Permit CITY OF TIGARD
MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT Permit #: MEC201000119
° K Date Issued: 03/24/2010
T [ G AR Q 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
w �r Parcel: 2S104AA06100
Jurisdiction: Tigard
Site address: 12745 SW WILLS PL
Subdivision: Lot: 0
Project: Kuffel
Project Description: Replace existing gas furnace.
Owner: FEES
KUFFEL, DOUGLAS L & KENNAN Description Date Amount
12745 SW WILLS PL
TIGARD, OR 97223 Furnaces < 100K BTU 03/24/2010 $46.75
12% State Surcharge - Mechanical 03/24/2010 $10.80
PHONE: 503 - 705 -3201 Minimum Fee Adjustment - Mechanical 03/24/2010 $43.25
Contractor:
ABLE HEATING & COOLING
8900 SW BURNHAM F -5
TIGARD, OR 97223
PHONE: 503 - 579 -2250
FAX: 503 - 620 -3980
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuanc, or! wor 1 •ended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili otification Center. os ar et forth in OAR 952 - 001 -0010 through OAR 952-001-011 • • .y obtain a copy of the rules
or : irect questions to OUNC callin 3.246.6699 or 1.800.332.2344.
I • sued By: k. Permitter ignature: i ��` ✓�`��
CaII 503.639.4175 by 7:00 a.m. for an inspection that b I siness day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicat a ' c ' f 7 ,.` �7 "�' ` ' `� ��r�,.'. ,�'
" t . . ' } , lr' }' 1 . `7 "Z ` ' Received - ) (�)12�t Y f f ur 1 ... i6- i4. r , . 4 .
� ° ' . ?Sf /
• .,, ,� Cit o f Ti x r Permit No :
tt q 13125 SW HaII Blvd., Tigard, OR 97223 ate By ' 'l Per ���������,�
V 0 Plan Review
s,. s Ph one: 5 Fax: 503.598.1960VI 2 4 2 1 3 Date By: Other Permit:
r te' . � Pe Ins ction Line: 503.639.4175 Date Ready/By: Iuos Sec Page 2 for
T.It tf)�
l IIacs , '. ingot .t Internet: www.tigard- or.gov CITY OF T iC$AAD Nmified/lotethod: Supplemental information
•
Pi in ri1Mt r \ /1C1'i(' $
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction i ition/alterationirepiacement Mechanical permit fees* are based on the value of the work
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION i Value: $
I -and 2- family dwelling ❑ Commercial/industrial RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ Accessory building
❑ Multi -family ❑Master builder Far special information use checklist.
❑ Other: Description Qty. Ea. I Total
JOB SITE •INFORMATION AND LOCATION Heating/cooling i
f {} Air conditioning
Job site address: \
c� \},� \ 5 ` („ f (requires site plan shotivingplacement) 46.75
City /State /ZIP: \ ,r` ` G\r� QN�� Furnace 100,000 BTU (duc /eerts) \ 46.75 •
r� I Furnace 100,000+ BTU ( ductstvenls) 54.91
Suiteibldg./apt. no.: roject name: \<�` �-` Hest . 61.06
���llll .
Cross street/directions to job site: Duct work ' 23.32
I lydronic hot water system I 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type. not electric), '
in - wall, i - 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 1
;
—
ei ! . , `_ \ \ ' 1A t� Flue vent for water heater or gas 1
4 4 fireplace I 23.32
Log lighter (gas) 23.32
Wood/pellet stove I 33.39
Wood fireplace/insert 23.32
( Q- OPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name
kA■k 4 L Environmental exhaust and ventilation
- Range hood/other kitchen
Address:
1C� •\. \)1 9 equipment 33.39 I
City /State /ZIP: 'AK 'j 1P.°'.3 . Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: (S14...% r\ , '2 ` Fax: ( ) toilet compartments, utility rooms) 23.32
❑ APPLICANT _ ❑ CONTACT PERSON Atticicrawlspace fans 23.32 I
Business 23.32 I
usiness name:
Fuel piping
Contact name: 514.15 for first four: $4.03 for each additional
Address: Furnace, em.
— — Gas heat pump 1
City/State /ZIP: Wallisuspended'unit heater
Phone: ( ) Far:: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: e `� ` ii •' - 6 ii , .
Clothes dryer (gas)
Other:
Address 0O , k)1 \ - , ` t _� MECHANICAL PERMIT FEES*
City/State/ZEI - �i f 0-Q `� � � � I. Subtotal
v �� Minimum permit fee ($90.00) LAD .00
Phone: _ `''4 ^� 5 Fax: (5 ,, ' Dr) . .o, g 0 Plan review (25% of permit fee)
� �+
CCB 1ic,: , \ '� State surcharge (12% of permit fee) 1 D. '�}
/ TOT PERMIT FEE 49\ DO A0
Authorized si: • two �� This permit application expires if a permit is not obtained within 180
' ' days alter it has been accepted as complete.
Print name: � // �� Date: - _
• Fee methodology set by Tri- County Building Industry Service Board
I:1BuildingTermitslMEC- Permii€. doe 10701/09 440 -46171 (1ti02fCDMfWEB)
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