Permit CITY OF TIGARD MECHANICAL PERMIT
RI
` COMMUNITY DEVELOPMENT Permit #: MEC2010 -00064
TI GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/12/2010
Parcel: 1S125DC00500
Jurisdiction: Tigard
Site address: 9655 SW 74TH AVE
Subdivision: BOULEVARD HEIGHTS Lot: 27
Project: Jeffs
Project Description: Replace furnace.
Owner: FEES
JEFFS, JERRY Description Date Amount
9655 SW 74TH
TIGARD, OR 97223 Furnaces < 100K BTU 02/12/2010 $46.75
12% State Surcharge - Mechanical 02/12/2010 $10.80
PHONE: 503 - 244 -9186 Minimum Fee Adjustment - Mechanical 02/12/2010 $43.25
Contractor:
TRI COUNTY TEMP CONTROL INC
13150 S CLACKAMAS RIVER DR
OREGON CITY, OR 97045
PHONE: 503 - 557 -2220
FAX: 503 - 557 -0919
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
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.
Issued By: Permittee Signature:
CaII 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.
FEB -11 -2010 03:20P FROM: TO:5035981960 P.1
Mechanical Permit Application ,.t►,t, ►,.,.,, ,. l's, ,►\, ,
City of Tigard FEB 112010 Received Or
Date/By: , A /v iv r Permit No."1/6-esaz0/a — 6 1 /204 y
13125 SW Hall Blvd., Tigard, OR 97223
Plan Revie
Phone: 503.639.41.71. Fax: 503.59(1.1960 fi -
r - - Other Permit:
Inspection Line: 503.639.4175 • r . • �' f' A Datrlay:
!WARD Date Rendy/Ry: lure: 0 See Page 2 for
Internet: www.tigard- or.gov ,,;�,1 DIVISION Notified/Method: Supplementallnformadon
TYPE-. OE ORiC COMMI RCI'A1 FEE* ;40:14D40 .USECII �CKr:1C '.
❑ New construction ® Addition /alteratinn /replacement Mechanical permit fees* are based on the value of the work
.performed. Indicate the value (rounded halite nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
- CATEGORY .0l"COI' STRUCTION . . Value: $
. • REsiiiiwriAL E¢UrEh1EN'I'J$YSTEMS Iik:l':S* •
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
❑ Multi- family ❑Master builder . For special iujormalioxi use checklist ❑ Other: Description I Qty. I En. I Total
, . ;LOB -SPI'P INFORMATION AND LOCATION Heating/cooling
Job site address: ' q(II 5 �U 7 Air conditioning
6. 4 (requires site plan showing placement) 46.75
City/State /ZIP: 1 a1223 Fumacc 100,000 BTU (ducts/vents) 1 _ 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Pmject name: Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall; in- suspended, etc. 46.75
Subdivision: Lot no.:
Flue/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 fireplace 33.39
Flue vent for water heater or gas
• R ' )V OZ �'f , r{/1 . l C fireplace 23.32
1` tN��, ��'lA ► tWL,U Log•lighter(Ras) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
` • , , . Chimney/liner/fluelvent 23,32
PROAERTY' OWNER 0 TENANT Other: 23.32
Name: l %.IQ.(� Environmental exhaust and ventilation
Address: ��``° Range hood /other kitchen
equipment 33.39
City /State/ZIP: . Clothes dryer exhaust 33,39
Phone: (DM) , ? ) l (P 2_44—A 1 S / Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
. .® APPLICANT.' ❑ CON1'ACP PERSON Attie/crawlspace fans 23.32
Business narne: Same as contractor Other: 23.32
m
Fuel piping
Contact name: Diane Mason $14.15 for first four; S4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /Z1P: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater ,
Fireplace
E -mail:
legit _
CONTRACTOR Barbecue
Business name: Trl County Temp Control
Clothes dryer (gas)
Other:
Address: 1315U S Clackamas River Drive MECHANICAL.PERMEf FEES"
City / State/ZIP: Oregon City, OR 97045 Subtotal
'hone: (503) 557.2220 Fax: (503) 557.0919 Minimum permit fee ($90.00)
Plan review (25% of permit fee)
., CC13 Iic.: 72623 State surcharge (12% of perniit fee) ! 00 a,
TOTAL PERMIT FEE
Authorized signaturc: This permit application
after it as been accepted l as complete.
obtained within 180
l te.
[ Print name: vi a rL mccoon I Date: 41.41b • Fee methodology set by Tn•County Building Industry Service Board
1 v' lit nr. "cnnnf MGC Per mit App doc 10.01'09 440-4617T (11/OLCOAVWr:a)