Permit q CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2013 -00390
TIGARD 13125 SW Hall Blvd.. Tigard OR 97223 503.718.2439 Date Issued: 07/16/2013
Parcel: 1 S135AB03201
Jurisdiction: Tigard
Site address: 10445 SW 90TH AVE
Project: Berry Subdivision: ASHBROOK FARM Lot: 10
Project Description: Furnace and water heater replacement
Contractor: HEAT RELIEF CO Owner: BERRY, PAUL
13122 NE DAVID CIR # 800 10445 SW 90TH AVE
PORTLAND, OR 97230 PORTLAND, OR 97223
PHONE: 503 - 261 -9915 PHONE: 503 - 410 -4166
FAX: 503 - 261 -9814
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 07/16/2013 $46.75
Type of Use: SF Water Heater 07/16/2013 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 07/16/2013 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 07/16/2013 $19.93
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 questioi o OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By. / i Q�� -f Permittee Signat e:
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.
07/11/2013 THU 8:59 FAX 5032619814 He Relief Co IZ002 /003
Mechanical Permit Appiic CEIVED '°' t t°rrl .,,, tl t,,`'1.,• '
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Ci of Tigard P
13125 9W Hell Blvd., Tigard, OR 97223 UL 11 2013 Plan Review N.. _II . Phone! 503.7182439 Fax: 503.598.19 Date/By: Other Permit;
T I G A R l � Inspection Lino: www.ligard-or.gov 503.639.4175 CITY OF TIGARD Date Read /B : Jena:
t www.t, y y S appkm Sea P for I
Internet: cnt a i Information
t Notified/Method: 6emlllnC
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❑ New construction 09 Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
'i 1 4f r . ,.� ,P'>: ;:,I'r er •.'; +'r ^;1:• • :. ,r•• r `r„ " "a.�„ , {y� •�a' ^t , '14.A , ' 1'; \ (tl' „v. Value: $
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cil I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For spedd informasion use checklist,
❑ Multi - family ❑ Master builder ❑ Other: Description I Qt I Ea. I Total
}'I '! r . yJM -cri, ,t� ,, .1 v . '4 ��.,� •�!1'v 'tl�y t o �"' Heating/cooling:
l
k .,i > `4 'f!,tk ; R TEON'AN '1 aitt tit (� 'i" 't
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Job site address: �, 1 A cond 46.75
s:
�l 7.L s 1.h. 7 Ci( . O _ „ Furnace 109,000 BTU (duets/vcros) i 46.75
City /State/Z1P: , _ m r (1;4 dr � � 2 � Furnace 100,000+ BTU (dome/vents) 54.91
a (� Heat pump - - - 61,06
Sulte/bldg. /apt e10.; Project na .+ i : u ► L • . r. " • " ■ " _A • A. Duct work 23.32
Cross street/directions to job site: Hydronic hot water system /� 23,32
! t ,, Residential boiler (radiator or
A.� CR J !'�"'' r, sV , 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
Other 23.32
Subdivision: I Lot no.: Other Fuel appliances:
Tax map/parcel no.: Water heater I . 1 23.32
;,'v Nnh" s, �.VV ,d "4,1 �a.v�r�'( ' „f' , x:..,,, Y?.' 1;: •,,sy,•I•�r{yy,y,.v,•, Qd4fire lace/insert
. 'i7 '' 'r, ';li':,!i j i'l,, )1' yeaa b , I ;'-"'- • 1S' i ti+''',n e- y ��,V r '". a Flue vent for water heater or gas
P 73.39
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1
4 e�a..r `-" Al r gretnAn, k -• fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23,32
Chimney/liner /flue/vent 23.32
^S qr r ,• : • . +F n ,.r ,o, I " I 1 27,32
.4 i4 ,j �+ ,. llir� 1� 1r /1 „• 1t r ;'g:i' "t;�,HS i'1�''u` .t l +m 4 y - ' 6:1 ;n1" s r Othe
"' I q •• 1„0.1 /i; '!f Ip.0 ,:. . 4 ,2o.,:p , 1.44 l�..4, 0' +,i'f:,,c.b]J,.i,, -', }• '�1 ` il.:' 3i�':,�•:'- ' "''4''"'t�1'�•�'.`, Environmental exhaust and ventilation:
Name: � Range hood/other kitchen
Address: equipment 33.39
C)I_'�1), �l}) GIC7 ti Ll.QZ• • Clothes dryer exhaust 33.39
City /Stale/ZIPr->,1 C419.9..- Single- duct J1 1 t oilet compartments, utility rooms) 23.32
Phone ( ,, ��, L \ Y 1 �1 - , . f r . !� . \li , •4•F•�,iy v "frtt C r ) �; .'<A i'` "r;t',' '��r h . �, or.;, `� 1s /. •.w +nd,i
, :; i+. ; 't' .! ° 1d NT ?•, i , )) , i) . . 'imi,.' ; y ``ft�'+'( ih �1i f iii.d� ,,V l r Other. 23.32
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Fete! piping:
Business name:. � �.. Q „� �,.. C $t4 tS for first roar: $4.03 for each additional
Contact name: I. G e - C�+C7C Furnace, etc.
Address: I i pa,. Th ( , o rda, caiz Gas host pump
V" Wall/suspended/unit heater
City /Sttlte/ZIP7V 1 a -, � Water heater
Phone: (• ) ati • aa1,7 I Fax: >.(a9 2L ,4z..44 Fireplace
Range
13-mail:
.. I� � N' !YA. I • +., ` , �,y(� ,�xi '•`I.., n • n, + �'� v .. u, ,,
':P 7' a dr; 'ltf,.`V; V k 1 / ,, I: .b' .,,., n , "° ) 1 Barbecue
.j 1 .�1''' 75 i� 1, ,, '.•r,.i ", ({ P,``'1�0 "M R��:��',` 'r41f" �J "•{
i1i:! 7;. 4�1 :� , +r " i��u.,1ICQ'„ 7r� 1•:.' P�! "':i�I,r.,�; /;Y IPi�'u,,n'�, •L7,:d', f,�a:. Clothes dryer (PIS)
Business tleme:.k.k ` \Q Other;
-
Address: . 2) / � l( I y , .. �':rIF.�I��`TP:�IJ:� [y lkT�� I ti•!1 ' r1<+••. "' I' .
i M1 /'
Yl v .,N 1. "1.
1S1�� y ���lasL Ca1�k r6, Subtotal
City /State/Zlf a
c i2 i ! Minimum permit fee ($90.00) Qv.f
l Plan review (25% of permit fee)
Phone: ( 9u.� , �� Fax: , , G'� t Slate surcharge (12% of permit fey) it),
CCB lie.: k •11 t 2. (4 (1-4l S '`+' TOTAL PERMIT FEE . `p (,),
`'� Thia permit application expires if it permit is not obtained within lg0
days AMY it has been accepted an complete.
Authorized signatu •',, v 1 ' CC.i & • lee methodology net by IA-County Building Industry Service Board
I Print name: ` •) .4 �, I Date: 11 1 1 I IS
i:WuitdtagkeermlulMEC Permhnep a4oe l7.doc 440 -161 (I 1/a?/COM/WED)