Permit CITY OF TIGARD MECHANICAL PERMIT
': COMMUNITY DEVELOPMENT Permit #: MEC2009-00129
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 03/26/2009
Parcel: 1S133CD15100
Jurisdiction: Tigard
Site address: 11577 SW TALLWOOD DR
Subdivision: Lot: 0
Project: Carpenter
Project Description: Install furnace.
Owner: FEES
CARPENTER, PEGGY A & HAROLD P Description Date Amount
11577 SW TALLWOOD DR Furnaces < 100K BTU 03/26/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 03/26/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 03/26/2009 $58.50
Contractor:
OHAC INC
PO BOX 241
DUNDEE, OR 97115
PHONE: 503 - 538 -2953
FAX: 503- 691 -8556
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
' r
Issued By: �� / (.5. ✓1 l 11 I) Q� Permittee Signature:
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.
''- Z -2 / 009 10:33 503 -691 -855b OREGON HEATING PAGE 01/02
Mechanical Per Applzca
City of Tigard nn 5 20 �)t[(F1 }'� r; permitNc • c �
r 13125 SW Flab Blvd., Tigard.. OR 97223 M N Plan Ret9ew r-
i °;. Phone: 503.639.4171 Fax: 503.59 &1960 .3\9O UetcBy. . _WV Other Po znrt:
Ti •: Ins eCUon Lute: 503.639.4175 V V ' ( t � A, Date Ready /By: 1� : El See Page 2 for
; Inte t�et' www.tigard -0r.gov `' `v
OLD�N� ®1v�s , ® NotiFicdlMPthod: µ.. G �Suppiememst
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New construction [ Addition /sltet'atiott/leplacct7acnt
Mechanical pern7 t fee s° are based on the value of the wok
ticrfomzcd. 1, rJ.ionte the value (rounded to the rteGxa;t dollar) of all
❑ Demolition ❑ Othez: mecllanjcal materials, equipment, labor, overhead and rofit.
^ Value $
rV ',l
h , '1 rk ' r �' I � 1�•� �.rGCy�j,;�' 0�'i C0�5��U�„� �7�� .. ! , r u<r f � �rJ ! � ��,�.,
� i�>iT' w7�i ��FE 1S
pad„ i i , rS� �✓> -� „ r „�
1 Ir �_.: r. u.,:. 1 �a,.rr
1- and 2- family dwelling ❑ Commercial/industrtal ❑ Accessory building �a' . 4 ,r,li (l use ch_ckl[S!'.
.... ,
rr :r,�' +�;, ❑ Other: 17escription Qty. � kia, Total
fl lblulti- family ❑ Master bui lder
, , .. a , :-'t r �,r. , �•i.,r , � R•% r'riAf;p'FIl' ! I t ridl'1'" ...
} k ; Fla, :¢ {L • l C3.P;�1L -?7'I i!i it i Q+~' x'' ;'; , `s;,w +istls 'I'Y : ;t.ji Heating/cooling
.. tn�lli.'1 ?, r, 5� ,r �t',.. �, � ",, a r'V�1� r`(,� -, , ;6a J •„td��n,)I r� <( �'6, :, ., -• Y
JoU site address: Air cOttdniotting or heat pump ii
\ 7 Tc . re.wr s site .lan sho vine placement) I 14.00
City /State /ZIP' �� q - Fumace 100.000 BTU (dints /vents)_,,! , 1400 ! •
Furnace 100,0001 BTU (duct /vcnt 17.90
Suite/bldg. /apt. no -: Project name: _Gas heat pump 14 -00
Cross street/directions to job site: . Duct work .,,. _ 10.00
- 1-lydronic hot watet'system 14.00
Residential boiler (radiator or
bydronic) _ 14.00
_, _ „ _ - Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
F1�e /vent for any of above 6.80
Subdivision' Lot no.:
.. _ . _. - Other: 10.00
Tar map /parcel no.: Other fuel appliances �m _
dp r t� z - P r 1: s >' 'u �.. „. +:. Si¢.„ t •i f r' , Water beater I 10.00
vF 7 t�l +'I �l i� ! y �1 k� r'e'+ i 1P 3��•Y I (n',, JII
���• I � ii.. �� � + ���al�` ���� " t���' , �.' � o . 'E ,, �Q,• a;l,.'�� ... � :,t������•.><.,. f {.I��,�_,��1� — w
Gas fireplace 10,00 _.
/
\\e \ k'. _ flue vent for water heater or as
fireplace _ 10.00
Log halter (gaa) 10.00
Woo&pelltt stove 10.00 _
Wood fireplace /insert 10.00
(himney/hner /flue /vza_t_ 10.00 _
Name: " - Environmental exhaust and ventilation _
1 Rue hood'other kitchen
Address: «tj' j5 v) X)C c1 _ - equiptrrent 10.00
` � Clothes dryer eft- hatrst IOAO
City/State /ZIP: + (�� _ rr^ -
� - S inglt; duct exhaust (batl�unoms, I
Phone: (K') 1 7 3 c5 Ej pax: ( ) toilet compartments, utility rooms) E.80 -
,.:
go :ri�.t }yl' Yt r, : � , : :4i�7.y;t1`r; :, t'I; i . ;.. r 1 r,.�,� A • A,ttic /crnwispacefans 10.00
�r,lydi.��illl I� t 1 1 S� t
: ��,`��, � �� i•yAt�°�'�,'[��3T• �'I� '"�� r 1 Pi. �' � �'` ' ' °I, �Yv�' '''�!�•,� . ,�1�I��!��
�li 1�1
Odtet: _ 10 -00
Business name. ( Fuel pipins� ^ .
Contact name: M $5.40 for first four; $1.00 for each addttlonal w
I ..
I -` !!��,,tt 1 FternaCe. GtG�
Address= '/� (]�r'i 1 k>eat
City /State /ZIP $ Gfl \\tZ Wall /ntcpended/unit heater
Phone: l \- q Fax:: (�?)) 6q l Waterizcater _
�, Fireplace w, _
E -mail: Range
p ,.a F': ?!` pE,s'rl'r ��� r ¢k;a 1:• �'YBr "f'r11;a,r,,a :M!�,,r a �f . lid: irr"` iif'i'!ly "' "� } ° �I,j' "1i''i ifC�r'i!rr "''�lil ._.N.
�F( 5� 1 V��� ��nrl l 1 �q tl i ��%.�i "+,� „� � ) I :�� i X5,1 � �'� r � 14 ,T Ilu � ,�t � i�l�ti� 1 Bat�F.CLI +:
.d}ls Y (ll�i�, I•'o ,� , .at.c�.�a • J P ,r� I;,y'IY t,,t,f , ..n,, :I '.,yr ti,a,i., �- t
Clothes diver (gal) . . r
Bu y ec name: �{ Other
Address ( + Sitlld;E }r n z�,�'r � � ,' i :',t "i
'.� -
,'! „?'.:.5
City /State /ZIP: - Subtotal
Minimum permit fee ($72.50) � C}
Phone: (�) Pax: ( ) Plan review (25% of perrrut tee)
CCB lie.; p� State surcharge (12% of permit fee) S7
TOTAL PER))VIIT FEE I
This permit application :spires if a permit is not obt:.tned within iS
Authorized SigXlatU rF '�,(�?Lr.,� days after it has tle2zl accepted P5 CPmpl�+�
Print name: � ..� l Q y Date s a ' Fcr nethodology set by TtCounty Building Industry Service Board