Permit III CITY OF TIGARD MECHANICAL PERMIT
a.. COMMUNITY DEVELOPMENT Permit #: MEC2009 -00180
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/28/2009
Parcel: 2S102CA00926
Jurisdiction: Tigard
Site address: 13260 SW VILLAGE GLENN DR
Subdivision: Lot: 0
Project: Freels
Project Description: Install electric furnace and heat pump, with ductwork.
Owner: FEES
FREELS, MARK H & KATHLEEN M Description Date Amount
13260 SW VILLAGE GLENN DR Air Conditioning or Heat Pump 04/28/2009 $14.00
TIGARD, OR 97223 Furnaces < 100K BTU 04/28/2009 $14.00
PHONE: Duct Work 04/28/2009 $10.00
12% State Surcharge - Mechanical 04/28/2009 $8.70
Contractor: Minimum Fee Adjustment - Mechanical 04/28/2009 $34.50
D & R HEATING & AIR CONDITIONING
PO BOX 1292
CANBY, OR 97013
PHONE: 503 - 678 -2517
FAX: 503 - 678 -2097
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Electricity
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
Issued By: �r'1 �Q 6Ak9A-i, Permittee Signature: I 0 *.! 1 4 `. 4 1 I III V� � ,( 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.
Apr 24 09 I-2:26p DR Heating 503 - 678 -2097 p.2
Mechanical Permit Applicatio F�r ( FOR t }rFlt E l SEONl.l
tteccictd e
City of Tigard ndl�;u�: 14. - 2 L( •O� ,42, Pero,ir a ` , , .: � - le()
14 - 13125 SW Hall Blvd.. Tigard. OR 97223 APR 2 4 2009 Pl,n Rev,e„
■ Phone: 503.639.4171 Fax: 503.596,1960 D,t other Permit:
T ti t Inspection Line: 503.639.4175 CITY Date B : rur. 63 See Page 2 for
Internet: wwwtigard.or.gov BUILDING t F I I yG'AR Motif R Mw I CI) Supplemental infor.uabno
BUILDING DI tl SION
TYPE. OF WORK I COMMERCIAL FEE" SCHEDULE -- USE CHECKLIST
❑ Nevi construction ® Additionialteration /replacetnent Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition El Other: mechanical materials. equipment.. labor, rncrhead, an,t profit. '
CATEGORY OF CONSTRUCTION I Valuu: S J
-` RESIDE TIAIL EQUIPME T I SYSI'Ehis; us
® I- and 2-family dwelling [3 Commercial /industrial ❑ Accessory building
For special usformahon use checklist.
❑ Mu[ti -family 0 Master builder 0 Other:
Description I Qty. 6a. I Total
' JOB ST'fil? -INFORMATION - AND LOCATION . Heating/cooling
i
Job sire address: 13280 SV'J Village Glen Drive
An G res s e plan - showing or heat pump 1 14.
I 14.00
g an;quires sit shuwinR phurneni � ()0
CityiStateiZfP: Tigard, OR 97223 Furnace 100.000 BTU (ducuwrrnst 1 14.00 14.00
SuitdbldgJapt. no.: P - roject name: Furnace 100.000+ BTU (dncur eac} I 17.90
I Gas heat pump I 14.00
Cross street/directions to job site: Duct work 1 10.00 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -t)pe. not electric),
in -wall. in -duct. suspended. etc. 14.00
Flue/vent for any of above 6.80
I Subdivision: 1.I na: ^_ Other: l 10.00
Tax map;parml no.: Other fuel appliances
.DESCRIPTION OF WORK Wafer heater i 10.00
Gas fireplace 10.00
Electric furnace and heat pump installation with sheetmetal alterations. Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) , 10.00
Wood/pclfetstove I 10.00
Wood fireplace/insert I 0.00
0 PROPERTY OWNER i _ : . u TENANT - Ot
Chimney/liner/flue/vent IO.OG
Other: 10.0C
'`lam Mark & Kathy Freelf Environmental exhaust and %cavitation
I Range hood /oilier kitten -
Address: 13260 SW Village Glen Drive _ equipment 10.00
City /State:ZIP: Tigard, OR 97223 Clothes dryer exhaust 10.00
Single -duet exhaust (bathrooms.
Phone: ( 503 ) 620 - 2425 Fax: l t toilet compartments. utility rooms) 6.80
0 APPLICANT 0 CONTACT PERSON Attic/crawlspace Fans 10.00
Business name: D & R Heating & Air Conditioning Oti1er i 10.00
Fuel piping
Contact name: Lisa Delzer Cox S5.40 for first four; $1.00 for each additiona
r
Furnace, etc. -
Address: P. O. Box 1292 _
Cias heat pump
City /State/ZIP: Canby, OR 97013 Wall/suspended/unitheater
Phone: ( 503) 678 - 2517 Fax: : ( 503) 678 - 2097 Water heater
Fireplace I 1
E - mail: drheataclisa@centurytel.net Range
. coritR4croa • . . Barbecue
Business name: SAME Clothes dryer (pas')
. Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal _$38.00
Phone: I ) 1 Fax: ( ) Minimum permit fox ($72.50) $72.50
1 Plan review (25% of permit fee)
GCB lie.: 84489 State surcharge (12% of permit fee) $8.70
TOTAL PERMIT FEE $81.20
Authorized signaWr 1;Y'i 1 t / This permit application expires if a permit is not obtained vitbin 1811
d azes after it has been nom-pled as complete.
.. print name: Lisa M. Qelzer Cox • -mI bate: 4/24/2009 I • C..--- ..- -.- , -. - - - - "'' e. - -. -.. - ,
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Apr 24 09 'fi2:27p DR Heating 503 -678 -2097 p3
H EATING & P.O. Box 1292 • Canby, OR 97013
C OND I TIONING (503) 678 -2517 • Fax (503) 678 -2097
www.drheating.com
CCB 0'84489
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