Permit 4
CITY OF TIGARD MECHANICAL PERMIT
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- COMMUNITY DEVELOPMENT Permit #: MEC2009 -00303
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503.639.4171 Date Issued: 06/23/2009
Parcel: 2S 104BB 10200
Jurisdiction: Tigard
Site address: 14070 SW WALNUT CREEK WAY
Subdivision: Lot: 0
Project: Perkins
Project Description: Install air conditioner Must maintain a minimum of 3 ft side and rear yard setbacks
Owner: FEES
JARED PERKINS Description Date Amount
14070 SW WALNUT CREEK WAY Air Conditioning or Heat Pump 06/23/2009 $14 00
TIGARD, OR 97223 12% State Surcharge - Mechanical 06/23/2009 $8 70
PHONE' Minimum Fee Adjustment - Mechanical 06/23/2009 $58 50
Contractor:
TRI- COUNTY TEMP CONTROL
13150 S CLACKAMAS RIVER DR
OREGON CITY, OR 97045
PHONE. 503 - 557 -2220
FAX' 503- 557 -0919
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 y calling 503.246 6699 or 1.800 332 2344.
Issued By: 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.
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r NOISIAIQ ONIQimn
- Mechanical Permit Application QIVJI1 dO,IO 1 (l Il 1 I t . I( I I SI ()NI 1
City of Tigard �J Received
L �; _ 1.)0 3 0
Permit No.:
111 i • 13125 SW Hall Blvd., Tigard, OR 97223 6OOZ g NnI' Plen Rev
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
I It ., It
Inspection Line: 503.639 Q3A I3 J3 Da te ReadyBy: Julia S See Pene 2 for
Internet www.tigard- or.gov J Notifiad/Mctfind Supplemental information
- ' TYPE OF WORK COMMERCL FEE* - SCHED[jLE`= 'USE'C IECKL IST
❑ 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 CONSTRUCTION Value: $
' RESIDEicT7AL EQI.IIPNEINr !SYSTEMS FEES*
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checkJlsl.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ea. I Total
• . ., JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 14tY16 8W 1 V /111 Air conditioning or heat pump f
"`^q (requires site plan showing placement) 1 14.00
City/ State/ZIP: Tigard, OR 4122P) 1 Furnace 100,000 BTU (duets/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt no.: I 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 (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue/vent for any of above 6.80
Other. 10.00
Tax map/parcel no.: Other fuel appliances
' DESCRIPTION OF WORK. - Water heater 10.00
• I n tl l cur cDn t fi Gas fireplace
ov CY Flue vent for water heater or gas _ 10.00
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert _ 10.00
® Chimney/liner /flue/vent 10.00
ROPF,RTY OWNER' Other. 10.00
Name: Ord C C N, 5 Environmental exhaust and ventilation
CA � Range hood/other kitchen
31U
Address: t^ �_. equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
,� Single -duct exhaust (bathrooms,
Phone: ( 5c )cl%' I $$2)i Fax: ( ) toilet compartments, utility rooms) 6.80 _
' - ' ®- A O CONTACT• PERSON - - Attid cmwlspace fans 10.00 .
Other 10.00
Business name: Same as contractor Fuel piping
Contact name: Diane Mason $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: Gas heat pump
City /State/ZIP: Wall/suspended/imit heater _ _
Water heater
Phone: ( ) Fax: : ( ) Fireplace
E -mail: Range
_ - _ ∎CONTRACTOR ,' - Barbecue
Business name: Trl County Temp Control Clothes dryer (gas)
Other: ,
Address: 13150 S. Clackamas River Drive •M E�HANICAI: PER MiT.F E E S *
City/State/ZIP: Oregon City, 97045 Subtotal
. Minimum permit fee ($72.50)
Phone: (503) 557.2220 Fax: (503) 557.0919 Plan review (25% of permit fee)
CCB lie.: 72623 State surcharge (12% of permit fe op, 1 i A
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained within 180
Authorized signature: days after It has been accepted as complete.
Print name: Diane Mason I Date: (1,404 ' Fee methodology set by Tri- County Building Industry Service Board
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