Permit CITY OF TIGARD MECHANICAL PERMIT
�'1 a COMMUNITY DEVELOPMENT Permit #: MEC2009 -00285
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06/15/2009
Parcel: 1 S 136AC00400
Jurisdiction: Tigard
Site address: 10595 SW ST AV.E,
Subdivision: METZGER ACRE TRACTS Lot: 5
Project: 48131
Project Description: Install gas furnace and heat pump.
Owner: FEES
BESS, BOB G AND EVA JO Description Date Amount
10595 SW 71ST AVE Air Conditioning or Heat Pump 06/15/2009 $14.00
PORTLAND, OR 97223 Furnaces < 100K BTU 06/15/2009 $14.00
PHONE: 12% State Surcharge - Mechanical 06/15/2009 $8.70
Minimum Fee Adjustment - Mechanical 06/15/2009 $44.50
Contractor:
SUN GLOW INC
2428 SE 105TH
PORTLAND, OR 97216
PHONE: 503 - 253 -7789
FAX: 503- 253 -7693
Type of Use:
Class of Work: Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressue:
Total $81.20
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.
(, 1
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Issued By: (.51(1 � �l (V(V ( �J \(Ili ,, A� Permittee Signature: � 9 vo \ ) �C 5 , 003.639.4175 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.
,-. iva4nonical Permit A ' . licati 0,tif r P IV r 0 1 01. V11_1' 1 !!". P. ()NI,Y • 1 : h
City of Tigard . , _ Received
Nivea No.: to, 0 c p . code
net • : . ■
III 1 -4 13125 SW Hall Blvd., Tigard, OR 97223 1 u N 1 1 2009 rio ,
1E4' Phone: 503.639.4171 Freci 503,5%1,1960 0
Datensy: Other Pennit
; ; ; , ;.; ,, , ., Inspection Lind 503.639,4175 - - ' , ' 0 Date Reedy/By: IWO in EteePsge 2 ihr
Internet: WWW.tigard-orgov CI ; . - 1 ' '.. •-° , krotifled/Mothocli Ompleinctred loforwhedon
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• • • :• .?.:'• . : .::. ' ••••• .. :':.. ' .. '... • '. i . ...• ::;:l.:•:: :L • , • . 00 VV01111C .. . • • . • . ' • ... • ..... ...... .„,,•; :: .• r: f ,1 4" CHECKLIST.
0 New construction 1 Addition/alteration/replacement 14ecbanical permit fees" are based on ate value Or the work '
perfumed. Indicate the value (rounded to the nearest donee) of all
CI Dentalition 0 Other: mechanical materiala,_cituipm $
11, labor. overhead, and profit
•.*:. • ,:- , . P.':; ' • ';';,,.......'..:':.? : , .,C.A7EtOORY OF cONSTRUCI101 : '' • ....• • . .... '•"
....=1:.,•' _ vuc
11E5Mipl'n4tOITIPIVIElvii sirkrEms FEES!' '. '. '
. : 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building - — ' " - •
For special irebrmation we checidisr.
0 Multi-family 0 Water builder 0 Other: Description j Qty. 1 Ea 1 ltdal
,' ,',"- .....; ; ..:;:. JOB 'SITE INFORMATION AND micATiox : ' :..::', .: Hew ,, —, . 1 . _
Job site andreso: rOni- FlIW..11111. 111 TA: Air conditionl r l or heel jiu .,.
reanleemite • an -. 14.00 i f-an
City/State/ZIP: \ • t ■ - o o•
• -?■ Furnace I I 4'10 S•U (ducts/venni 14. ". irj)
.., ., aZil 00,0004- BTU (ductstvents) .1 7.90
Suite/bldg./apt no.: Project name:
. Otet hcat pump 14.00
Cross street/directions to job site: Duel %voile 10.00
Flychonle hot water sYstem 14,00
Residential boiler (radiator or
hydraniel 14.00
Unit heaters (ftscl-type. not electric),
itmvall in-tli,e ..........
Flue/vent for any of above 6.N
!Subdivision: Lot no.:
Other 10,00
Tax map/parcel no Other ft:el appliance ,
• : : --•:•.;:-:.:::-.:::::: •.. .....:-:•'-..:' ::... ' DEsatirrioiv OF WO= . ....... , . .. .
Cos fireplace 10.00
• KIER Flue vent ft weer heater or gas
■111111SIBEITIEMISD 4a fiFilacc
lighter (gm) 10.00
10,00
• 'R 1 ). Y l' 1 ° Wood/pellet stove 10.00
od $
',.•-•'.-.?.' : ' **"..' CO ' - N ' r . 7 : • • • • • •
. . . 1 : . . .... 0
• • ...., . . , ,:.. ts .... . W "c12/1113cr----- Chininey/linerfflue/vertt j(1 10.00
• °Thor' 10 00
0 —..--:-----.............-.-4,...............—
Name: 11P V . ,; .41 A. Enterrnmetaxtril exhaust and venom=
_ _ . __...
Range hatittfotha kitchen
Address: k..1._.) Vr' cquipment _ 10.00
City/State/ZIP: TAA.,. Clothm dryer exhaust 10.00
Single-duct exhaust fbothr0011111.
Fhonc: ( ) Fax: ( ) toilet cointattdents,111 morn) , 6,80 _
' '',..''':' i:' 1 :.•.' ' s';'•' PLICANT .•-., •: ‘,...::,.....,.,•...!::. o •_ FFAStrd, :'..'..:l'i: :' '.• . AtticicradIP fans 10.00
Other: 10.00
Business name: - 5-,u...n k..,,Acii..x...) .like....) relel Ming .. — .
COMM name; MAD for fir* four: $1,00 ibr each additituud
Furnace, etc.
Address:
066 hot pumF
City/State/ZIP: Wailistianendedfunit heater
Water heater
Plume: ( ) I Fax; : ( )
Fir Incgc
E Rale
, . ',:, •'. • ';',..‘••: •• ' • • -',.:.: • .1. ,...._ dammt.amrat •:,..... L:.:2.L_: ...:, ' ': . '• .. •
.' ,. ' : :'• Betbeetra
Clothes dryer Va)
Business name SUN GLOW, INC. other •
____
Address: Heating & Air Conditioning .:.:: ',. z '::,...
— 2428 SE 105th Ave. Portland, OR 97216 — ....._
scoters; ri i ai. ,.,
citYistateW: (503) 253.7789 FAX (503) 253-7693
—
Minimum permit Ilse (S72.
none: ( ) 1 --- ' , .. Plan review (25% of permit fee) h p
te CC lio.: •
State surcharge (12% orpermit fix) u • L1
" B m ianillitui . . SO k t
TOTAL FERNLIT FEE u. ,,, t•
, •
• 11 48 Porch talnucedon emigre, it a admit Its aot obtained ' 7 1 .i
Authorized siviturc: ...wilif 1 .0 1, 1 - 4 6 ;Iiiss4 or atter It bits been accepted ea complete.
Frill 1 ....- ii‘rf) VA a () .r ‘, Mt . - 0 7 6 FM Mente §Et hy 7e4Coenty Building huhully Sm fj
IAINNetingtPerrnIevAtreererwiMptdoa 01 /19107 440.4017T (1 7/02/COMMEM
1.1.1 002/00d
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INSTALLATION ADDRESSI
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PROPERTY LINE
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