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Permit Mechanical Permit Applica ' iFOR OFFI(7: 1 S 011.1' City of Tigard EChVED ReeerveaO? � �•7g DatdBy: it /� /3 63#, Permit No.:/1/44,40,73.„.6 lig,� 'I 13125 SW Hall Blvd.,Tigard,OR 9722 q Plan Review li Phone: 503.718.2439 Fax: 503.598.196 O V 2 1 2 01 3 Date/By: Other Permit: I.t G,1,L) Inspection Line: 503.639.4175 Date ReadyByE X . s. fI 1 E3..D " H See Page 2 www.tigard-or.gov Supplemental Information CITYOFitUA ` Notified/Method3/a7 /// . I! 'r , + - '* Ia z ' .4,1.."44-54/4k44 . §;, '.,e'-.;.,--,,',..,,-,..,;.; ' � s. n •e;-,- " „ - t ., j r i .P,` , �3i ;,,•,r r€ tc, � '.*w .,.-?", txX �� : 33 ..' � $! ; , � . - ` t , . riC - ., .zw. + 2a„- . ' ' Merhaoical permit fees”are based on the value of the work ❑New construction a Addition/alteratio +eplacemen performed.Indicate the value(rounded to the nearest dollar)of all ❑Demolition 0 Other: mechanical materials,equipment,labor,overhead,andprofit. Value $ .ca 4 z R 4e � sv . .q : , �.zs� rot -r ,-t ,, • y e1}-' ^a ',,, Yee ❑ 1-and 2-family dwelling Commercial/industrial ❑Accessory building For special information use checklist El Multi-family 0 Master builder 0 Other Description I Qty• I Ea. I Total t" - " ";--e---10`..:71-4t:677- ' ja ,: a H.�i ' a r Heating/cooling: Job site address: © Air conditioning 46.75 ( 4 Li 7 h..t C a1 fig,'Ay l Furnace 100,000 BTU(ducts/vents) 46.75 City/State!ZIP: T ktA,ti1D Ola. ('17'z- I Furnace 100,000+BTU(ducts/vents) 54.91 Heat pump 61.06 Suite/bldg./apt.no.: I Project name: C.4,0V i 4 P/,e6by.SLA., Duct work 23.32 Cross street/directions to job site: 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: I Lot no.: Other: 23.32 Other Nuel appliances: Tax map/parcel no.: Water heater 23.32 ',' is r, 'e r 4 t ,;:;'1-i > '‘:4116,,e-4,0-SC -4„1 Gas fireplace/insert 33.39 DD L-lFlue vent for water heater or gas GpIA t.e LZ, I `(TCp L�, 1 1�Ai.4 O t-rt tef:4,6, fireplace 23.32 L.Tias c:"•L 41 i,A. 410p,,, A. (.L�LTIZc„1S Log lighter(gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 Chimney/liner/flue/vent 23.32 - ��� Y •a‘ '- s� Other 23.32 N.Irr ... i,:l'v...�L . A:p w •waw -`':•2. .".Ir '::.._=� t sns,_.rz`a•- °r. Environmental exhaust and ventilation; Name: CA.IV/.44 Pire., b J i Ala Rangehood/otherkitchen 33.39 Address: 7 equi �o`I4 fj.�: -nnY-C 6 Ji / (/,.�/ Clothes dryer exhaust 33.39 City/State/ZIP: r(�� 1� d AL2 N Single-dud exhaust(bathrooms' "� toilet compartments,utility rooms) 2332 Phone:(C ,'1J) g 3 „ 32.73 Fax:( ) Atiic/crawlspace fans 23.32 J ' _ e s Other: 23.32 �.mi � ,y� Fuel piping: Business name: A e1k.eo�,,� /� L s- A u i eA I $14.15 for first four,$4.03 for each additional Contact name: Z tea Fr ,n&1At)y Furnace,etc. 4 ! e ' Gas heat pump Address: i0j3 `✓__iai 'I uA`A litl d Wall/suspended/unit heater City/State/ZIP: TO A L'i tT oie '17e'kJ- �y Water heater Phone:(5-c )6 R'Z i 5/ I Fax::(603) (Di I'I$79 Fireplace E-mail: Range Barbecue ,Ii-;i3:34 xi 79'r-`.-'47:, `s '17::::::::-1.7-r-' 4 , `y<.w` �..< £�,� fit.,,. >.;""--';.;,% 3 � a x..., ., .. K - Clothes dryer(gas) Business name: Af� A,,,,,,6uyAN n:.A j Other: Address: I p33 e, `V:n! 'Tu A ki Jam° .'U . Subtotal City/State/ZIP: "To !.q-r a 1 706-1- Minimum permit fee($90.00) t: ) �'' Fax Plan review(25%of permit fee) Phone: (b' b1T-15 (5-03) 19/ 1879 State surcharge(12°k of permit fere) CCB lie.: 6-(q 3 TOTAL PERMIT FEE This permit application expires if a permit is not obtained within 180 daysAuthorized signature * Fee methodology set after k has been Building Incomplete. ogy set by Tri-County Building Industry Service Board Print name: pf'p.l 1e. L l,u�a/4,,. Date: Ili/CV/3 l:\B ulding1Pemuts\MEC_Pan itApp 040113.dac 440-4617r(11/o2/COM/WEB)