Permit r
CITY OF TIGARD MECHANICAL PERMIT
11 m • - COMMUNITY DEVELOPMENT Permit #: MEC2009 -00385
Date Issued: 07/29/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S111CD01400
Jurisdiction: Tigard
Site address: 15606 SW SUMMERFIELD LN
Subdivision: Lot: 0
Project: Topolski
Project Description: Replace Furnace, install a/c minimum 3' side yard and 5' rear yard from property lines.
Owner: FEES
TOPOLSKI, CHARLES F Description Date Amount
15606 SW SUMMERFIELD LN Air Conditioning or Heat Pump 07/29/2009 $14.00
TIGARD, OR 97224 Furnaces < 100K BTU 07/29/2009 $14.00
PHONE: 12% State Surcharge - Mechanical 07/29/2009 $8.70
Minimum Fee Adjustment - Mechanical 07/29/2009 $44.50
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 $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: Permittee Signature: 6j/ /970,6/ e4_77
4 ‘01, 4,.. _
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.
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Mechanical Permit Application i • ( ) , z . ' • i • u i a , 1 ( 1 \ 1 1 1
City of Tigard R " " Z
~ Recei
13125 SW Hull Blvd., Tigard, OR 97223 � V 1 b • ��
a Phone: 503.639.4171 Fax: 503.59&1960 &/ ilL';:, Other Permit
] Inspection Line: 503.639.4175 •
I is :\i I JUG 2 7ZO , ir;, Ready/By: : RI See Page 2 for
Internet wwW.tigatrd -or.gov Notifed/Met ed:
C/ r • . U9 - Supplemental lafenwtioa
❑ New construction i / Addition /alteration/replace �I�. Mechanical permit fees* arc based on the value of the work
❑ Demolition � prmed• lndtcade the value (rounded to the nearest dollar) of all
0 O ther: mechanical materials, equipment. labor, overhead, and profit.
t '_ l y � :. ..t 1 i 1 7 y .,i n ylt }yd: a - r _ - , n .1.7,,, Value: $
}°4 I and 2 - family dwelling 0 Commercial/industrial 0 Accessory building For special information tan rJrreJdfst.
0 Multi family 0 Master builder 0 Other:
.. . � yet, ,...,, I Qty. Ea. Total
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Description
.,, t ..... ,., , � (,. � . .. �.,..:� .., r �.. , , -,; , ,,,_ r.n t Ikatiorr/coolinl:
_
Job site address: I Inp f Air conditioning or heat pump
I ` , •• - 4. (requires rote plan showing placement) l 1 a.00 l
City/State/ZIP: ` Furnace 100.000 BTU (ducts/vats) 14.00 f
pal Furnace 100,000+ BTU (ducts/vents) 17.90
Sttite/bldgJapt no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (furl -type, not electric),
•
in -wall, in -duct, suspended. etc. 14.00
Flue/vent for any of above 6.84
Subdivision: I Lot no.: Other: 10.06
Tax map/paraxl no.: Other fuel appliances
t r , r1.t f. tey.: r - t r ti { , . ,'. .i Water heater 10.00
!�t 1 ', C... !, i l I a ( a t . r ; .,
r .x.,,.. - • Gab finplatce 10.00
Flue vent for water heater or gars
et fireplace 10.00 ,
Log lighter (p 10.00
Woodlpellot stove 10.00
Wood fireplace/insert 10.00
,r 4 r 1 ' z
, . : t -nom t r i r,ry '. r G h r M ,( .dr • ) tr t pq Chimney /liner /fludvent 10.0()
e 7 . •, t t, 1 4 <_ i. , d r i . n .. t o t n . d n t t ' a 1
. . _,, . . ..a.., .. i _ ', �r._._1_ !!. t ._J i
1 .1:(._l �..e .:... ,',...=.:
,. -a... a. .. ..,...; Other 10.00
Name 41 .,A l ... 1 ` lap 618, t Euvironmeutal exhaust and ventilatiou -
Address: i 5(j), ti!)Ca ( . L p hood/other kitchen 10.00
City /State/ZIP: 7 4 . Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: 5 ) d..00 —1 'D- Fur: ( ) toilet compartments. utility rooms) - 6.80 _
I 1 ,t'` ,, .. - ;:`1.. `1". :- , - - ••ri_ •' ai ti ,. ' t , .," 7 , �(' ;!!f � I ^ �,1 y f A' � :.� i��' , 1 A crawl pale fans 1 0.00
..t ,.1,1.�.:...._ s_- _..,_ -ur {, ; + y • '_± 4 ` , ,u•r ..a: _.r r ,. ( J .� . Oth er: 10.00
Business name: Fuel piping
Contact name: $5.411 for Get four; $1.00 for each additional
Address: Furnace. etc.
Gas heat pump
City/State/ZIP: WO/suspended/unit heater
Phone: ( ) l Fax:: ( ) Water heater
Fireplace
E-mail: (,.r e �:.0 n a', .. }t� -.< ; t r 7 t i !! s
i,'`. i R ? t '.:1:12 1 c f s 1 o J•a f arb eCUC
Business name: Sunset Heating & Cooling Clothes dryer (gas)
Other.
Address: 0607 Sw Idaho St - °' : ; ;+ "',71'; 0 ;•:.••; - ;;• , ','
City/Statr/ZCP: Portland OR 97239 Subtotal 6 , -it
. .. Minimum permirfce ($72.50) '
- - Phone: (S03) 234-0611 Fax: (503) 234.0439 Plain review (25% of taermit fee)
CCB tic.: 161085 - . Stare surcharge (12% of permit fcc) • - - - - TOTAL PERMIT FEE ran
�+�
Authorized signature: • k - - - • • - -- - This permit application aspire if ■ psrmie jraot obtained within 180
y, t days after it has bore =opted as complete
I Print earne rFG , NA.I��r� i Ili / A AI . � - = Date: 1 !a'71. ) -_ • Fw method 'al-County sat try -County Building htdusny'Service Board
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SUNSET Site Plan
Fuel Company
Name & Address:
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