Permit 1 .
���� ® MECHANICAL PERMIT
„ OF TIGARD
i ''" COMMUNITY DEVELOPMENT Permit #: MEC2009- 00565
Date Issued: 10/23/2009
TIGARD: 13125 SW Hall Blvd., Tigard OR 97223 '503.639.4171
Parcel: 2S 1026600201
Jurisdiction: Tigard
Site address: 1 SW KATHERINE ST
Subdivision: Lot: 0
Project: Fleming
Project Description: Replace gas furnace.
Owrier: FEES
FLEMING, PATTI Description Date Amount
10060 SW KATHERINE Furnaces < 100K BTU 10/23/2009 $46.75
TIGARD, OR 97223
FlueNent For Any of Above 10/23/2009 $23.32
PHONE: 503 - 639 -5408 12% State Surcharge - Mechanical 10/23/2009 $10.80
Minimum Fee Adjustment - Mechanical 10/23/2009 $19.93
Contractor: .
BEN'S HEATING & AIR CONDITIONING LLC
PO BOX 80607
PORTLAND, OR 97280
PHONE: 503 - 233 -1779
FAX: 503 - 651 -3345
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 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 -0100. You may obtain.a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. w
•
Issued By: G 1 - -- Permittee Signature: D !/ i / �r G/ C ��e
Call 503.639.4175 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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1 City of Tivird Received -. , I
PVIII111 NO ■••"-- , /7 ri m a...A
Dme/t3y; /49 04,3 '/ .,:rhAgel , • ..0-‘,90 t./0.5
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6 , ,,, . ,., .1,3125 sw j1 ligard. OR 72...
Phi 501.639A 1 71 Fax! • M)3.398; I L)60
f D l a a :C/ R n e y v 7 kw Onwr Perini'
# ., Inspection Li ne: '503'.6:39.4 i 75 CITY OF TIGARD
Dale Ready/By: ,.., , Fa See Page 2 fur
Irlie'rlICI: wwW.ligard-or.gov
BUILDING DIVISION Notified/Method .-ri 6 .-- Supplemental Information'
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TYPE ‘V • OF ORK COMMERCIAL FF.E* SCIIEDULE - LSE CHECKLIST
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Meehanieal permit reCti' are bused on the value 01 %\ Olk
0 New construction g Additionialtcration/replacement
performed. Indicate the value (rounded to the 11irust dullur) or all
Ej [),,nolition 0 Other: • mechanical materials, equipment. labor, overhead, and profit.
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CATECORA' OF CONSTRUCT Valu S
ION .
RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
I - and 2-flintily dwelling 0 Commercial/industrial [..] Accessory building
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N1(.10-1.flu 0 M
.., aster builder q Other: _
Dcsuiption 1:0)- special uliarnialion use checklist
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JOB SITE INFORMATION AND 1.0(:3:9 )ON I lea ling/cooling
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ob address: / ' N‘ie ^ IIVC_,
V e 6 0 Air conditioning or heat mono
. 1_ 14 00
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Furnace 100 000 13'111 t
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City/State/7 '7 1/11 •t 0 C , 1 ag. 1 1 100.000+ 13 ohici, 17.90_ •
Suite/bIdglapt. tto.: Project name: as heat pump 1 4.00
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Cross street/directions to job site: 1)tiet work . , ...-- 1-1.00
- Ilvdronic hot wino' S\ a011 (4.00
Residential holler (radi)tor or
' --,
hydronic) 14.00
— - Unit heaters 1111cl-type, not electric).
in-wall, in-dttet. suspended, el e ,.. . .......„ 1 00_,
-
--• Flue/vent lkmy of above /
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suid165i _-, .-
on: i tot no:
Other 1 0 no L
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fax map/parcel no.. . Other fuel appliances
Water'heater Ill 00 T
DESCRIPTION OF WORK .... _
fireplace. 10.00
(rill-pl Gas e4t.e.- e )5:stAir144"" Flue vent for WtliC1' healer (ir gas —____...._„.„...__ ,.
fireplace , . 10 0(1
' Log lighter (gas) i 0.0o
—..... -..,...
Wood/pellet stove _ 10,00
....,, . ..
Wand liteplace/insert it) 00
--„----.....
— Chinuieviliner/Ilue/vein 1 0.00
Milr PROPERTY OWNER • 0 TENANT
t Other 10.00
m _ 71
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N:iu et ,. .Birm,e . _ - En
. . vironmental exhaust and ■entlla Ion
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-- • "itimge. hood/o(her kite:1%n
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• Address: /00fi /9 _Ct e ( j cquillmoll __ 1 0,011
City/SIT,th2/ZIP: 1 — 1 •
s' – 0e.
q- :133 Clothes.ther exhaust -- - 0
t , 00
., , - Single-duel exhaust thathrtthnls.
. i'litlitcg2 ) 6 1 - . g g I'i': 1 ) toilet corlparlimills utility t)0111q
0 APPLICANT Ezi CONTACT PERSON AttiefcrimisEice rain. 11111()
- ---- - ' °lifer 1 1)1110 . .
111.1S illeSS,1111rrle: f 1 ..„ ' , 1 A r . 1 L C. Fuel piping .
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s5.40 for first pulp; SI_00 for eaCil :icidilional
C oilLavl itamc: C ( A , (:),,, r i r ..,
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Furnace. etc, , .. .
Addres,i;
_ • tins heat pump ___._._ ... ,_. .____._._____._.....
City,tate/Z10: - Wall/supended/unit heater .
Phone, (5‘ --', ) 3 i 3 — '3 4',,f .(..., 1 — ra.,, : (3 ) 6 1 .. 33 ( J Water hatter -- .,
------ --- Fireplucc
F.-Inail: - Riirl,g0
CONTRACTOR Barbecue __._ __ _
Clothes di , ,er (gas)
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g-L,. & 0 9 MECHANICAL.PERMIT FEES*
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CI 1}t'SI 11 IC/ZI I e„ +.,,,.A. ,,, (-/ 2:)..f1,-...) _ subi.,
■ . Minimum perinti lee (1.1.2, 9'n_, _fa
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ne: ( l'it ) , , , i 3 3 —17 9 ? l'ax'1,3 1 _J/ - 3 J— Han NVIew (25%01 pc.rroil 1o:1
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,\■ lie.: L/ q - i a Slate surcharge CI 2% a permit Cee)
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.10 PERMIT FLI.; ily_a_
1 ' 1 ,.: This permit applieaoireg
llilre, If a penult is not obtained ■vi thin ISO
Authorized signature: dap, after it hi N ileell lieeelltrIl 05 comidele. •
int nal 11: -E-.. A CL
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