Permit •
r
.7' CITY OF TIGARD MECHANICAL PERMIT
1 1 4 2 COMMUNITY DEVELOPMENT Permit #: MEC2009 -00489
Date Issued: 09/16/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1 S133DB03600
Jurisdiction: Tigard
Site address: 11565 SW SHEFFIELD CIR
Subdivision: Lot: 0
Project: Short
Project Description: Furnace replacement
Owner: FEES
SHORT, CATHY Description Date Amount
11565 SW SHEFFIELD CIR Furnaces < 100K BTU 09/16/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 09/16/2009 $8.70
PHONE: 503 - 261 -7620 Minimum Fee Adjustment - Mechanical 09/16/2009 $58.50
Contractor:
MECHANICAL INC
PO BOX 19569
PORTLAND, OR 97280
PHONE: 503 - 244 -1730
FAX: 503- 245 -7613
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
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: littik,eat jkt)tt Permittee Signature: i l /
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.
m& ef1,9t /e z _
0 . 4 A•1!Se p. 15. 009?t11:2 ANb llicati No. 1509 P. 2
City of Tigard CEIVED Reeeived I t,It 0., I( 1: I: ' uNt,y
• 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: pamtitxo./Ix�E;'Un� �
' Phone: 503.639 4171 Fax: 503.598.1960 plan Review it ir
. 1• I (. n Jl E, Inspection Line: 503.639.4175 S E P 15 2009 Date/ey; Other Permit
Internet www,tigard- or.gov Dote Ready/By. Jab: III see Page 2 tor
CITY OF TIGARD Notified/Method:
a µ Y J� x riE' rc Sepptemental IMormetion
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❑ New construction Addition/alteration/replacement Mochanieal permit fees' are based on the value of the work
performed. indi
❑ Demolition Other:
❑ e value (rounded to the nearest dollar) of all
„� mechanical materials e'
�y `i , „`; rr¢9 ;n ° ,> 1;7, or, r, i• labor, overhead and rofit
� � 4i+.rY ki: , N tSu+a Sr�,:lt� s i? � � a 1 � t� r B!S , (° � �. i � ��,. ���y+'���""��•",��' %iN�
• .,4,4aLli ; :;:mrs kv; 'S. . c, n �.,,-, d „; 11 r�r ti we
Accessory rw ,r , 1 r at Epa t � rx
CI 1 ^D A II l , � r� 'x'��'�'
Multi-family c essory bu ilding m 1 C: :+ • ., .� :r.'�. ^i ? t�`.'t .��t��'"x ,:1� { ;i a
MI- and 2- family dwelling ❑ Commercial/industrial
y ❑ Master builder ❑ Other: , f . .
• . ` jrt. ,{iiT,tir,1�,1y -t n „ w _ l�e9er1 don
_" r ��li Fd) ,I f�Tf f � { j JE hllY C'J /a • �y�i •'�I C'' • �t N R1 { 7 6 ,y;,r r K 1r r r1 •
~.,. Vi"� y t '/ ?4. : i T :,{M c 1 1 )•: 4i' (iP 1P ><- t i 9''1 i i JAAr e,cr ,``!]�ly,. i �7 � Xf� Ea. Total
1 14 :.0.. :e_:. .h" . Y1': r."Pkr. K/ sf.... .. ''' 3 %. __2.: Beatin; eon •
• Job site address. �` ' . , Air conditioning or he pump
City/State/ZIP: • -
ea site • .. theme , tecement m 14.00
Is► + • Furnace 100 000 BTU duets/varn r� 14.00 IIIIIII
Suite/bldg /apt. no.: Project name: � 1 . F . Furnace 100 000+ BTU duats/vente MI 17.90 ME
Cross street/directions to job site: Clan heat . um • 14.00
Duct work 111111 10.00
H dronic hot waters stem 14,00 NMI
-
Residential boiler (radiator or
h dronic - 14,00
Unit heaters (fuel -type, not electric),
in -wall in-du- sus•end - . etc. 14.00
Subdivision:
Lot no.: Plue vent for an of above NM 6.go NM
