Permit 1
CITY OF TIGARD MECHANICAL PERMIT
e.' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00173
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 04/21/2009
Parcel: 2S103BD00300
Jurisdiction: Tigard
Site address: 11800 SW WALNUT ST
Subdivision: Lot: 0
Project: Wright
Project Description: Replace gas furnace.
Owner: FEES
WRIGHT, LARRY A & MAUREEN L Description Date Amount
11800 SW WALNUT ST Air Conditioning or Heat Pump 04/21/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 04/21/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 04 /21/2009 $58.50
Contractor:
WESTERN HEATING & COOLING INC
50618 COLUMBIA RIVER HWY
SCAPPOOSE, OR 97056
PHONE: 503 - 647 -5808
FAX. 503 - 543 -3693
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
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
Issued By: /�lC/ Vt Q �� 5 p U Q Permittee Signature: ., a
1J l j� r l Call r 5003 .66339.4175 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 20 ' 09 02:45p Western Heating 503- 543 -3693 p 1
Mechanical Permit Applicati i r• oR o 1 sE -
City of Tigard Recei �—{• • r 1 . Il .
13125 SW Hall Blvd, Tigard, OR 97223 APR 2 0 2009 — y.�a
Phone: 503.639.4171 Fax: 503.598.1960 ean Review DateBy Other Permit:
T 1G A R D Inspection Line: 503 639.4175 CITY OF TIGARD Dare Ready/By. ® See Page 2 for
Internet www.tigard-or.gov BUILDING DIVISION Notified/Method Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction Addition/alteration /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUC'T'ION Value: $
and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
1
y g ❑ Commercial /industrial ❑ Accessory building
[Multi- family ❑ Master builder ❑ Other: For special information use check list.
Descnption I Qty. i Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 1 $0Q ScO L a I v 54- Air conditioning or heat pump
(requires site plan showittp; placement) 14 00
City /State/ZIP: 0 \ A h 3 Furnace 100,000 BTU (ducts/vents) 14.00 y
Furnace 100,000+ BTU (ducts'ven,$) 17.90
Suiterbldgiapt, no.: Project name: r 1 hi- 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
hydrontc) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Flue /vent for any of above 6 80
Subdivision: Lot no.:
er 10 00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater _ 10.00 I
R f� Gas fireplace 10.00
1� 4 l �`i( S U (1 cc_ Flue vent for water heater or gas
fireplace 10 00
Lag lighter (gas) 10 00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /Inver /tlue/vent 10 00
10 00
PROPERTY OWNER ❑TENANT Other.
Name: Y Y d 1 I 1 Id ��� r1 1 t{ I- Environmental exhaust and ventilation
` j� � Range hood /other kitchen
}
Address: f) �( s u..) lJa I h!/J4- ...1._ equipment 10.00
C ity/State/ZIP: 6 , n A. n f 9 -,, 3 Clothes dryer exhaust 10.00
• 3 5 � / j Li' 9 ( F ax: toilet omp exhaust (u tility
Phone: moms) 6.80
{ ) ( ) toilet compartments, ulilit., roo
9r° APPLICANT ❑ CONTACT PERSON Attsc/crawlspace fans 10.00
r. Other 10.00
Business name: t.(1 p ( n -- 'i O ,, of C co l 1 y.p ' ry.1c Fuel piping
Contact name: �a y-cl Ile' So J �J4 $5.40 for first four; $1.00 for each additional
n Furnace, etc.
Address: QpI ( o1 V i'1•l't & 1 V - e r I - I I Gas heat pump
City /State/ZIP 6C arpoOS� to q70, WalUsuspended/unitheater
Phone: ( ) r 4'7 5 0-6,)s-- Fax:: ( ) 5// 3-3 i 93 Water heater
w Fireplace
E -mail:
Range
CONTRACTOR Barbecue
t Business name: O r r �C 0-5 ,� t Clothes dryer (gas)
1 CQ ►1 Other:
Address: MECHANICAL PERMIT FEES*
City/State/ZIP Subtotal / r
Phone: ( ) Fax :( )
Minimum permit fee ($72.50) 7a- 50
Plan review (25% of permit fee) , —
CCBtic.: 7W ! , `, State surcharge (12%ofpermit fee) g', 70
iiel W J— TOTAL PERMIT FEE �) J.
Authorized signature:
/ W/� This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
r Print name: r ,/ ) � Sa
1 m -2,9 I Date: 9 " -Q
I I • Fee methodology set by Tri -County Building Industry Service Board
1 tBuildingiPermiu\MEC -Pe mitApp 01/19/07 40-4617r(1 I /02(COM,WEB)