Permit a CITY OF TIGARD
MECHANICAL PERMIT
: ;_- a COMMUNITY DEVELOPMENT Permit #: MEC2009 00629
T 1G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/24/2009
Parcel: 2S114AD01300
Jurisdiction: Tigard
Site address: 8887 SW WAVERLY DR
Subdivision: Lot: 0
Project: Davis
Project Description: Replace existing furnace.
Owner: FEES
DAVIS, ELWOOD Description Date Amount
8887 SW WAVERLY DR
TIGARD, OR 97224 Furnaces < 100K BTU 11/24/2009 $46.75
12% State Surcharge - Mechanical 11/24/2009 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 11/24/2009 $43.25
Contractor:
A -TEMP HEATING & COOLING
16000 SE EVELYN ST
CLACKAMAS, OR 97015 -9519
PHONE: 503 - 650 -5014
FAX: 503- 557 -2990
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: ■ - Ai" A ( �_, I I. ` , Permittee Signature: Q_Z___ YiPP
Ney 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.
1 ":/23/2009 16:48 5035572990 A -TEMP HEATING PAGE 01/02
1yMec'b,anica.i ,Permit ,ppplicatiOn v -, 9 1!isi clu t.ti h ,'.,.
Received
a `� : ;. City of Tigard Date/ , r A 10 , •
A23" nate�ti , f _bi.
J t - . 13125 SW Tiall 'Blvd., Tigard,
:gyp Phonc: 503.639,4171 Fax: 503.598.1960 q 4 zoo9 , ; 4tar Permit:
R Ins ection Line: 503,639.4175 v D Dat ReadyBy: Ftf See Page 2 for
TIt'rA` — - Internet: www,tigard- or.gov Notified/Method:
p ■ttttlLV>• Supplemental Information
NO 'VNotified/Method: t� � t z- � 'rt w '''�•,� �e.Ir�.I ��', m� e i � �r [� �•.�J�, ? �, w �,�;.; ��s �p~� tri!
� w " ? 1 L , ', V 1 l ,. in Y i 1 6 1 iT i kz""'. k'I'fS a �`,: f ukil A'fier' yL1t 6lt. 4y�i , dt�,. roj �, 1�. ..1 rsa Z. ..2
." - Mechanical permit fees" are basod on the value of the work
❑ New construction 11 Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 4.50E4‘' CI Other: mechanical materials, equipment, labor, overhead. and profit.
�M� � r ., , ,,, ,. r!P'` " . �' G � c� . value 5
4 v
„ b 7 h
" 1 s m bt r r'. .,.t r dr1 ip p . r1n. °tti h °:" t
1- and 2- family dwelling 0 Commercial /industrial 0 Accessory building l x "' �' "r j` ` ai i„' � r' ` t� • r
For special information use checklist.
❑ Multi - family 0 Master builder 0 Other: Description Qty. I Ea. 1 Total
'
* „4r1T :Tot t � t !' 1a t tiw. ` rf' ; ` liming/cooling
coolin
��'�`�I �� r:. ? � 1 ., ,�ta�, �� .t �a> ' i "_ tii•�ii�. F1 R
Air conditioning
Job sitc address t � ' A , 1 . 0 (roquirce site plan showin�epm
lnoeent) 46.75 , 'f, / Furnace 100,000 BTU (ducts /vents) 46.75
City /State /ZIP: '
�r /
1 ' - fir+ Fumaco 100,000+ BTU (duets/vents) 54.91
Suitc/bldgiapt, no.: Project name: ,11.114 I•Ieat pump t 61,06
Cross street/directions to job site: Ductwork 23.32
I-iydronic hot water systCm 23.32
Residential boiler (radia r or
hydronic) Ir. 23.32
Unit heaters (fllel•typc, not electric),
in -wall, in -duct, su. ended, etc. 46.75
Lot no.:
Fluc/vcnt for any of abo�c 23.32
Subdivision: _ Other: 23.32 .
Tax map /parcel no.: Other fuel appliances
a nt i 1 t 4 z:. � T , #i r� at .. t ( k p ' , � ; y p. Water heater
[ 23.32
1 ',,. ��k;'� ., I itM .. s i+ � 'i ..Pity v "I..y b mr
Gas fireplace _ 33.39
• * . J tl A #, _. t d 1 _ ' _ _ Fluc vent for water heater or gas
• fireplace -- 23.32
Log lighter (gas) 1 23.32
Wood /pellet stove 33.39
Wood fireplace /insert ' 23.32
,, 1 Chimne /liner /flue /vent ^ 23.32
rt � " ` i � arc *A x, 1:,, i t$l #,,Na1 (� l l "d . Al'''l' „ - 1 . . g k`'.gt, ..'lk`, k a ''1.1 X
a3+; :i .,.< Other: 23,32
Name: Ma A' 'Ili,/ Environmental cxhauatand vcntilntlon
Range hood /other Idtchen
Address: 9 i� 1 AP — equipment 33.39
City /State /ZIP: • • eV Clothes dryer exhaust . i i , _ 33.39
q Singlc -duct exhaust (batl4irooma,
Phonc 6 at ! . Are Fax ( ) toilet compartments, utillt ooms) 23.32
P " - t 1 3l W 1,". ,. 5 VON no Im es , . e bik$ x �1 t , Attic /crawlspaccfans 1 23.32
Other: 23.32
Business name: = . I i • • S �, a. , 1 ., Fuel piping '
Contact ,.......,e, e: � ;� A a. - .. _ $14.15 for first four; $4.03 for each additional
Furnace. etc.
Address:
uV1
Gas heat pump
City /State/ZIP: (' 1 Ka YYat �D ('I Wall /suspended /unit hector
Phone: 60 0 , w 11,4 Fax: : CO / l 4 50 Plater heater
' F ` ' Fireplace
E-mail: y qn ^l R r.. V 1/ ', • i c // Ranzc
��w;� ' 'vN 1 ' - *,�r A r� . �. ' WV. o • 0 • 4 .. Ct) 'M111"r' D • l. r i ,Yt Barbccac •
, W, t '. `alaMi5r41 LSt?. I,.i„ k1,, , , P •i. ; i-Sit . ' ,,itt,.' 4 ii i
1 ,v, t 0A '
� �� � (3 • ,ii A Other; Clothes dryer (gas)
Business name:
�� .k{.i , 1�� ., •�G Other:
y�- tiw�+ �"r•., r e f , w. 't • l
Address: C �� ki4� , ,x , ,r jasinz ° � .'• v � X 1; . 4 S.
City /State /ZJP: k ,5 012-L '1'1c Subtotal �^
Phone: t U J(.' Fax: ' ) / ! v - Minimum permit fee (590.00) • •
Plan rcyiew (25% of permit fee) ....------
CCB lie,: r 1 1 State surcharge (12% of permit fee) wawa
TOTAL PERMIT FEE do . ,
Authorized signatu This permit application ettpires If n permit is not obtained within 18n
f di , + day after (than been accepted as complete.
Print. name: j / _� I ' � Date: WI& • Fec methodology set by Tri- County Building Industry Service hoard
I:\ mild !ne0tclaaMP.4- PermltApp,dec 10/01/09 440.:617T(11/02/COM/W131i) ,
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