Permit v CITY OF TIGARD MECHANICAL PERMIT
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' "-. COMMUNITY DEVELOPMENT Permit #: MEC2013 00136
- EGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/11/2013
Parcel: 2S103DB01800
Jurisdiction: Tigard
Site address: 11475 SW VENUS CT
Project: Carlson Subdivision: GENESIS Lot: 12
Project Description: (1) gas furnace replacement
Contractor: FIRST CALL INSTALLATION COMPANY Owner: CARLSON, RICHARD A & JUDITH S
13150 S CLACKAMAS RIVER DR 11475 SW VENUS CT
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503 - 231 -3311 PHONE: 503 -418 -9568
FAX. 503 - 557 -0919
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 03/11/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 03/11/2013 $10 80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/11/2013 $43 25
Occupancy Grp:
Stories:
„
Fuel
•
Fuel Types
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 questions to OUNC by calling 503 232.1987 or 1.800 332 2344
Issued By: _4_/./±, I L J Permittee Signature: Okl 11-Peti e 4 iQ k
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.
MAR -11 -2013 02:25P FROM: per TO:5035981960 P.1
Mechanical Permit ApplicationECEIVE) 1.01z ►1i () 11• I (1 I ',, I ()NIA
City of Tigard l'ermitxo.:E(,' X13 — j
13125 SW Hall Blvd., Tigard, OR 97223 MAR 1 1 2013 Plan Review
a Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit
I !(,Alt1) Inspection Line: 503.639.4175 CITY OF TIGARD Date ReadyBy: huts: ® See Page 2 for
Internet: www.tigard- or.gov BUILDING DNISIO Notified/Method: c 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: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1- and 2- family dwelling ❑ Commercialindustrial ❑ Accessory building For special ►gjormauon use checklist.
❑ Multi- family ❑ Master builder ❑ Other Description j Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Hadng/cooling
lab site address: 1 U I 1 .4- w Y V ! Air conditioning
(requires site Man showing placement) 46.75
City/State/ZIP: Tie 41� Furnace 100,000 BTU ( ducts/vents) 'I 46.75 _
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: , Project name: Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in'wall, in.duet, suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision: I Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater _ 2132
Gas fireplace 33.39 _
..�/ !! t ,! . 1 Flueventfor waterheater or gas
r l .1 i '
1 I( . fireplace 23.32
Log lighter (gas) 23.32 ,
Wood/pellet stove 33,39 ,
-Wood fireplace/Insert 23.32
Chimney/liner/flue/vent 23
PROPERTY OWNER,
I ❑ TT Other 23.32
Name: ICI a l ��soY �/� f Environmental exhaust and vendladon
t J ! I�' Range hood/other kitchen
Address: equipment 33.39
City /State/ZIP: Clothes dryer exhaust 33.39
Phone:
( 41i-• ll@til Fax: ( ) I Singt compartments, rt exhaust (bathrooms,
toilet t•tnperx a , utility lity rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic/crewlspace fans 23.32
Other. 23
Business name: Tri County Temp Control Fuel piping
Contact name: Diane Mason $14.15 for first four; 54.03 for each additional
Furnace, etc.
Address: 13150 S Clackamas River Drive -
Oes heat pump
City/State/ZIP: Oregon City, OR 97045 Wall/suspended/unit heater
Phone: (503) 557.2220 I Fax: : (503) 557.0919 Water heater
( ) 7 Fireplace .
E-mail: ,Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Bus name: First Call Installation Other.
Address: 13150 S Clackamas River Drive MECHANICAL-PERMIITI'EES*
Subtotal
City/State/ZIP: Oregon City, OR 97045 Minimum permit fee ($90.00)
_ Phone: (503) 557.0230 Fax: (503) 557.0919 Plan review (25% of permit fee)
CCB Iic.: 182714 State surcharge (12% of permit fee) n do
TOTAL PERMIT FEE (Oa
This permit attpticodon expires If a permit b not obtained width] 110
Authorized signature: days after It has been accepted as complete.
` Print name: Diane Mason I Date: 310/0 ` • Fee methodology set by Tri - County Building Industry Service Board
I:\ BuildirtipermhelMEC- PerraluVpduo 10/01/09 440-4617 (I>/02ICOM/WB)