Permit t .
CITY OF TIGARD MECHANICAL PERMIT
11 11 2 :`. COMMUNITY DEVELOPMENT Permit #: MEC2009 -00199
Date Issued: 05/06/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S1146C00600
Jurisdiction: Tigard
Site address: 10155 SW RIVERWOOD LN
Subdivision: Lot: 0
Project: Anderson
Project Description: Add (5) ducts in crawl and exhaust duct in bath.
Owner: FEES
ANDERSON, LEIGH C /LEANNE P Description Date Amount
10155 RIVERWOOD Duct Work 05/06/2009 $10.00
TIGARD, OR 97224 Single Duct Exhaust (Bathrooms, Toilet, 05/06/2009 $6.80
PHONE:
Utility Rooms)
12% State Surcharge - Mechanical 05/06/2009 $8.70
Contractor: Minimum Fee Adjustment - Mechanical 05/06/2009 $55.70
THERMAL FLO INC
7236 SW DURHAM RD 100
PORTLAND, OR 97224
PHONE: 503 - 670 -8343
FAX: 503- 598 -6746
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
issuanc . • uspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili otification Cente . T e ules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
Is ued By: L / � Permittee Sign: / / .011Wirj,
Call 503.639.4175 by 7:00 a.m. for an inspection that busi • s 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.
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05/01/2009 15:57 5035986746 THERMALFLO :0347 P.002/002
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Mechanical Permit Application FOR OFFICE USE SLY .
City O Ti a nd a a n Received ,t'/ ,
g 1111 � ,! DateBy: 4 , , �J t' P ermit No.: fled ,40...- 09/9
a 13125 SNr Hall Blvd., Tigard, OR 97223 �. _ ; -.1 plan Review Other PCrnnl'
Phone: 503.639.4171 Fax: 503.598.19' Dale/By:
Inspection Line: 503 (39.4175 pt��/ i r,
TIGARD Interne[_ www•tigard -or._ov WIHt 0 ti . 2009 Date Read /By a P1 See P e2for e
Notified/Method: Supplemental lnformxtiun
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. . .. TI'�E 'OF wUR a'. _ yy 1 ,I . ( .t;
.. , , COMIVI,,RCIA T L .* S G'IIl^+t,I)UL . C'SE :(HP,CICI;TST.
'� �11_tI °' "`:
kS Mechanical permit fees" arc based on tltc value of the work
❑ New construction Addition /alteration /replacement performed. indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: - mechanical materials, equipment, labor, Overhead., and profit.
Value: 5
Sill Jf [ALQCII►43 1\ I /:SYSTF�MS FEE5',
l:i i and 2—family dwelling ❑ Commercial /industrial ❑ Accessory building
Fur vela' information u.Se Checkl ds;.
D Multi - family ID Master builder ❑ Other: Description p Qty. Ea. Total
.JOB SITE::I FOR1 iOl\ .ANI.> . •OC:4TIE3:N . �' lydeatinFiccxilin�o
t�� / Air conditionin5 or heat pump
Job site address: 1p �` ! • 0p/ ouires site pi showing piacemcml 14.00
City /State/ZIP: / /,! , f I z 91144- Furnace 100.000 BTU (ducts /vents) 14.00
Furnace 100,000-- BTU (ducts /vents) 17.90 •
Suite/bldg. /apt. no.: Project name: y / Gas heat pump 14.00
Cross su�et/directions to job site: Duct work
1 1(1.00 IiD �"
- f T'Ivdronic hot water system 14.00
Residential boiler (radiator or
hvdronic) 14.00
• Unit heaters (tact -type, not electric),
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in -wall. in -duct. sus erased, etc. 14.00
I Flue/vent for any of above 6.80
Subdivision: Lot no.: Other _ 10,00
Tax map /parcel no.: Other fuel appliances
Water heater 1 10.00
- 1 Cray' fireplace 1 1, 10.00 1
Flue vent for water heater or gas
/ I► j B '' / y fireplace 10.00
'/ /+ � 1.0" burner (gas) I 10.00
et Ta! 10 &id Wood /pellet stove _ 10.00
Wood fireplace/insert .. I 10.00
PIGQi tT'I CJiWNEIt L TJS NAr T 10.00 j
Ot chimney/liner/flue/vent cr: 10.00 . 1
h
Name: / • l'i db►e)�,, Environmental exhaust and ventilation _ _ _
�" Range hood /other kitchen
Address: equipment 10.00 _
City /Statc/ZIP: /— .1 Clothes dryer exhaust I 10.00 _
y � ` ite-d exhaust (ua s, `
Fbanc I ! 170/2 )
t Fax: ( toilet corn tirtrutients rrtlu, utility lity rooms) 1 6.R()
p Auic/crawispace tarts 10.00
A'PPLIC : :: �,,;:(.0Nt CACF' kERSnN . . •
Other: j 10.00
FFusiness name: Fuel piping
Contact name: 55,40 for first four; S1.00 for each additional '
� . /�I //! r Furnace. etc,
Address: l
Gas heat pump
City /State/ZIP: • y Wall /suspended/unit heater
mm
Phone: ( ) • . i Fax:: ( ) Water heater � _._..�
/�_`��/- _j Fireplace
E -mail: o'Gil,e l /at � l�(r m..
... �CON`TItAC'TO i. .... b
Business _ 7�? '�?? / Flo r' Cl oth:; dryer �`a
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Ad s: dl/ i / / - T . . c )ther:
1 . 'MEQrI NICAL,P`ERMit.FE :..• :.:.. .
� v ��r � tDD j � � J
City /Statc/ZIP:./"tpr� /�'L-G�-., 1.�Q`, m_ Subtotal j I
Phone: �~ Fax - % !1O ' Minimum permit fee ($72.x(1) • '
,
f P im review (257o of permit feel .
0 GCB lie.: / I State surcharge (12% 0 of pennit fee) R. �Q �
or TOTAL PERMIT FEE 1 • r
This permit application expires if r permit is not obtained within 180
Authorized gignatu _ / . r./ '' i 1 days after it has been accepted as complete, •
�-J ` '1 • ;cc methodology et by '1'ri Count) Building lndtst - y Scrv�er Posrd
Print name: !a / / f f G Dar,.. .