Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009-00294
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 06!22!2009
Parcel: 2S111AC00500
Jurisdiction: Tigard
Site address: 14570 SW 91ST AVE
Subdivision: PINEBROOK TERRACE Lot: 46
Project: Klein
Project Description: Replace furnace and NC
Owner: FEES
KLEIN, FRANK E & JULIE M Description Date Amount
14570 SW 91ST AVE
TIGARD, OR 97224 Air Conditioning or Heat Pump 06/22/2009 $14.00
Furnaces < 100K BTU 06/22/2009 $14.00
PHONE: 12% State Surcharge - Mechanical 06/22/2009 $8.70
Minimum Fee Adjustment - Mechanical 06/22/2009 $44.50
Contractor:
ABLE HEATING & COOLING
8900 SW BURNHAM ST
TIGARD, OR 97223
PHONE: 503 - 443 -2058
FAX: 503 - 620 -3980
Type of Use: SF
Class of Work: ALT Type of Const: VB
Occupancy Grp: R -3
Stories:
Fuel
Fuel Types: Natural Gas
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.
Issued By: eA A I Permittee Signature: C6. ski._ Apr)
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.
RECEIVED
Mechanical ddoc r f •
4) 3" •r4 i T l A t- f't tl 6 til 1 r
Permit E�pp�ICatiOl! r � .l :�'' � te� c� � t4� ttt5s��.1' f`I U'` � v � 4 l t,��,
ilit`,•t i 8 ?(, " ;'� ` j:~, Ci i CEkl15 Lt71 11 ft r � r rr ,' • s , a + �
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City of Tigard Received
;. " 13125 SW Hall Blvd., Tigard, OR 97223 Date. 3y: p >;o. � _ j
Phone. 503.639.4171 Fax: 503.598.1960 CITY OF TIGARD plan Re ,•,�, • '`1 a9y
T[GARl7 Inspection Line: 503.639.4175
BUILDING DIVISI01`e,B} Other Permit:
Internet: wwwtigard- or -gov Daze Re /8 Luria la See Pace 2 for
Noti
Supplemental Information
TYPE OF WORK COMMERCIAL FEE" SCHEDULE — USE CHECKLIST
1] New construction Addition'alteration /replacement 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: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
and 2- family dwelling ❑ CommerciaVindustrial
❑ Accessory building
0 Multi- family ❑ Master builder ❑ Other: For special injormatron use checklist. 1
Description _ Qty. Ea. Total
•
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 1 fl 1i, �. ) (k Air conditioning or heat pump
V \ � (requites site plan showing placement) I 14.00
City /State /ZIP: \ \ ' a _ Z-\"1.DO'k"-- Furnace 100,000 BTU (ducts!vents) 0 / 14.00
Suite/bldg. /apt no.: Project none: Furnace 100,000+ BTU (ductsiventsj 17.90
Gas heat pump 14.00
Cross street/directions to job site: Duct work
1 0.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel- type, not electric),
in - wall, in - duct, suspended, etc. 1 14.00
Subdivision: i Lot no.: Flueivent for any of above I 6.80 1
Tax map/parcel no.: Other: 10.00
Other fuel appliances
DESCRIPTION OF WORK Water heater 1
10.00
Ff'LC J� LriC! J � �S tJ Gas fireplace 10.00
'� c 1 r 11 Ai &A.) Flue vent for water heater or gas
/60 _ - ri C / y G-E.s rv?wAC A I r' fireplace 1 0.00
CO A /? ,-YtU ,../c_ Log lighter (gas) 10.00
Wood/pellet stove 10.00
' Wood fireplace/insert 10.00
❑ PROPERTY OWNER I ❑ TENANT Chimneyilinerffue /vent 10.00
Name: Other: 1
1
Environmental exhaust and ventilation
Address: Range hood/other kitchen
City /State /ZIP: equipment 10.00
Clothes dryer exhaust 10.00
Phone: ( ) Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 1 6.80
❑ APPLICANT ❑ CONTACT PERSON Atlic/crawlspace fans 10.00 I
Business name: Other 10.00
C
• Fuel piping
Contact name:
$5.40 fur first four; 51.00 for each additional
Address: Furnace, etc.
City/State/ZIP: Gas heat pump
Wall/suspended/unit heater
Phone: ( ) ! Fax: : ( } Water heater
E-mail: _Fireplace
Range
CONTRACTOR Barbecue •
Business name: n' (\��, t Clothes dryer (gas)
�ptF , fl
Address: i'::\ _ 1 ' Other:
•
C t�ltt1 '- V--`• MECHANICAL PERMIT FEES*
City/State /ZIP7V ,l c r1
"1 Subtotal
Phone: f % ` — 1,., (
5b `' C� � I Fax: ( M O —
Minimum permit fee ($72.50) -7Z . 31:1
CCB lie.: Plan review (25% of permit fee)
ida,ki -Dio State surcharge (12% ofpernsit fee) 1?
�1� ,,, ) TOTAL PERMIT FEE Z
Authorized Signature: / Y ( This p ermit application expires if permit is not obtained within )80
�� !! days after it has been accepted as complete.
Print name: \ C t ` k ' �e. Date: ( - — /19 ' Fee methodology set by Tri- County Building Industry Service Board
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ABLE HEATING & COOLING Air Conditioning Site Plan
• . 8900 SW Burnham St Suite F5
TIGARD, OR 97223
• - • (503) 443 -2058 Fax (503) 620 -3980
CCB tfi84392 Email: ablehvac2 @aoi.com
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