Permit „� n CITY OF TIGARD MECHANICAL PERMIT
ill . C ..- COMMUNITY DEVELOPMENT Permit #: MEC2009 00681
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/23/2009
TIGAA Parcel: 2S104AC13400
Jurisdiction: Tigard
Site address: 12950 SW 135TH AVE
Subdivision: HANDY ACRES Lot: 31
Project: Baxter
Project Description: Install furnace, duct work and gas piping.
Owner: FEES
BAXTER, BARRY Description Date Amount
12950 SW 135TH
TIGARD, OR 97223 Furnaces < 100K BTU 12/23/2009 $46.75
Duct Work 12/23/2009 $23.32
PHONE: 503 - 524 -4961 Fuel Piping 12/23/2009 $14.15
12% State Surcharge - Mechanical 12/23/2009 $10.80
Contractor: Minimum Fee Adjustment - Mechanical 12/23/2009 $5.78
HONKE HEATING & AIR CONDITION INC
840 NE CLEVLAND
GRESHAM, OR 97030
PHONE: 503 - 666 -3725
FAX: 503 - 666 -0589
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.
Issued By: �0 k , . Permittee Signature: O7' , f 7 / 61 L iC' 7 o
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.
Dec.. ?3 09 03:20p Honke Heating 503- 666 -0589 p.1
r t .� ,<� 'bT` tax., �; a
Mechanical Permit Application ,, • ¢- - - ' FO 0E H Ic E :� � -
v 3 Received 3 Permit Ngll, P
Cit of Tigard � c, Race
9 Date/By: ✓ ,,? / %0 l
° 13125 SW Hall Blvd.. Tigard, OR 9 p la n Revte
�O Other Permit:
I;.'1 F. lj r�: Phone: 503.639.4171 Fax: 503.598. 960 on C1 Plan n Re
r �tT77i G• . � sR D � lnspectton Line: 503.639. } 175 `� r D A R9 Date RcadyiBy: runs: '' El See Page 2 far
it Internet: www�.tigard- or.gov '
V O � ( '� r' ".0 Notified/Method: 0 6 Supplemental Information
(`� � `�.Nr1 l COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
TYPE OF WO A %
��vv Mechanical permit fees* are based on the value of the work
❑ New construction ®Additiun/allerati0rt /replacement performed. Indicate the value(rounded to the nearest dollar) of all
❑ 1)emalition ❑ Other: mechanical materials, cquipmenI, labor. overhead, and profit.
CATEGORY OF CONSTRUCTION Yahie:
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
Z I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description i I Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/coaling i
Job site address: 12950 SW 135 AVENUE Air conditioning i
(requires site plan showing placental() 46.75 L
City /State /ZIP: TIGARD, OR 97223 Furnace 100,000 BTU (ductsivcats) 1 46.75 14. a)
Furnace 100,000+ BTU (duclslvents) 54.91
Suite /bldg. /apt. no.: Project name: BARRY BAXTER _ Heat pump 61.06
Cross street/directions to job site: Duct work i j 2332 a 3. 3.7
Hydronic hot water system ; 23.32
Residential boiler (radiator on
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, 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 i
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
Flue vent for water heater origas
fireplace 23.32
Log lighter (gas) 23.32 y
Wood /pellet stove 33.39
Wood fireplace/insen i 23.32
1 Chimney /liner /Ilueivent 23.32
® PROPERTY OWNER ❑ TENANT
Other: 23.32
Name: BARRY BAXTER Environmental exhaust and ventilation
.Address: 12950 SE 135 AVE UE Range hood,'ather kitchen
equipment 33.39
•
CityiState /Z1P: TIGARD, OR 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms.
Phone: (503)524 -4961 Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans i 23.32
Business name: HONKE HEATING & AIR CONDITIONING Oder: , 23.32 ■
Fuel piping
Contact. name: I)AN PLUIIIONDORE S14.15 for first four; 54.03 for each additional
• Address: 840 NE CLEVELAND AVE Furnace, etc. 7 14 46
Gas heat pump
' CityJStaleiZIP: GRESHAM, OR 97030 Walllsuspended/unit heater
Phone: (503) 666 -3725 Fax:: (503) 666 -0589 Water heater
Fireplace
E -mail: DAN@HONKEFIEATING.CO I Range
CONTRACTOR Barbecue
•
Business name: HONKE HEATING & AIR CONDITIONING Cloches dryer (gas) .
Other: L__
Address: 840 NE CLEVELAND AVE MECHANICAL PERMIT FEES*
City: /StateJZIP: GRESHAM, OR 97030 Subtotal _ 2
Phone: (503) 666 -3725 Fax: (503) 666 -0589 Minim* permit fee ($90.00)Q ,
Plan review (25% of permit fee)
0 V CCB lie.: 71762 i✓ Adak State surcharge (12% of permit f) 1 „ $0
TOTAL PERMMT FEE
This permit application expires if a permit is not obtained within 189
Authorized signature: , days after it has been accepted as complete.
Print name: DAN PLUMONDORE 1 Date: ' Fce methodology set by Tri -6eunty &lading industry Service Hoard f�
1:1 Building \Perwit st.MEC- Permit.App.Sec LC/01 /09 440- t617T(11;02 /COMIWEa) - MO J j C i7