Permit ° k`:f.' • CITY OF TIGARD MECHANICAL PERMIT
-;.. COMMUNITY DEVELOPMENT Permit #: MEC2009 -00534
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/09/2009
ta g Parcel: 1S133CD02500
Jurisdiction: Tigard
Site address: 11798 SW SWENDON LP
Subdivision: Lot: 0
Project: Manning
Project Description: Replace gas furnace
Owner: FEES
MANNING, MARY Description Date Amount
11798 SW SWENDEN LOOP Furnaces < 100K BTU 10/09/2009 $46.75
TIGARD, OR 97223 12% State Surcharge - Mechanical 10/09/2009 $10.80
PHONE: 503 - 524 -4024 Minimum Fee Adjustment - Mechanical 10/09/2009 $43.25
Contractor:
EASTSIDE HEATING & AIR CONDITIONING
7200 SW JOHNSON CREEK BLVD
PORTLAND, OR 97206
PHONE: 503 - 774 -3281
FAX: 503 - 774 -3057
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: Permittee Signature: 14.
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.
Flom: 10/07/2009 15:16 #777 P.002/002
Mechanical Permit Application "+k ° F t H rE, IC,L • s� it
City of Tigard erved _
Date/By Permit NoA
° 13125 SW Hall Blvd., Tigard, OR 97223 OCT ® n p ItAC --` 0 - dr-Y 3
i, 7 2'J J Plan Review
�, i Phone: 503.639 4171 Fax: 503.598.1960 Date/By: Other Permit:
Li 16 -415.' Inspection L.inc: 6 a te eay $ huts: u Wit Internet www.tigar 39.4175
CITY OF TIGARp y S upplemental Information
See Page 2 for
Notif ieRdd/Meth/od: S
__ ___ BUILDING DIVISION --
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees' are based on the value of the work
El New construction )21
performed. indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
•
CATEGORY OF CONSTRUCTION Value: $
dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
)2(1- and 2-family g ❑ C ommercial /industrial ❑ A ccessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address ') Air conditioning or heat pump
S ° "' S C O ` _ (requires site plan showing placement) 14.00
City /State /Z.1P: -, cl &cc\ + 0-.7., t 7 2 Furnace 100,000 BTU (ducts /vents) 1 14.00 1 y. l ) �
Furnace 100,000+ BTU (ducts/vents) 1 7.90
Suite/bldg. /apt. no.: I Project name: Gas heat pump 14.00 _
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, induct, suspended, etc. 14.00
Subdivision: Lot no.: Flue/vent for any of above 6.80 1
Other: 10.00
Tax map/parcel no.: Other fuel appliances
DESCRIPTION OF WORK _Water heater 10.00
1 - Gas fireplace 10.00
e ? `x„C 3 -- 1J.c - Yl0. e , Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
_ _
Wood fireplace/insert 10.00
(PROPERTY OR NER ❑ TENANT f Chimney/liner /flue/vent 10.00
j Other: 10
Name: \0. \ 0.`n Y Y -
\\Gr, Environmental exhaust and ventilation
Address: t J Range hood/other kitchen
G Su.l 5v...le.vv.c.r L - o0 ` t 7 equipment 10.00
City /State /ZIP: -7 csp -� \ , 0% c -' z 2 3 Clothes dryer exhaust ! 10.00
5 3 5 � Single -duct exhaust (bathrooms,
l
Phone: ( ) L\ - L.UZ LA Fax: ( ) toilet compartments. utility rooms) 6.80
APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Business name: Ewsts eta &.,r.s Fuel 10.00
Q\�e Cbv�.��Or�vn� Fuelpipin>;
Contact name: cuh to a rw0QA /+ �� ` S5.40 for first four: $1.00 for each additional
Address: -12DC, `,E Sohr,SCn c., -Z,i's �\VG1 • Furnace, etc.
Gas heat primp {
City /State /ZIP: Pta,c_kos.Y.a OR y1 ZO Cs. Wall /suspended/unit heater
Phone: (Se3) 1 Lk_ 32sk Fax: : (503) 1 - 3pr,1 Water heater
Fireplace
E -mail: v ncC (a e_C.-S . •'.‘q... .•'.‘q... \ ` r1' -Nt :.v- , t.:C - ) Range
CONTRACTOR Barbecue
• Clothes dryer (gas)
Business name:
r�S•ti5:e1 vr\ -1(- \� GrY.:s3: Other r
Address: .7100 SE S:.��r,v-. .,c:v1 CrLt_-\h ... \\18, • MECHANICAL PERMIT FEES*
City/State /ZIP: PtN + Cj G' Subtotal 44.(2 f s
Minimum permit tee ($72.50) 1.2-, 143- LS
Phone: (aC3 - ' l'ax:(SC3)•77 3.1 _
Plan review (25% of permit fee)
CCI3 lie.: s'25 s / State surcharge (12% of permit fee) �O- gJ
TOTAL PERMIT FEF, } 04
Authorized signature� a '.,,,.. ` This permit application expires if a permit is not obtained within 180 VO ��
� days after it has been accepted as complete.
5 n, +„• 0_6- I m
Fee ethafolnev set by Tri- County Buntline Industry Service Board
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