Permit • �- •
CITY OF TIGARD MECHANICAL PERMIT
• a. - COMMUNITY DEVELOPMENT Permit #: MEC2009 -00132
T I GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/27/2009
Parcel: 1 S133DD07900
Jurisdiction: Tigard
Site address: 12796 SW WINTER LAKE DR
Subdivision: Lot: 0
Project: Sunset Group
Project Description: Replace furnace.
Owner: FEES
SUNSET GROUP Description Date Amount
12796 SW WINTERLAKE DR Furnaces < 100K BTU 03/27/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 03/27/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 03/27/2009 $58.50
Contractor:
HEAT RELIEF CO
13122 NE DAVID CIR # 800
PORTLAND, OR 97230
PHONE: 503 - 261 -9915
FAX: 503 - 261 -9814
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
l
Issued By: n � 1/1 n 1 Permittee Signature: yam( )pl r
Call503..63 9.411 7755 by 7:00 a.m. for an inspection that business day. """ `d
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.
Mechdlnlical Permit Applicatio : E C ' fi. -- -- FOR OFFICE USE ONLY
City of Tigard MAR 2 7 2009 Ra By. (3 a ( 0 - q
- DateBy. 0 Pe rmit No.: h/ ILe� � � � I ► Q
II ° 13125 SW Hall Blvd., Tigard, OR 97223 t f [�. �� i Oo l.0 2
Phone: 503.639 4171 Fax. 503.598.1960 Plan Review
Inspection Line: 503.639.4175 CITY OF TIGARD Date/By: Other Permit:
TIGARD g g Date Ready /By: funs 0 See Page 2 for
Internet: www.ti and -or. ov BU ILDING DIVISION Notified/Method: fi 1.4 Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees' are based on the value of the work
❑ New construction ® Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
® Multi- family ❑Master builder For special information use checklist.
❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: ! ta-1 c) c S W u n-Ee.v Ltu(g Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: G f-(2..() 0» O'y? Furnace 100,000 BTU (ducts/vents) 1 14.00 /40
K j Furnace 100,000+ BTU ( ducts/vents) 17.90
Suite bldg. /apt. no.: Project name: 1�1T nO 1v Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
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. 10.00
Flue/vent for any of above 10.00
Subdivision: Lot no.:
Other. 10.00
Tax map /parcel no.: Other fuel appliances
•
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
n' ' C 1 , n n G c . O r � Le fireplace 10.00
`� V� Y\ h� -JrrX Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
(PROPERTY OWNER I - ❑ TENANT Chimney/liner /flue/vent 10.00
Other 10.00
Name: Sun SO- (5, ‘.4_, f Environmental exhaust and ventilation
Address: S 6_,01\._„(2 CV J 1� CX1. 0\./C* Range hood /other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Fax:
Single-duct exhaust (bathrooms,
Phone:
( ) ( ) toilet compartments, utility moms) 6.80
., ,(APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other
Business name: HEAT RELIEF 10.00
Fuel piping
Contact name: MARK DEFRANCISCO $5.40 for first four; $1.00 for each additional
Address: 13122 NE DAVID CIR DR # 800 , Furnace, etc.
Gas heat pump
City/State/ZIP: PORTLAND, OR 97230 Wall/suspended/unit heater
Water heater
Phone: (503) 261 -9915 Fax: : (503) 261 -9814 Fireplace
E-mail: Range
CONTRACTOR Barbecue
Business name: HEAT RELIEF Clothes dryer (gas)
Other:
Address: 13122 NE DAVID CIR DR # 800 MECHANICAL PERMIT FEES*
City/State/ZIP: PORTLAND, OR. 97230 Subtotal
Minimum permit fee ($72.50) °7?
Phone: (503) 261 -9915 Fax: (503) 261 -9814 Plan review (25% of permit fee) "T
CCB lie.: 122424 State surcharge (12% of permit fee) 'J 0
TOTAL PERMIT FEE Ig 12C
This permit application expires if a permit Is not obtained within 180
Authorized signature: days after it has been accepted as complete.
I Print name: MARK DEFRANCISCO Date: • Fee methodology set by Tn -County Building Industry Service Board
I .\Builduig\Pamits\MEC- PamitAppdoc 04/06/06 440-461iT(II /02/COM/WEB)