ax map/parcel no Other: 10,00
% L am`.✓• *'fro ti r`!jl^"• ayr+�.s .S t •4 r< ,�. ; , Other fuel a • , fiances
y,li af it A7 to t°i 107 c "J i7:� sSY 1 ro .T2,t lTl
� k "` ��'J':1".,r,! � ���� " r h eater 10.00 IMIN
�•�'a:j..r�• �r1� i,'',���5•�?�t:��&�,.r��M �'`�;.�„d:�,�`.,��,v..1�5 Wate
' w. a
Gas fire dace 10.00 JI Flue vent for wear heater or gas III
fire • lace 10.00 r
_ 10.00
-- Wood/.ellet stove 10.00 MEM
f � Wood tart.1a e/insert 10.00
° t� °. V ] 'r JI i M1 r•WAr°. l t• s l a p p iAskt 'v're:..4. ,Ttt r.r " -
ri 1 ��w ^S.tk'rF:L�r3rt '�+ I! }..w Il�e�l�ts.n1i 10.00 NMI i
•
Name: 0, C 6 f4 other 10.00 r
Address: 4 J Environmental exhaust 2nd vendladon
�� , e ,.. Range hood /other kitchen
City/State/ZIP: y ~ .ui•ment 10.00
0i'Z • Clothes . •r exhaust MI 10.00
Phone: "r► O Fax: ( ) Single - duct
exhaust (bathrooms, rooms ,
�-- .,�,,, , R , x � 1 toilatcom.artmonts udli roo 6.80
V C.1b ' ;,� 5 . i D I7 ,. ,r .i l 077,1 j t i p � ff.3`� 1,;. ! . +{O = R FJ 'P It ,~' ` ' '
4- :. r ,..'�w cl 1 ,:t�6t?" ^ ,•i` ( 9� K u 5.. i . -.*?2 ,Le J; i q * . 1 1 .00
Business name: Outer 10.00
_ontaot name: 14,s Fuel , I.In_
A; $5.40 for first four; 91.00 fi r each additional
address: 4' IIIIIIIl
el.
.V
Fax:: (
qty /StatrJZIP: .4 � f M s, Wal Oas heat •um. ��
Wall/sus • ended/unit heater
'hone: ii - 1 6 �j �- 1 3 Water beater �_ MIIIII
i [!1' .. i ''( J'; '.`¢` . z- ti r.; l r r) `: a . / t ' �$L•'' r tS? ti x t k � ���
', . tartr A' Qt,i r 1 ' , rY' ° ur u m , . �R h�14. +I - 4 4 ! .1'„- '; : e . it i � ,y'!t4 BarbeCUe
a wJ,Y s ,ri tr41�h°ib17Y.S7'cY ���
usinoss name: A_ �tJ �
:
ddress: J - Othor �;,_ ��
Other:
r ' � �i f \ tai I f 1 i r T "'�'f "f' {�'•' '? '
ty /State/ZIP: .LL::r,t '4i. r .J•iy l` I) try p, v..
Subtotal r
lone. ( ) Fax: ( ) • Minimum permit fee (T72.50
State surcharge (12% of permit fee)
PERMIT FEE WIE
thorized signature* s TOTAL, RI 5,
Tme permit application aspires If a permit la not obtained thin 180
nt name: - �� days after It ha, teen accepted u Complete.
ii - - I I ...01 ' pee methodology Jut by Tri Cotmty Building Ind I
ildinoormitswec mitApp... oul e/07 g uelry Service Board ■
Per
44046ItT (11/01/COMNIEB)
•
r
.7' CITY OF TIGARD MECHANICAL PERMIT
1 1 4 2 COMMUNITY DEVELOPMENT Permit #: MEC2009 -00489
Date Issued: 09/16/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1 S133DB03600
Jurisdiction: Tigard
Site address: 11565 SW SHEFFIELD CIR
Subdivision: Lot: 0
Project: Short
Project Description: Furnace replacement
Owner: FEES
SHORT, CATHY Description Date Amount
11565 SW SHEFFIELD CIR Furnaces < 100K BTU 09/16/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 09/16/2009 $8.70
PHONE: 503 - 261 -7620 Minimum Fee Adjustment - Mechanical 09/16/2009 $58.50
Contractor:
MECHANICAL INC
PO BOX 19569
PORTLAND, OR 97280
PHONE: 503 - 244 -1730
FAX: 503- 245 -7613
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
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: littik,eat jkt)tt Permittee Signature: i l /
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.