Permit IT .
ii CITY O,F TIGARD MECHANICAL PE RM
COMMUNITY DEVELOPMENT Permit# MEC2009-00606
13125 SW,Hail`B1vd:, Tigard OR 97223 503,639.4171 Date Issued: 11/13/2009
TIGARD ,Parcel: 2S1.03CD01300
Jurisdictions Tigard
Site address: 13705 SW FAIRVIEW CT
Subdivision: Lot: 0
Project:.Spang
Project Description: Install gas furnace.
Owner: FEES
SPANG, ADAM Description Date Amount
13705 SW FAIRVIEW CT
TIGARD, OR 97223 Furnaces < 100K BTU 11/13/2009 $46.75
Fuel Piping 11/13/2009 $14.15
PHONE: 12% State Surcharge - Mechanical 11/13/2009 $10.80
Minimum Fee Adjustment - Mechanical 11/13/2009 ' $29.10
Contractor:
MIDWAY HEATING CO
12625 SE SHERMAN
PORTLAND, OR 97233
PHONE: 503 - 252 -4003
FAX: 503- 252 -5881
Type of Use: SF
Class-of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
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 workwill 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. ATTENT.ION:,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 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: W /4 /l1 �r11 O F --. n1 Permittee Signature: Q o '
r { �1 d, X—� Call 503 :639.4 "by 7:00 a.m. for an inspection that business day.
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.
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;Pali . Received' �,
J City of T><gard Date/By: rto.:
Li) ' 1 " ° • 1 3125SWHaI1BIvd,Tigard OR 97223 } l wild �® ��
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s t I II � ti I ,r , Phone:- 503 639 4171 Fax 503.598.1 !'et Date /By; Other Permit:
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mit;: J ns ec tion Line: 503:639 1 � 2009 •
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(�� CIIY OF TIGARD
am Rl7 DIVISION 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
9 Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: 5
RESIDENTIAL EQUIPMENT / SYSTEMS. FEES*
® 1- and 2- family dwelling 0 Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/coaling
Job site address: 13705 SW Fairview CT Arc - Conditioning
ite p
(requires site plan showing placement)
City /State /Z1E: Tigard, OR 97223 Furnace 100,000 BTU (ducistients) 46.75
1 46.15 46.75
_ Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldgJapt. no.: Project name:
Heat pump 61.06
Cross streetidirections to job site: Duct work 23.32
H,vdronic 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
Subdivision: Lot no.: Fine/vent for any of above 23.32
Other: 23.32
Tax map/parcel no.: Other fuel appliances
• DESCRIPTION OF WORK Water heater 23.32
Gas;lireplace, 33.39
Install gas furnace . Flue ,vent .for water heater or gas
• fireplace. _ 23.32
Log fighter (gas) 23.32 _ _
Wood/p`cltct stove 33.39
• Wood fireplace /insert 23.32
... Chimney /liner /nue/v'ent 23.32
❑ PROPERTY OWNER . ❑ TENANT --
Other 23.32
Name: Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 33.39
City/State/ZIT': . . Clothesidrver exhaust 33.39
Single:ductexhaust (bathrooms,
Phone: ( ) Fax :( ) toilet utility rooms) 23.32 -
❑ APPLICANT 0 CON TACT PERSON Auickrawlspace fans 23.32
Other: 23.32
Business name: ---
____ Fuel piping
Contact name: , - $14.75 for first four; 54.03 for each additional _
Address: ' Furnace, etc. 1 I 14A 5 14:15
- -- ' ' Gas heat pump .
CityiState /ZIP: W al1stispended/tmit Beater.
Phonc: ( ) Fax:: ( ) Water heater
Fireplace
E-mail: Range
CONTRACTOR _ Barbecue —_
Business name: Midway. Heating Company Clothes dryen(gas)
Other:
Address: 12625 SE Sherman ST 'MECHANICAL PERMIT FEES*
City/State/ZIP: Portland, OR 97233 Subtotal 60.90
Phone: (503) 252 -4043 Fax: (503) 252 -5881 Minimum permit fee (590.00) 90e00
1 Plan review (25% of permit fee)
CCB lic.: 24044 121)-[ 1 11 State surcharge (]2 %afpermit fee) 10.80
_ TOTAL PERMIT FEE 100180
' 1 1 t This permit application expires if a permit not obtained within 180
Authorized.signature: l, : , ' as,41. days after it has been accepted as cornp[ete
Print name: Debbie Jandro Date: 11/11/2009 * Fee methodology set by Tri -County Building Industry Service Board
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