Permit CITY OF TIGARD MECHANICAL PERMIT
= COMMUNITY DEVELOPMENT Permit lit: MEC2009 -00090
1 3125 SW Hall Blvd , Tigard OR 97223 503.639.4171 Date Issued: 03/05/2009
TIGARD Parcel: 2S111 AB04200
Jurisdiction: Tigard
Site address: 14400 SW 92ND AVE
Subdivision: PENMAR TERRACE Lot: 6
Project: Boroweic
Project Description: Install furnace.
Owner: FEES
Description Date Amount
Furnaces < 100K BTU 03/05/2009 $14.00
12% State Surcharge - Mechanical 03/05/2009 $8 70
PHONE. Minimum Fee Adjustment - Mechanical 03/05/2009 $58 50
Contractor:
OHAC INC
PO BOX 241
DUNDEE, OR 97115
PHONE. 503- 538 -2953
FAX: 503- 691 -8556
Type of Use: SF
Class of Work: ALT 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
Issued By:
I LAA Permittee Signature: I
• 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.
_ .
• • •l• •„:,-, .::
lltesImpical,Perinit A pp cEvE . ':: , Y.:: . .,•5. ,-,, .' , :::;P - .. , '''.-, , ..: . ...r... ,, . , ::
. .... ,.,..,....
riattilily
Ihi ...L VI sat.) Permit No.:(itteC2 .0007 n
. , , Y'' . ' . • 4 13125 SW Hall Blvd., Tigard, P. 7223 %
'' .',.. .. 2 ' • Filmic; 503.639.4171 Fax: 503.51AR) 0 3 2.00
Plan Review
Other Pe■
Date/By: O
.::, •:'- ..•■••. :. inspection Line- 503 639 4175 --"
TlirATt II; ., . -- Datt Ready/By: Jurit: g See Page 2 for
. ::..'.?...-,., :.'' I
' nternet; www,ttgard-orgov crry OF TIGARD Notified/Method: 11 cl Supplemental Information
.i. , . .. . ,., -,,,.... ,.....,
IJA,oil,44
.,...,,,,,,,,..; .;..;,...,,,,,,..;;,, :;,;.;,■,,;:,,,,,,, .,,,,,i4; ,;,,,..,,i,- ; .,..,,,,,,,,,,....,,„ ,,,,,,,,,,, :•; t,,, ,,,,,,... :;;;,.,.,„, ..„, .,. ,.., . ,,, , ..; 4 :„ •,. .,,,, ,,, ..,.,„1,,,,,, ,,.,„- .,.;.;,.„ . ..;...,,,,,,,
Ni.h.ical permit fees* are based on the value of the work
0 New construction kJ Addition/alteration/replacement
perfumed. Indicate the value (rounded to the nearestdollai) of all
III Demolition ill Other: , mechanical materials, et Luipment, labor, overhead, and profit.
Value: $
Ti' iO ,,,--,,,,,,,,, ...., .. , . ■ 1 .. . y y i , WP , { ' I. 1,7
4 ' 2. SI • Er ; - I • •14 'T'N ST. ',' '
1- and 2-family dwelling 0 Commercial/industrial ID Accessory building
For special information use check) in.
El Multi-family 0 Master builder 0 Other:
Description I iiy Ea. Total
00 st taut!coo.ty.
7 ' 10, 1'11NikkiliqvliTWEVARRWRIF8•'601/rfiri;TOillfi.SOIM I . ./ t
, :t. ,1•{1• -, ng -
•
Air eonclitioning Of heat pump
Job site address: I 1 1100 . t/t/ c) 2 )\ d A v € (reoi site plan showing placement) 14.00
City/State/ZIP: f a - d 0 R 1 1 2 2 LI Furnace 100,090 BTUJductQvents) / 14.00 / 1- 1,S-' 2
Pomace 100.000+ BTU (duets/vents) 17 90
.
