Permit ;'' CITY OF TIGARD
MECHANICAL PERMIT
'� COMMUNITY DEVELOPMENT Permit #: MEC2009 -00640
4,[ G1lRt� 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 12/02/2009
Parcel: 2S111CD03600
Jurisdiction: Tigard
Site address: 9585 SW BRENTWOOD PL
Subdivision: SUMMERFIELD NO.9 Lot: 525
Project: Ulwelling
Project Description: Replace gas furnace.
Owner: FEES
ULWELLING, KATHY Description Date Amount
9585 SW BRENTWOOD PL
TIGARD, OR 97281 Furnaces < 100K BTU 12/02/2009 $46.75
12% State Surcharge - Mechanical 12/02/2009 $10.80
PHONE: 503 - 706 -5286 Minimum Fee Adjustment - Mechanical 12/02/2009 $43.25
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD
TUALATIN, OR 97062
PHONE: 503 - 692 -1565
FAX: 503 - 691 -1879
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 qu o OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B Okef _ , Q D Permittee Signature
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.
-.12/01/2009 08: 21 5036911879 ARROW MECHANICAL PAGE 02/02
. . ._.... .... ... . .. ... .. ..._.... . . .......
- Mechanical Permit A . lication FOR Ol:F10E USE ONLY
City of Tigard RECEIVE Received 0
Datc/13y: , ' •
....,, i Pcirnit No.. IC •
. 13125 SW Hall 131vd., Tigard, OR 97223
1 1, Plan Review
I' Phone: 503.639.4171 Fax: 503,598.1960 D E C 0 1 2009 Datc/By: Other Permit.
TIGARD Inspection Line: 503.639.4175 Dote Rcady/By; • • ; ; • ; , 0 See Page 2 for
Inthruct: www.tigard-or.gov Nniified/Methed: • .. r, :.., kdT Supplemental Information
CITY OF TIGARD . .
' I 9;' . ',)' OVEMS,3■ ''' 7 ...ZiEVAVA'''' ,P '' ' '
, , ok. , . .44.■ ../(4.4 4.
• . Mcchanidal peimit fees* arc based on the value of the work
0 New construction [1;1 Addition/alteration/replacement
Performed. Indicate the value (rounded to tho nearest dollar) of all
0 Demolition 0 Other: . . ., Methanie,a1 materials, equipment, labor, overhead, and profit,
• Value; $
629 '7 4 r .' 14 .1 7§gi2V — OW ' : Ifict§W11?- 3 1441
q , i , ' ,,, 7 A ,, a 1 - ,, Pr i (, 177 0 72 , 7FA . ......„,,.., , p „, z _ z.zr
n
,:.Yr.i,:; ,i. .:, Al* f 4 • • ' - , 'In ' ., . ' , ■ • "'" S ' 4 ' • '. .' ' • • . ' ' ' • .•' • • ' d - ''''' .. . - ' . ' . " - " .. . ' ' i .11Witit . t7).4111,53M.11* 4.1:14etfri-.1ri;
i - and 2-family dwelling 0 Commercial/industri ' al 0 Accessory building ' •vt„,. .., ,,,,2=,--= MINAkvAii..,.iiy.sfe.7. •MS-44/Q1:14'....-Itt.31,.... rr , .
For .spccial information use checklist
0 Multi-family 0 Master builder 0 Other:
Description Qty. 1 Ea, 1 Total
" N n 9 4.1" n . • f ,..tFr''
,!, I ' ' j! :: P k ' rir'iq 4-it Tita
Air conditioning
Job site address: _15e6 . 1,A) 81rv( cop ft " (inquires site plan •lowing placement) 46.75
Ci ty/Statc/ZIP: , P 0 - :: .t. 1 Furnace 100,000 BTU (duets/vents) 1 T 46.75
, V • II
• • -..' Furnace 100,000+ BTU (dtiet,/vcnia) 54.91
Suite/bldg./apt. no.: Project. name: of ki , , 6, Heat pump 61.06
.
