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Permit CITY OF TIGARD MECHANICAL PERMIT 111 ` COMMUNITY DEVELOPMENT Permit #: MEC2011 -00329 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/14/2011 Parcel: 2S 111 BA01500 Jurisdiction: Tigard Site address: 9755 SW INEZ ST Project: Frederick Subdivision: Lot: Project Description: Residential boiler and vent. Contractor: LARRY & CHUCK'S HEATING INC Owner: FREDERICK, SCOTT G & KATHLEEN R 2026 SE 11TH 9755 SW INEZ PORTLAND, OR 97214 TIGARD, OR 97223 PHONE: 503 - 232 -5747 PHONE: FAX: 503 - 232 -8922 FEES Specifics: Description Date Amount Residential Boiler (Radiator or Hydronic) 07/14/2011 $23.32 Type of Use: SF FlueNent For Any of Above 07/14/2011 $23.32 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 07/14/2011 $10.80 Occupancy Grp: Minimum Fee Adjustment - Mechanical 07/14/2011 $43.36 Stories: Fuel Fuel Types: Gas Pressure: Total $100.80 I 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 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. Issued By: ! . --� Permittee Signature: vi /77 / 61 , Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 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. 107/13/11 9:1.8 AM Page 1 Mechanical Permit _4 i ic EIVED 1 (7,R OFFICE, t SE ONE ,A . _. . _ Tigard s Received Permit lyo City o .A Hard Ltate/I•ty: 9 / / // //1��.2c1 /r' DO,���2 9 • L3 125 SW hall Blvd., Tigard, OR 97221pL 1' 3 2011 ri,, Review ' 1I: Phone: 503. 718.2439 Fax: 5(13.598.19'6 t 'Jalu/Ky- Other Permit: T I GAR U JnS Line: 503.639 C TfY C OF TIGARD Date Ready/11y: a IA' till See Page 2 t intermit www.tigard or.gov Nntiiicd/Mcthod: uppement Slal lnforntafion BUILDING DIVISION 1 ...,.. -.. .. TYPE OF WORK C:OMM1 RC1AI, FEE* SC'HFDIILE — USE CHECKLIST ecbanicel permit. fees* are based on the value of the work ❑ New conSt111ction ® Addition /altertltiot)/repltacenient performed, Indicate lie value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials_ equipment, Tabor, overhead and profit. -- -- - .....,T- Value: $ CATh,CUuv 01 CONSTRUCTION -- .__.....,....._ RESIDENTIAL EQUIPMENT / SYS l'UMS 1 ;ICS" E81 I- and 2- 1'tlrnily dwelling ❑ C; otnmercia1/industri:a 0 Accessory building For ,special Inform lion use rirerktivt ❑ Multi- family ❑ Muster builder © Other: Description Qty. Fn. Total ,1013, SITE INFORMATION AND LOCATION Heatin site address: )755 SW Inez Si. - -_ _........_.....,.___ -- Furnace 100,000 Job s • _ lanhe ti n g du ct s/v� e .,_ ' t Inez _ 46.75 City /State /LI1' :'1'lagard, OR 97224 (.- .,.__......_.,, .._.___ 46. Faro - -- .. ............ ......._....,_ .. - . ace 100,000 t BTu tductal 549. - (regains sttcplan showing placement) __._ Suite /bldg. /apt. no.: Project name: Roder re,placunent Hest nom, Cross stool /directions to job site: Hall Blvd Duct work 23.32 south of hwy 99 on Hall blvd to McDonald Si. west on Medonald to 97th Ave • l lydronic hot water system 23.',32 - -- -._ -. -- _ Residential boiler (radiator or south: on 97' Ave 1/4 mile just past Brooklyn La on the right is Inez, hydronic) 1 23,32 23.32 u _--__—_.__.__..__.._ ...,..............._.........:. I Jett hcslcrs (fuel -type, not electric), Inez is a gravel driveway with 5 mail boxes in -wall in -duct suspended, etc. 46.75 - -- __.....- Hue/vent for any of shove I 23.:32 23.32 Subdivision: Lot nn.: —..... ..._.._......... — Other: 23.32 'l'ax map/parcel no.: Other fuel appliances: DESCRIPTION OF WORK Water heater 23.32 Cu firep ltu:e 33.39 __......_....... ., ... ............. ..... ,,., ., Flue vent for water heater or gas Fireplace 23.:32 ....... , :........ .: _ ._._............. L .... ,o�lightcr (g --._........ __ ............................. _........... ..........._ .. ac) 23.32 _- Wood /pellet stove 33,39 Wood fireplace /insert 23.32 r Chimney/liner/0110v= 23.32 111 PROPERTY OWNER © - I•EN Y ... - -- - -- Other: 23.32 Name: Kathy & Scott Fredrick Environmental exhaust and ventilation: ui nu Address: 97,5$ SW Inez, St, '._.__.. _._.. - -- hen e Range hood/other kttc __.._._. +339 tot City /State /LIP: Tigard OR 97224 Clothes diver exhaust 33.39 Single -duct exhaust (bathrooms, Phone: (5113)0211 -4560 Fax: ( ) toilet compartments, utility !owns) 23.32 0 APPLICANT ❑ CON'TAC'T PERSON Attic /crawlspace tans 23.32 Other; 23.32 Business mitre: additional Contact nttnxc ..._...._...._ ................ - - -- ......._.._. ._.....-- -.._.. - -.. g.f 4. I S for first four; 54.03 for each nd Address: F'umacc, etc. Um heat pinup (:ity /State % /..I I': Wall/suspended /unit heater Phone: ( ) I „ Fax; : ( ) Water heater l:- retail: , ace , ...Range CONTRACTOR Barbecue . Business name: Larry & Chuck's Heating Inc. _.......---- ._._....._. -- ...... .......--- .-- ....- .- .._.._. Cloihes dryer (gas) _._ -. ._._ ._.._.....,.._..__ ..._ ............. _........._... -- Other: Address: 2026 SE 11 Ave. MECHAM:7.A I • PERMIT FEES* Cily /Sh.utc /7.TP: Portland, OR 97214 Subtotal 46.64 - _ ............._............ _............_........,...., ........ -- Minimum permit ($90.00) 90,00 hone: (503) 232 -5747 1 Fax: (503) 232 -8922 ter. — ..... - — ..._.,... itili — ._.__ ............. l'Ix Fit review (25% of permit tee) S tate s urchar _....._ - -_ C,;CTI He,:37566 / I ;23 � � gc(12 %of permit fee) 10.80 1U / Authoicerl rued signature: 1/4.J! f4 - / t.� T -- - - - , This permit application sale t iexpires o r p e i ( uM mien 100.80 1/ uo within 180 ff Print name: Timothy U llodgson I Date: 7/13/2011 " I ee methodology ert by . Fri.-CounW Binldinr, Industry Service Board r u..:r.r..,.a u,,.,,.as..ur•�...,,.:. ,.,. a„_ nnrnarin nnn.n.;wm Fir I ■errnnnn,m1n