Permit ,`�� CITY OF TIGARD MECHANICAL PERMIT
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;' a COMMUNITY DEVELOPMENT Permit #: MEC2012 00542
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IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/18/2012
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Parcel: 2S111 CA11000
Jurisdiction: Tigard
Site address: 9596 SW BATTLER ST
Project: Minderhout Subdivision: LAKESIDE PLACE Lot: 1
Project Description: (1) furnace and (1) NC replacement NC must maintain 5" side yard setback and approved rear yard setback. (1) ,::
flue /vent
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Contractor: FIRST CALL INSTALLATION COMPANY Owner: MINDERHOUT, CAROL A
13150 S CLACKAMAS RIVER DR 9596 SW SATTLER ST
OREGON CITY, OR 97045 TIGARD, OR 97224
PHONE: 503 - 231 -3311 PHONE: 503 - 523 -6676
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Air Conditioning 10/18/2012 $46.75
Type of Use: SF Furnaces < 100K BTU 10/18/2012 $46.75
Class of Work: ALT Type of Const: FlueNent For Any of Above 10/18/2012 $23.32
Occupancy Grp: 12% State Surcharge - Mechanical 10/18/2012 $14.02
Stories:
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Fuel
Fuel Types:
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. Gas Pressure:
Total $130.84
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: / / Permittee Signature: 04 4P00 C. All. 0 L_(
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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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C ---- s RECEI OCT 18 2012
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.,� CITY OF TI
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Bala. Iii ie.: .
Mechanical Permit Application - G rtlu OHi(1 l
•4 CI Received , /
• 131 Of Tigard
SW Hall Blvd., Ti Da1eBT ! V 1 gi I a --T 1 Pewit Na.:A EL N ) - Dos - - .,
Plan Review
gtud, OR 97223
Phone: 903.639.4171 Pax: 503.598.1960 D Other Ramie
1 i c; n u 1) Inspection Line: 503.639.4175 Dote Ready/By: hilt!: 0 Se Page 2 for
Internet www.tigardor Notified/Method: .11 cc, 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 CONSTRUCTION Value: $
® I- 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES'
y g ❑ Commercial/industrial ❑ Accessory building
❑ Multi - family ❑ Master builder ❑ Other: For special (gfornurlion use checklist.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: n pp��//�� //�� '^/ el - Air conditioning
M i J'{ U( Y 1 V I 1 46.75
(requires site plan showing placement)
. City/ State/ZIP: r) g C1 Fumace 100,000 BTU (ducts/vents) I 46.75
17 124 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Pr oject name: Heat pump 61.06
Cross street/directions lu jub site: ' Duct work - 23.32
Hydronie hot water system 23.32
• Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in- wall, in-duct, suspended, etc. 46.15
Flue/vent for any of above l 23.32 •
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Subdivision: • I Lot no.: Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23:32
Gas fireplace - 33.39
Pcplacoftuta,ce q air corlitione_ r Flue for water heater,or gas
fireplace 23.32
- Log lighter (gas) 23.32
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Wood/pellet stove 33.39
' Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
. PROPERTY OWNED I ❑ TENANT `
(� I Min 1 a
Other. 23.32
Name: l � Environmental exhaust and ventilation
CJ U I Iv Range hood/other kitchen
Address: 1 equipment 33.39
City/Slate/ZIP: Clothes dryer exhaust 33.39
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� Z , I W Single -duct exhaust (bathrooms,
Phone: (6D3) 62. "/`Y i Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT , ❑ CONTACT PERSON Attic%rewlspace fans 23.32
Business name: Tri County Temp Control Other: 23.32
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Fuel piping
Contact name: Diane Mason $14.15 for tint four; $4.03 for each additional
Address: 13150 S Clackamas River Drive Furnace, etc.
Gas heat pump
City/State/ZIP: Oregon City, OR 97045 Wall/suspended/unit healer
Phone: (503) 557.2220 i I Fax :: (503) 557.0919 Water heater
I Fireplace
E -mail: •
Range
CONTRACTOR Barbecue
Business name: First Call Installation Clothes dryer (gas) ,
Other. •
Address: 13150 S Clackamas Rivet Drive MECHANICAL-PERMIT FEES*
City / State/ZIP: Oregon City, OR 97045 _ Subtotal
Minimum permit fee ($90:00)
Phone: (503) 557.0230 Fax: (503) 557.0919 Plan review (25% of permit fee)
CCB lie.: 182714 State surcharge (12% of permit fee) 1 TOTAL P
Authorized signature: Mils permit application expires If a permit is not n FEE 1 ot obtnloed within V ' 190
days after It has been accepted as complete.
I Print name: Diane Mason I Date: 1012211e I • Fee methodology set by Tri - County Building Industry Service Board ,
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