Permit ? 'a CITY OF TIGARD MECHANICAL PERMIT
•
. 2 COMMUNITY DEVELOPMENT Permit #: MEC2009 -00692
T i GARD 13125 SW HaII Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/30/2009
Parcel: 2S110DA04700
Jurisdiction: Tigard
Site address: 10652 SW KABLE ST
Subdivision: ERICKSON HEIGHTS Lot: 8
Project: Whitney
Project Description: Install exhaust fan.
Owner: FEES
WHITNEY, THOMAS Description Date Amount
10652 SW KABLE ST AttiGCrawlspace Fans 12/30/2009 $23.32
TIGARD, OR 97224 12% State Surcharge - Mechanical 12/30/2009 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 12/30/2009 $66.68
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: Q 1 AQ l� Q�� Permittee Signature: Q
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.
- 4 DEC -30 -2009 10:00A FROM: T0:5035981960 P.1
• - RECEIVED
_ Mechanical Permit Application : x,44.: d,,, i to l.,til 1 1tt (',1 t1 1 . 47.' � r .
_Y0 DEC 3 0 2009 Receive
City of Tigard y t Permit No.: r ��Q
IL
r,, 13125 SW Hall Blvd., T OR 97223 r ITY OF TIGARD Other Permit:
lve � nFt Datc/f3
Revi
i + i e • Phone: 503.639.4171 Fax: 503.598.191 DatePlan /O
. Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready/By: EN RI See Page 2 for
tat
. Internet: www.tigard or.gov Notified/Method: Supplemental Information
TYPE OF WORK 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
0 Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
0 Multi - family ❑ Master builder ❑ Other: For specral information use checklist.
Description I Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/canling
Job site address: I Ot(ItI2 w i�O, Air conditioning
_ (requires site plun showing placement) 46.75
City /State /ZIP: No q,�,� Furnace 100,000 BTU (ducts /vents) 46.75 ,
Furnace 100,000+ BTU (ducts /vents) 54.91
Suite/bldg. /apt. no.: Project 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 -duct, suspended, etc. 46.75 ,
Flue/vent for any of' above 23.32
Subdivision: Lot no.:
Other: _ 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater - 23.32
Gas fireplace 33.39
( ni,441 1 Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
• Wood fireplace/insert 23.32
11 PROPERTY OWNER ❑ TENANT Chimney /liner /flue/vent 23
Other: 23.32
Name: TOM Vv ( Environmental exhaust and ventilation
Address: 8Q+! "� Range hood /other kitchen
equipment 33.39
City /State /ZIP: Clothes -dryer exhaust 33.39 ,
- Single -duct exhaust (bathrooms,
Phone: ( S) t 4 O"72D Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 1 23.32
' Other: 23.32
Business name: Same as contractor
Fuel piping
Contact name: Diane Mason 514.15 for first four; 54.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: Wall /suspended/unit heater
Fax: Water heater
Phone: ( ) ( ) -
Fireplace
E -mail: Range
CONTRAC'T'OR Barbecue
Business name: Tri County Temp Control Clothes dryer (gas)
Other:
Address: 13150 S Clackamas River Drive MECHANICA-L PERMIT FEES*
City/State /ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee (590.00)
Phone: (503) 557.2220 Fax: (503) 557.0919 Plan review (25% of permit fee)
CCB tic.: 72623 State surcharge (12% of permit fee)
G TOTAL PERMIT FEE 10030
Authorized signature: �" - This permit application expires if a permit is not obtained within 180
��� da a fter it has been accepted as complete.
`
Print name: D 1 cox. Mahon Date: • Fee methodology set by Tri -County Building Industry Service Board
t.lauildingTermits\MEC- Permit App doc 10/01/09 444.4617T(11/02ICOMIWE11)