Permit CITY OF TIGARD MECHANICAL PERMIT
s. COMMUNITY DEVELOPMENT Permit #: MEC2009-00098
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/11/2009
Parcel: 1S134DB00700
Jurisdiction: Tigard
Site address: 11175 SW 114TH PL
Subdivision: WINTERS ADDITION Lot: 1
Project: Violette
Project Description: Install gas furnace.
Owner: FEES
VIOLETTE, LORITTA COLLEEN & Description Date Amount
LOUIS E, 11175 SW 114TH PL Furnaces < 100K BTU 03/10/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 03/10/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 03/10/2009 $58.50
Contractor:
THERMAL FLO INC
7236 SW DURHAM RD 100
PORTLAND, OR 97224
PHONE: 503 - 670 -8343
FAX: 503- 598 -6746
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
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.
t
Issued By: M% 3 n Q /j4 Permittee Signature: 44111)
`1( 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.
03/09/2009 06:11 5035986746 THERMALFLO #0061 P 002/002
Mecha Per mit Appijcatio n
CEIVED Received FOR OFFICE 1:SE ONLI
City of Tigard Daway. a . (c : A Pamir No.: a c:2c939
13125 SW Halt Blvd., Tigard, OR 97223 Han Review
a Phone: 503.639.4171 Fax: 503398.1960
IN
MAR 0 6 2009 Dam/Ely: Other Permit:
TIC3ARI)
Ins Line: 503 639.4175 Date Rattly/By: ,beie F d S e e p age 2 kW 1
lnternet: wm,rw.Listard-or.gov
CITY OF TIGARD N.iif.mood. 1 i Supplemental InformatiOn ,
gDIV' I
' ...:::* ' " ' " " " , • .' ' '' ' " -: ' . - .:: - - .." 1:0F"."M"" -- •' :.::•," " ' -- f- : ' .- 7COMMERCIAL:;;FEW . :-SCHEDULT. ,,,, AISE4JtuiCKLT7;;::
Mechanical permit fccs# are based on the value of the work
El New construction )g(Addition/altcration/replacemcut performed, indicate the value (rounded to the nearest dollar) of all
El Demolition 9 Other: _ ________ materials, equipment. labor, overhead, and profit. ,
7 Value: $
disl*CORI ::- ‘-.::. - :;-: ..1::::, .. - .:::7 -- '
... 7.:'.3tESVDr.r.tilAQUIPMENTFSN 7 : - ..:: • . : : .;
X 1...and 2-family dwelling 0 Commercial/industrial 9 Accessory building . .
For special Mfarmation use c
O Multi 9 Master builder 0 Other: Description Qty. Ea. Total
-
---------,-,--,-. •
'•.:JOB7.:SErf,, :LOCATION '„::::: ... '' i : . .. • ::: IleatinWeouling
c j i ,... Lymx ---- p --, 1._______ Air conditioning or lleka pL1Mp 1
(requires site plan showing placement) 14.00
I
_Furnace 100,000 BTU (ducts/vents) 4 14.00 . 7 d f• ' Pun'
city/State/ZIP: 77/ arid-. 0' 91Z, •' Lace
100.000 BTU (ducts/vents) 17,90
Suite/bldg./apt, no.: Project name: 1 / 2 f 170 Gas heat pump 14.00 _ I
Cross street/elirection.s to job site: u
Dct work
10,00 ,..._
Hydronic hot water system 14.00 .
o Residential boiler (radiator or 1
■
DMils# Ili"' ' hydronic)
Unit heaters (fuel-type, not electric), 14, (X)
in-wall, in-duct. suspended. etc, 14,00
- ------ Flue/vent for any a above 6.80 1
Subdivision: Lot no.:
Other . 10.00
Tax map/parcel no.: Other fuel a' • fiances
:::":;::: ' :'::.. ':::: , '':•:; `.;:::: 0Egdiiptio.,.r.4.:*fitikk.1".. , ;:..:' ..4 waler heater 10.00
Gas fireplace 10.00
Flue vent for water heater or gas I I
----- fi alb Fe1y44ee. fir 'lace
• lighter sas) 10.00
10.00 .
_
Woodipellet stove 10.00
----------. i 10.00
,
.
Wood fireolace/insert
- Chimney/liner/flue/vent 10.00 li .
............., ...-::.•,,,.•;.;,..;;; t•7•7.!PROP,WrY :.00 - '' . „;:0--741 :;Y: 1 n...h 1 .... j 10.00
Na Lowe.. ,Ittfelrirtd iMii=iMI ,.,___.
E.„,„„-„,,,,,t,1 exhaust and ventilation
Range hood/other kitchen 1
Address: . e . tii • ment 10.00
City/State/ZIP: i 40 0 ... e- C.lothes dryer exhaust • 10.00 1
Singlc exhaust (bathrooms,
Phone + '7 ) i i d' . ir .."
A Fax: ( ) toilet compartments. utility rooms) 6.80 1
74 APPLICkfir ,D -covrAur..;:pERsciN:7‘,. Attic/crawl ace fans 10.00
. .
Other: 10.00
Business name: Fuel piping
if
Contact name: $5.40 for first four: $1.00 for each additional
A 1
Address: r- 4 I • 1 r .
Furnace
r a . etc.
Gas heat pump .
IMMIIIMEMINE Wall/suspended/unit heater 1 ,
Water heater
Phone: ( ) Fa: : ( )
Fireplace ..,. I
E-mail: tier . ririla 011ie . el,fti.-- Range -
I
klusiness name: 7 / c/o .The
I v a ,
...._ [Ot er
Clothes dryer (eas)
Address:
..-- .
I
/ /I.! - a -
, ......,.. MECHAN1C-AITERNIFTIFEES* .
cit
-
L_ y istatelzip, r t .;"..„ i t /1 el 141- . subt.,.. ......_
. Minimum perinit fec ($72.50) 2 ,
. No'
phoric, i „,,,,e)... ,f±p
I Pin review (25% of pormit fee) ....-
'
CCB 1k: i / „e; . ,, 0 State surcharge (12% of permit fee) „,
f I ■
- . ____,
TOTAL PERMIT FEE 9/. 6
Authorized signatu i/ / • / , Tint permit upplic.utiun expirea if a PerIllit is not obtained within 180
allYS after it us been accepted as complete.
l
l'sr,I2/21).an ea Date: h. •• ...0M
Fr., methcitioinzi set by Tn. County Building Industry Server ?.ms)
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