology sct,by Trl County Building industry Service Board / S•
+: 1 $ uildingl Permltl \MEC- PermliApp, Coe el/l 440.4617 (It/O2ICOM/WKH)
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