Permit •
y CITY OF TIGARD MECHANICAL PERMIT el
2 :- COMMUNITY DEVELOPMENT Permit #: MEC2012 -00638
• 'TIGARD- 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/06/2012
Parcel: 2S 101 DCO2300
Jurisdiction: Tigard
Site address: 7610 SW CHERRY DR
Project: Takahashi Subdivision: ROLLING HILLS NO.2 Lot: 33
Project Description: Replace gas furnace
Contractor: HYBRID HEATING & AIR CONDITIONING CO. Owner: TAKAHASHI, WAYNE H
PO BOX 329 SHARON S
CORNELIUS, OR 97113 7610 SW CHERRY ST
TIGARD, OR 97223
PHONE: 503 - 357 -5663 PHONE: 503 - 639 -4061
FAX: 503 - 357 -0668
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/06/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/06/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/06/2012 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
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 • - - ' • s to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issue By: ' �� �` _ � / Permittee Signat.re• � ,�
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.
Mechanical Permit Applie. 'P' . IV ED FOR OFFICE IISL ONL1
L.l° Received
City o Tigard Date/13y: � 2 / Permit No.: Hee„ . /. - 001038
• 13125 SW Hall Blvd., Tigard, OR 97223 C o. 5 2012 Plan Review
• 0 Phone: 503.639.4171 Fax: 503.598.19 Date/By: Other Permit•,
r i c_: A R I? Inspection Line: 503.639.4175 ^' TIG e D Da1e Ready/By: El gee Page 2 for
Internet. www.tigard- or.gov V IGARD Notified/method: Supplemental Information
BUILDING DIVISION
.. TYPT
,.i >WiORT� ... NCO . SEIE'IEDIT %T'.W �,r•... , LS�
❑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.
— . CAiTEGORY , . OF,:COI!I*TRUCTION`
Value
1- and 2- family dwelling 0 Commercial/industrial ❑ Accessory building
For special information use Checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description . f Qty. { Ea. T Total
.. JOB, Si'TE °YN)F'OkM TION:.AND''.T.00A'.t'YON , _ .: . , ,, . Heat ng /cooling
•
Job site address: `� Air conditioning
7 l o s S k) (t - r �' (requires site plan showing placement) 46.75
City/State/ZIP: 0 V ,d/ q 7 2?. 3 Furnace 100,000 BTU (ducts/vents) f, 46.75 4 v�
Furnace 100,000+1311J (ductS/verm) 54.91
Suite/bldg. /apt. no.: 0 I Project name: -4a .�s -
Heat pump _61.06
Cross street/directions to job site: Duct work 2332
Hydronic hot water system 2332 •
Residential boiler (radiator or
hydronic) 23.32
Unit.heaters (fuel -type, not electric), .
in -wall, in -duct, suspended, etc. 46.75 .
Flue/vent for any of above 23.32
Subdivision: l Lot no.:� 2332
Tax map /parcel no.: Other fuel appliances . .
DF SCRiPTIO OE•. W.,OIt1S: • ' . .. -..: . •
Water heater 23 32
i Gas fireplace 33,39 .
/ 4.C.Lr ffaxt Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
_ Wood/pellet stove 33.39
Wood fireplace /insert 2332 ,
•
' 1:;:PROPERTY 'OWNER ' . U:.1V. r ..
Chimney/liner /flue/vent 23.32
Other 2332
Name: ( n Tiketi Environmental exhaust and ventilation
Address: 7 ( .. to t--- us r
Range hood/other kitchen
equipment 33.39
City /State/ZIP: 1 1 „..4J & 77 3 Clothes dryer exhaust 3339
6 ti) 4 _ `' r toilet
Single-duct exhaust (bathrooms, •
Phone: ) 7 � ' Fax: ( ) pilet compartments, utility lity rooms) 2332 -
APP . -•❑ .CON:' CT :;YERSdN .':;`..:.:::,.: Attit/crawispacefads 2332
Business name: Other 23.32
Fuel piping
Contact name: $14.15 for first four, £4.03 for each additional
Address: Furnace, etc.
- Gas heat pump
City/Statc/ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax: : ( )
Water heater
Fireplace
E-mail: Range
Barbecue
Clothes dryer (gas)
Business name: Other: .
Address : ^,,
City/State/ZIP: I cQef•ks epe 971/ 3. Subtotal 114..7r
Phone: (003) 3 3 I Fax: (��) 35i.._ 0 66 Minimum permit fee ($90.00)
/ ' r 3 p Plan review (25% of permit fee)
S Pla
CCB lie.: /. 72,—i State surcharge (12% of permit fee) rd gQ
a
7 1� _ TOTAL PERMIT FEE /°00 -
T
Authorized signature :��'� —" — _ This peruse application a,pirea if a permit is not Obtained within 189 L
days sitter it has been accepted as complete. ( 1 1 , ". -X,J
Prin name: �p tom• • p p r [ D ate: (L 4� /2_ • Fee methodology set by I'd-County Building Industry Service Board
1:e 2uiidinglpermits1NfC-PermitApp .doe lo/DI/o9 440.4617r(It /02/COM/WEB) .
■
•
Hybrid Heating & Air Conditioning
McClenny RHC
P. 0: Box 329
Cornelius, Or 97113
Phone: 503 - 357-5663 f-
Fax: 503- 357 -0668
Fax
S uie44,
J �" ' ^ Y►�1E� � From: Hybrid Heating & NC -- a
Date / /5/� z.
Pages incl. Cover.
Pax: 5 o )5'675 CC:
Urgent For Review Please Comment Please Reply Please Recycle
•Comments: •
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