Cross street/directions to job site: Duct work 23.32
• _
±lydronic hot water system ..... 23,32
Residential boiler (radiator or
hydro:lie) 23.32 -----
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended. ctc. 46.75
- .---....
Fluc/vent for Any of above 23.32
Subdivision:
•
-- Lot no.:
I _Other: .
23.32
•
Tax map/parcel no.: Other fuel appliances
. 2.3.32 1
fire lace 33.39
1 er_ifi!—Ef-7-.42■C,67 Flue vent for water heater or as
fireplace 23.32
o, ; ,,,,,,,,,,,,,,,,,,,,,, .;: ``.. , ,• 4 : - .. , *rim dc,..„2ZIOterikRaY)*
:.;; , ,;;;-.7.,44, 4eodipMet g10 ,::L7, .: • ,
Wood fireplace/insert 23.32
",,,,.'i..'.'4:,;:i,,:v,•:4 Chimney/liner/flue/vent 23.32
. .., -1. :'.' . ..;& . 1::17):;.1.)1;1 4 p.fi t tl,INitA k S . ,F,;,!. '1,...,-,-4, , ,,,,.. 0 h ,
t er: 23.32
N timc: KA )! (- ( A I wellir-i3 ... Environmental exhaust and ventila ion
Rimge hood/other kitchen
Address: 45-., ,...• at20.47acycla PL equipment
City/State/ZIP: : , P OR q7 AI Cl dryer exhaust 33.39
Single-duct exhaust (bathrooms,
k .
Phone: (0 ) 706 -- G2,06 Fax: ( ) toilet compartments, utility rooms) 23.32
0 t,,:•••; . ,;;; , - ;;;;•:, yrii.)-..,!-,;:.,ii.:;, snt
,..;: A tt ic/crawlacc fans 23,3
!::::.i.t.'5,..:x.$1,,,:.,,,,;ait;,!:.,'.:1,,,T.j.:,'.0, .J. 00 „,, '- .........
• •
23,32
—
Business name: ij / ... y , t. 6.
Fuel piping _
Contact name: $14.1.5 for first four; S4.03 for each additional
jig FA "
. — Furnace, etc, _
Address: 0 33 ,,,,,....,. T A 'ATI ly le-d Gas hcat pump
City/Stare/7TP: . T A irrri . eM l . - - - ... — - ---- Wall/suspended/unit heater I----- 1
phone: 603 )6.1z.--/566 1 F.: : (9,5) 6:3 8 .7c7 Water heater
Fireplace _
E-mail:
Ti:iM%;".iM;YJ'Ai,106$00: 0 ',',.", B arhecue ---
' Clothes dryer (gas)
Business name: Aeko l 1, ..__ 44 ‘b u ti !c ( .
Other:
77 ,,,:,-,'?:+14,114ViktiCtigAR.lat.41"1f•41?1,:-.2.g:.
Address: 16;330 b\AJ 71Lkia 71-‘) 44
.........._...... _
Subtotal 1.1.&.16 .
City/Stoic/ZIP: 7I 0 41 2
Minimum permit fee (S9(,00) 0.
Phone: (c0,3 ) 69%.216-6_,c Fax; ( (0.7,1 _ _ bv-,6# oif Plan review (25% of permit fee)
,—.,..., ___
State surcharge (12% of permit fee) to. SO
1 J..: 5-115
. _ ..
TOTAL PERMIT FF,I. I, Oc;i6
'T 0 ;perm i t i x i 1 is
dnc c o t o in n 1
Pri d v,i thn 180
i
Authorized signature: ,"---------
A
nt name: 7 6„....„ .
....s
7
Dnic: )1 - al i • r'c Inethodnlogy se; by Tri-County Buildinpin(11,stry Scrvicc Board
1 ',11,1,1d,ngTermi,x‘NIEC .Per mit Apr tloc 101009 4 ( r 1 in7/Cf1M/Velirs)