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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2009 -00085 F 13125 SW Hall Blvd . Tigard OR 97223 503 639.4171 Date Issued: 03/03/2009 TIGARD Parcel: 2S 114BB 15300 Jurisdiction: Tigard Site address: 10375 SW RIVERWOOD LN Subdivision: Lot: 0 Project: Hartley Project Description: Replace gas furnace. Owner: FEES HARTLEY, PAMELA J Description Date Amount 10375 SW RIVERWOOD LN Furnaces < 100K BTU 03/03/2009 $14.00 TIGARD, OR 97224 12% State Surcharge - Mechanical 03/03/2009 $8.70 PHONE: 503 - 684 -5877 Minimum Fee Adjustment - Mechanical 03/03/2009 $58.50 Contractor: A -TEMP HEATING & COOLING 16000 SE EVELYN ST CLACKAMAS, OR 97015 -9519 PHONE 503- 650 -5014 FAX: 503 -557 -2990 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: R -3 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 questions to OUNC by calling 503.246.6699 or 1 800.332.2344. Issued By: L �n J LN ^ Ls Permittee Signature: C S ` ,� �J kiOr1 K +(` 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. 02 %27/ 12:04 5035572990 , —TEMP HEATING PAGE 02/02 Mechanical P0:1_1 _Ili .t Iic t 0 FOR OFFICE USE ONLY p��f1G 71 City of Tigard 0 09 Received A - 07 .Ock . Permit Nn11/1Lt 1� -VIM) �J ogteisr " 13125 SW Hall Blvd., •Tigard. OR 97223 Plnn R�ie,v : ;, Phone: 503.639.4171 Pax: 503.598.1960 C � IGARD Dntcw, O her Permit TIGAR.D Inspection i.,inc: 903.639,4175 pi96 f0y; Date RcnctwIlvi MM.: 1Z( see Pogo 2 far Interact: tvww.tigarti- ot',go \' Nati CthoQ n TI l� Supplemental tnfarn,atlnn T'•VPV bF 'WO'Rlc COMMERCIAL FEE" 5C1#x l)IJLL -- t1St C'1IECJU ISt' Iti1�t1U construction /�ddit10t1 /niterttUOn � y1nt. meu Y, Mechanical permit Cdr "' are bayed on the ":11ue of the work performe(1, indicate the value (rounded to the nearest dollar) of alt ❑ 17entolition ❑ Other: mechanical materials. e(luipment, Inbor overhead. and profit. C`AT1`+;012'1,'.OT CONSTRIJCt1ON „ Value: 1 -and 2-1 d ItlCb LQC11I'rtT�l`r'f rfsl s� t'iu�1� FEES« yelling El Con /industrial ❑ Accessory building For special irtjortnatfon use checklist. lD Multi -family 111 Mastcrbt,tilder ❑Other: 17 cscripn .Qty. );n, 1 Total . . 11:iii 91TE IiNr.OHISix1crliri r..N17` beating /cooling, Job site cddress. LO 2' 5 5 1� V c r, f �b06 1 Air the i conditioning hn ha pump J * ^*,,,� -- (rcgniressitc - plan showing placement) • ( /St ate / Furnace 100.000 BTU (duos /vents) 714.00 14.00 , SIP: . Furnace 100,0001.13TU (duct_clvcnro) 17.90 Saito /bids. /apt. no.: Project name: p;,s heat pump 14,00 Cross street/directions to job site: �' Duct work - 14,00 Hydrroonio hot water system I + Residential boiler (radiator of hydronic) 14,00 , . - _ .m „ . T -- Unit heaters (fttel- type, not electric), in -wall, in -duct, suspended, etc. 10.00 Subdivision: y. � � I Lot no,; „,T Flue /vent for any of above -�- __ 10.00 _ __ Other: Othe 10.00 I'm; map /parcel no.: Other fuel applinncel, .- ':1S,S`C'R1'l l Pl \li,P,I Water heater 10,00 • + r G fcrcplacc _ 10.00 T ,.7 �, I. Flue vent for water heater or gas - dace _ 10.00 - - Log lighter (ga) 10.00 -- mm _ _ �.^� Wood/pellet stove 10,00 ____ Wood lircplacc /insert 10.00 r cat 10.00 RO I'C12T `' 1`fY t ©'TENr1NT Ot ev /liner /t ugh Other: 10.00 Name: . Environmental exhaust and ventilation Address: ' ' ` 1 1 _Q f � / • p ■ Ran hnpd /ot kitchen W +4 -Y e, 6� ^ L - � . i = J . cgnipntCnt 10.00 City/State/ZIP: ,r" . S `4 i Clothes dryer exhaust 10.00 --l! Singk -duct exhaust (bathrooms, Phone: , 0 ", 4 fah ( ) toilet compartments, utility rpops) 6.80 1 AP00,00T; ,dCON P]1kSOk , ,, Attic /crawls pace fans 10.00 _ Other; 10.00 — Business nro c; _ Fuel piping Contact name: &TEMP HEATING AND COOLING, ir' : $5.40 for first four; 51.00 for each additional 16t t. L t. -- . —„ Furnace, etc. Address: (R ( )'i(? i5 - ,__ -- - -- Gas heatpum _ City /State /ZIP; 503 -650-5014 Walt /suspended /unit heater Phone: ( ) Fax :: , SD �r 5""1 ",G1 al. 0 Water heater ____.— Fireplace E lnnil. Range i , t�ON I I2A Ct �JI� 13 irbecne :,:. ....�.: _- �.... -...� Clothes dryer ( pas) .�. Business name, A-TEMP z � C A �L � Otllcr, - Address; • 1 SE Evelyn St. 'MECHANICAJ, PERMIT Ft ES* 90 • City /State /7.1P: ( • I I - Subtotal 1 � Minimum permit fee ($72,50) ?2- Phone: ( „ ) Fax: ( ) — _ - _. „.,.._._ Plan review (25"a of permit fee) • A i COB lie.: State surcharge (12% of permit fee) _; • TOTAL PERMIT FEE .�..0 ." ed St ire: ill"" This permit application m Ober. If n permit is not nbtnlned , thin 180 4 _ ‘ A+ 0 ��'' ill "" days after It has been accepted n cnu,Plete, dr • 2 U [ name, , rl fir . , er I Doe: ' E w Pee methodolo cet h Tri Cnunty Building Industry Service Board l 1',1 R„lldi,A\ Perils \t4tiC- Ttrin1tappr�.dnoo 04 /06/06 4,10,4617 111 1071COMnVE.)