. Suite/bldg./apt. no.: Project name: 0 q - O /13 6 2_
Gas heat pump 14,00
Cross street/directions to job site: Duct work 10.00
1-tydronic hot water system 14.00
Residential boiler (radiator or
bydronic) 14.00
- --
Unit heaters (fuel-type, not electric),
in-wall, in-cluet, suspended, etc. ' 14.00
•
-
Flue/vent for any of above 6,80
Subdivision: Lot no.:
_Other, , 10.00
Tax map/parcel no.: Other fuel appliances
- f f i'l. 9 IT Ik:01,110r1 Mi ..■ ii."0%.'1 1 in tl..^6:1,0(% :Y..d) i ` ' '''' 611 ' '''; 4. it t ,- .4 i • , i
Water 1 116igi lb PAV - ,
„,,
vrflt ,,,:r clreroace 10.00
Mc vont for water heater or gas
fireplace ,_ 10.90
.7._ 4,glighter (gas) 10.00
. .
Wood/pellet stove 10,00
Wood fireplace/insert
Chirrinc
000000,0,1gingilkhlt,ReffiNgilM i rlakfiPiaMPPIR -------> ,
,_,, . ., - 1, • ,i,,t01 ' -,- l• ., •-, ) , td .• . d - •6. Other: _10.00
10.00
10.00
Name: - 3 - a ir 4 s gc. ,-„, v., ; e. c Environmental exhaust and ventilation
Address: i 4 / i f 0 0 s vv 9 -2 A 4 Avg, Range hood/other kitchen
equipment 10.00
-„-
City/State/ZIP: •- (4 4 op, ci-772Y. Clothes dryer extaust 10.00
I, a i ,
Single-duct exhaust (bathrooms,
Phone; (c0 3 ) 3,i-3y9 2- Fax: ( ) toilet compartments, utility rooms) _ 6.80
Fin Atticklawispace fans • 10,00
1,,,`61..;ll:iq1 ,Iir.A „let •;,,i,.r,.,,i, „,, ; li,nNksi,lil.,IlllquM14,10 ilq,a1;!): ,:l.. ,zeF,eg
O
. ther. , 10.00
_Business name: 0 r e _ 0 IA. H ea + ;„ ,,,, 4 A / c
_ Fuel piping
Contact name: 3 Ion Ff 1A 1 ii, +4/ P $5,40 for first four:, sloe for each additional
---„,
yumace. the
Address: po 13 0 )tr 3 q
City/State/ZIP: D LA 'Ad e e 0 R 9 7 It 6 wey,,pendesuriit heater
---
Phone: (9 ) cgg- 2q6s3 '1 Fax: : (5b3 ) -
6,qt•-f_g6 Water heater
--
_---- 1 Fireplace .
E Range --
i1 4 1. . i il ,'•':', Ba
roarr
Clothes di er ( • as)
Business name: S a ret e
00m
•
Address: VM1011•P;11040.VOik... -,44 41 1:vgiwglimpy19
, .,, . !I till4k ::■,?i .* ); ',.
City/State/ZIP:
' Subtotal - 2 .co
__........ ...-
..,...._,.. - Minimum permit fee ($72.50)
Phone: ( ) . .1 Fax: (
Plan review (25% of permit fee)
-
CCB lie,: f r i i 1 - 2, 6 ,..._ State surcharge (12% of permit fee) ca . i G
_------,
TOTAL PERMIT FEE 1. 20
Authorized signature:
4 F:thk arri e This permit applleation expires If a permit is not obtainea *Willi 180
1 )140.-
darys after it has ii accepted as complete_
[ name: -3 1., ' .4-/2 r '.. r. +
, e...1 Date: 21 .? / 0 q j
1 - $ Fee methodology set by Tel-County Building Industry Service Beard
1:\BOildint;Termitsl/v1PC-PermitApp.doc 01/19/07 440-46I7T (11/02/COMAWER)
ZO/TO 39 9NI_LVH NOD3NO 9GG8 -T69 -E0g g17:60 600Z/E0/E0