Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00678
Date Issued: 12/23/2009
TIGAAD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S111CA08000
Jurisdiction: Tigard
Site address: 9955 SW KABLE ST
Subdivision: GULF SIDE ESTATES NO. 2 Lot: 24
Project: Carrigg
Project Description: Replace furnace.
Owner: FEES
CARRIGG, STEPHEN Description Date Amount
9955 SW KABLE ST Furnaces < 100K BTU 12/23/2009 $46.75
TIGARD, OR 97224 FlueNent For Any of Above 12/23/2009 $23.32
PHONE: 503 - 624 -9154 12% State Surcharge - Mechanical 12/23/2009 $10.80
Minimum Fee Adjustment - Mechanical 12/23/2009 $19.93
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: ,tlagalik Permittee Signature: p.' /°G j07
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.
Q -23 -2009 08:55A FROM: TO : 5E135981960 P.1
Mechanical Permit Anplicati iii, ECE IVE ,1:-,,4.,' = Y . ,, , I IJR csi a I(l f,: l t3 a , '� o f�°. '''':1'''
" City of Tigard Received pe rmit No.
° DEC 2 3 2009 Date/By: Review
/ "0 � 007 -- 0 0 6 7,P
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
S a Phone: 503.639.4171 Fax 503 Date/By: Other Permit:
tnl: .A ra Inspection Line: 503.639.4175 D ate R eady /By: Ju ' • fa See Page 2 for
Internet: www.tigard or.gOV CITY OF TIGARD Notified/Method: /I br Supplemental Information
BUILDING DIVISION
TYPE OF. WORK COMMERCIAL FEE* SCHEDULE .USECIIECKLIST
Mechanical permit fees' are based on the value of the work
New conslructian
❑ ®Addition /alteration /replacement performed.. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT 1 SYSTEMS FEES*
® I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/tooling
Job site address: SS s wit V l - Air conditioning
(requires sitcplan showing placement) 46.75
City/State /ZIP: 1 rI V22-4 Furnace 100,000 BTUI(dects/vents) 46.75
�,J Furnace 100,000+ BTU (ductslvenls) 54.91
Suitelbldg. /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, induct, suspended, etc. 46.75
Flue /vent for any of above 1 23.32
Subdivision: Lot no.:
Other: _ 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
• "'T ( O Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Woodhellet stove __ ______ _ 33.39 _______r.
Wood fireplace /insert 23,32
PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name: CQtrl' I Environmental exhaust and ventilation
Address: S 1 1`_ ' Range hood /other kitchen
equipment 33.39
City /State /ZIP: Clothes d er exhaust 33.39
b) W � ' ! i comp
Single-duct exhaust (bathrooms,
Phone: Fax: ( ) toilet compartments, utility rooms) 23.
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 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
Furnace, etc.
Address:
Gas heat pump ,
City/State /ZIP: Wallsuspended/unit heater
Phone: ( ) Fax:: ( )
Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: Tri County Temp Control Clothes dryer (gas) ,
Other:
Address: 13150 5 Clackamas River Drive MECHANICAL PERMIT FEES*
City/State /ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 557.2220 Fax: (503) 557.0919 Plan review (25% of permit fee)
CCB lic.: 72623 State surcharge (12% of permit fee)
TOTAL PERMIT FEE 1 V V. ILi
This permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: ,1 (QJt M. .SOr1 I Date: 1212.b1)913) • Fee methodology set by Tri -County Building Industry Service Board
1. 111uildingWPcrmit t \MEC•PermitApp.doe 10/01/09 440-4617T (1 l /02JCOM/waa)