Permit • ,fl , CITY OF TIGARD MECHANICAL PERMIT
ill 1 ; ' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00551
o -
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/20/2009
�T'I 1 • Parcel: 1S134C806601
Jurisdiction: Tigard
Site address: 12500 SW NORTH DAKOTA ST
Subdivision: Lot: 0
Project: Pham
Project Description: Replace furnace.
Owner: FEES
PHAM, HUANG Description Date Amount
12500 SW NORTH DAKOTA ST Furnaces < 100K BTU 10/20/2009 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 10/20/2009 $10.80
PHONE: 971 - 226 -0436 Minimum Fee Adjustment - Mechanical 10/20/2009 $43.25
Contractor:
COMFORT AIR HEATING & COOLING INC
PO BOX 821484
VANCOUVER, WA 98682
PHONE: 360- 891 -2665
FAX: 360- 891 -2666
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: i lit-44 i- Permittee Signature: 0--)4---- 0--)4---- / r '/ A
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.
R ' .0/15/2009 23:03 3608912666 COMFORT AIR HEATING PAGE 01/02
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Mechanical Permit Applicati Ft I 1! U t Received
= City of Tigard Date/By: PermitNo.: ` (�/1� A200 q (
N. 13125 $W tlall Blvd., Tigard, OR 97223 0 Plan Review r �x l� C l J ,7
Phone: 503.539.4171 Fax: 503.598.1960 f L ' I ' .- '' G ' / DaielBy. Other Pertnit:
Inspection Line: 503.639.4175 R l See Pa 2 T I C A R 11 Date •
Resdy / Juri ge for
Internet: wttw.tigard- or Cl'
O� 5 IGAR Notified/Method: 1 - ' Supplemental Informati
S'9li DIN a DIVISION _
° �, , it .... "T' 11 rYl 1 d!1 I ,, ..,,,.•... •,r,, ,.{ t u „•l u
I if' t ' l :! !.. s I , ,,, i i i 1 ! ++ . ,,,,,, t 6 { 1, , iJ tit r: Mill 1 P 0` :''.�..!{� Wit , jk4,1
.
i ,rl l.,;:, -, l?,,!„ ,;.0 1,(,''il`Et.0iiii'iil.i..:. �t „, ,'.�� i+n��11 . ,._ I111!ii�ld. i9i Sn•,.,dlf ,. +. ,. +,...+tr Ii9 F�ilISf,Y it ........... ..Ni,dl .„, „,,,I, 1 • • ,, ,, ,•., .i.- ,2,,,LI. . !?, i. 11
Mechanical permit fees* are based on the value of the work
❑ N w construction rldditionlalteratign /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
t .i. ,. . Y 1 - ,,,,, , , IlHlllt't N t i Value: ' tt +� INS 1.0. I11 iI 11 y �„{,� J • i llu 1 i ,,' r i l ' • " " . 1 . '"*''" it )11'il' Nt i t4S
- and 2- family dwelling �` tT
❑Commercial /industrial ❑ Accessory budding •' ' ° ° " ' ' �` ` " "'' � °"�' " • ` �'
For special Information use checklist.
❑ Multi-family ❑ Master builder ❑ Other: Description Qty. I Ea. I Total
h1 q+ 'i �, •�, ,.•..;_ , 11' ltiaG�++Il iii ii
+ ,1� 7 uli Ili, ' ° , l t` 001 t I� i1). :1'130A ti{ ;ICI �`'1 Ifil' i 13eatincic0oling
r.J, ..: llu V( ey, G.,, a. .:. ,w1 ' ) t l c . v. l.LA�LI p :•:.Ll. ra
Job site address: ,'It' &AD 1.3o k ' '�� 6 Si- Air conditioning
ices . e p
(requires siteplan showing placement) 4 6. 7 5
^ City /State /ZiP: ' 0,(A1C (j( t of, "-223 Furnace 100,000 BTU (ducts /vents) f• 46.75 ybo� 5-.
