Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2013 00635
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 10/22/2013
Parcel: 1 S135CD05000
Jurisdiction: Tigard
Site address: 9765 SW LONDON CT
Project: Anderson Subdivision: LONDON SQUARE NO 1 Lot: 3
Project Description: Install new electric furnace and ductwork
Contractor: G THOMAS ENTERPRISES Owner: ANDERSON,ALAN B
PO BOX 880 9765 SW LONDON CT
NEWBERG,OR 97132 TIGARD, OR 97223
PHONE' 503-804-6333 PHONE: 503-544-1306
FAX 503-537-3021
FEES
Specifics: Description Date Amount
Furnaces<100K BTU 10/22/2013 $46 75
Type of Use: SF Duct Work 10/22/2013 $23.32
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 10/22/2013 $10 80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 10/22/2013 $19.93
Stories:
Fuel
Fuel Types.
Gas Pressure.
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days ATTENTION. Oregon law requires you to follow the rules adopted by the Oregon
Utility No' - ion - -r. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or dire questions to OU • . 'ng 503 232 1987 or 1.800 332.2344.
lssu d By: ! I I �.� k Permittee Signat e:
Z
Call 503.639.4175 by 7:00 a.m.for the next available inspecti. date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Oct 22 13 10: 00a Gar Thomas 503-537-3021 p. 1
Mechanical Permit Application �� FOR OFFICE I SE oNI.'
City of Tigard �i Received �� 5-
q�1�,1,� Date/By /0�ICOM Permit No: Zi
• 13125 SW Hall Blvd-,Tigard,OR 972 ('{�J Plan Review
' C Phone: 503.718.2439 Fax: 503.59''1'• DsiciBy Other Permit
inspection Line: 503 639.4175 '' O++J tuns ®See Page 2 for
'f I G A R D P r1 \ Date Ready/By R
Internet. www.tigard-or.gov �•q n I. Notified/Method Supplemental Information
OC \ "� ���,` COMMERCIAL FEE* SCHEDULE -USE CHECKLIST
NI TYPE OF WORK �� a����
®� kZ D Mechanical permit fees*arc based on the value of the work
❑New construction ®Addis ion/alterationtt m lj` performed Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: , IA mechanical materials,equipment,labor,overhead,and profit.
ra,� Value:$
CATEGORY OF CONST'`r . ION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special lnformarlon use checklist
❑Multi-family ❑Master builder ❑Other: Description I Qty.1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning 46 75
Job site address:9765 London Ct Furnace 100.000 BTU(ducts/vents) I 46 75
City/State/ZI P:Tigard,OR 97223 Furnace 100,000+BTU(ducts:sents) 54 91
Suite/bldg./apt.no.: Project name.Anderson Flcat pump 61.06
Duct work 1 23.32
Cross street/directions to job site: Hydronic 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 75
Flue/vent for any of above 23 32
' Subdivision: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23 32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for wafer heater or gas
Install new eletric furnace and ductwork in crawlspace fireplace 23.32
Log lighter(gas) 23,32
Wood/pellet stove 33,39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® PROPERTY OWNER ED TENANT Other: 23 32
Environmental exhaust and ventilation:
Name:Alan Anderson Range hood/other kitchen
equipment 33 39
Address:9765 London Ct Clothes dryer exhaust 33.39
City/State/ZIP.Tigard,Or 97223 Single-duct exhaust(bathrooms.
toilet compartments.utility rooms) 23 32
Phone:(503)544-1306 Fax:( ) AnieJcrawlspace fans 23 32
® APPLICANT ❑ CONTACT PERSON Other: 23 32
Business name:G.Thomas Enterprises Fuel piping:
514.15 for first four,$4.03 for each additional
Contact name:Gary Thomas Furnace,etc
Address:PO Box 880 Gas Beat pump
Wall/suspended/unit heater
City/State/ZIP:Newberg/Or/97132 Water heater
Phone:(503)804-6333 Fax.•(503)537-3021 Fireplace
Range
E-mail:gthomasenterprises@gmail.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:G.Thomas Enterprises Other.
MECHANICAL PERMIT FEES*
Address'PO Box 880 Subtotal
City/State/ZIP:Newherg/O//97132 Minimum permit fee($90.00) 9 .eve'
Plan review(25%of perntit fee)
Phone.(503)804-6333 Fax:(503)537-3021 State surcharge(12%of pemiil fee) /Q•g0
CCB lie.:88093 `YiaJw 70,/( //[t/A/ TOTAI,PERMIT FEE GeV• VC
Thin penult application empires if n permit o not ubmiacd rr ithin 180
days after it has been accepted as complete.
Authorized signature: • Fcc methodology set by Tn-County Building Indust.Service Board
Print name: �y Oa Li 1-fioet/n J Date: /0—.2.1/.?
f\BwldinglPermns\MEC_PermnApp_040113 doe 440-40L76(I I/02/COM/WEB)