Furnace 100,000 BTU (duets/vents) 54.91
Suite /bldg. /apt. no.: Project name:
Heat pump 61.06
Cross street/directions to job site: Duct work _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
Subdivision: 1 Flue /vent for any of above 23,32
Lot no.. I Other: _�__ 23.32
Tax map /parcel no.: I Other fuel appliances
tiiid 4i 11f I, : �' ill °I H q 1 . iiii( 1 1 idi3Fii e*( {i�rl :iti'tt i 1 ' 1 giii!t IIigi, W ate r heater 23.32
1 I °�11C V/t ,,.:.t,.,i e „ ,,.,,, ,., .. nu,u ....... e . lx}7 n1 i, .,x,.. udl l«rd• +.ln,,,t h,c.,r.
� di l .. h G es fi t l ace 33.39
(9-- 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
, r t r t ' 4 P ! 1 , ,il,+, Chimney/liner/flue/vent
23.32
ii } t; s l l' ll j , ` ' ... :.: • . 'Y. :' : :,.0.,l l f i l l., l ,l i i,.,...t�n.l;∎1 /1t f :k ° onp u �v�1, ( - ..! - Other: 23.32
Name: ciVACkvyA C W� Environmentsl exhaust and ventilation
1 Range hood /other kitchen
AddreSS: 1'2 SA., 06'x( .- y . ._ * • " equipment _ 33.39
City /State /ZiP: - ` �,�r, ' t
' Q g., 00-22_ Clothes dryer exhaust 33,39
" Single -duct exhaust (bathrooms,
Phone: (MI) ` 2 „Leo -0L- -4, ILO Fax: ( ) toilet compartments, utility rooms) 23.32
,) _ , 1 q , 1•Tr'' 1, 1 1' 3 ? •' C 1 , 1 ,yi1. 1 .. `
l t Akti N 4( n 1 1 4 r sf , 0 C"C i� i I g �l '1 Artic/crawl, pace fans 23.32
i A.; R 1 df , l . ; , . 6 {i l l dt 'l nl i ll ,r'' - l ). ", , i''' . 1 +, r , ; 1 tl ■Y l I ; ri l
' ,mom �
. .... - - Other: 23.32
Business name: _ Fuel piping
Contact name: V\ Vt' � ethv1.t� 514.15 for first four; S4.03 for each additional
Furnace. etc.
Address: J
Gas heat pump 1 _.,_.,._. ,,:.
City/State /ZIP: heater 1
' Q
Phone: (0) s q ` ... 94_0 s -- Fax:: ( ) Water heater _
Fireplace E-mail: \j‘ ' / r A. , es ' 1 l�T�`+ �Y' \ Range _
I❑ ui ! 1 i' It" NI ' u 11 i I 1 1 t u , � .,.- .T..._�„
s!l „ fi 4 t t.i t t 1 il i pi l ,r, I Barbecue
i• , ..;, 1;(�Ibu,,, •!lh+�'ili?;($1�',, +, i tfif( Yur ri,,. r!.(..iillll, °•9E�11 .,.,, r.
, !
Business name: Ct 6 i k� • C�� - . � UL Clothes dryer gas
Other: _-
Address: w d l it 9 ii s t 1 GLal k1 �f >, E)a 8 i lyi - `: rfl 1 I i
M�- 2, lltlllt,,,,,P., i r + „1,„�. f .x, I,i �,t
City /State /ZIP: v {-- ,ait U.M. 04-149,2_
Subtotal
( Ng) % ``"ZL_ b] (' V , I .-1,W Minv • � •
Phone: / Fax:
Plan review (25 °b of permit fee)
CCB lie,: 1 rp U . 5. State surcharge (12% of permit fee) P4?)
TOTAL PERMIT FEE r , •.r
This permit application expires if a permit is not obtained within 180
Authorized signature: 411111,111
days after it has been accepted os complete.
r Print name; . - ..n..... i = r Date: 1 W' CSI : Pee methodology Pet by Tri- County Building industry Service Board
1: 113uiidin5WVInit9 1nfEC- PernlltAD➢ dOC 10/01/09 440 - 4017T (11 /01/COht(VEB)
V i c.-k or ' rev tiin n OU
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