Permit 6 q
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009-00219
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/20/2009
TIGARD Parcel: 2S103BA00104
Jurisdiction: Tigard
Site address: c 11.890-SW-ANN :ST - �
Subdivision: LERON HEIGHTS Lot: 4
Project: Hutchinson
Project Description: Install furnace.
Owner: FEES
HUTCHISON, PERRY C Description Date Amount
11890 SW ANN ST Furnaces < 100K BTU 05/20/2009 $14.00
TIGARD, OR 97223 12% State Surcharge - Mechanical 05/20/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 05/20/2009 $58.50
Contractor:
SKY HEATING & AIR CONDITIONING
1637 SE NEHALEM
PORTLAND, OR 97202
PHONE: 503- 235 -9083
FAX: 503- 234 -0454
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.
Issued By: # - , , _ I •
�\ A Permittee Signature: ∎ I • y � � a l
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.
'0.5/14/2009 23:09 5032350454 SKY HEATING AND AC PAGE 01/02
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Mechanical Permit ADpli cati, ol<� . . i ill of Ic : t: ON .i "
g ��� _ a
City of Tigard Received a /��
S ,ate _
Date/By: �J V � _ �, Pc ritit No.: riii . 40 . 13125 SW 1 - Tall Blvd., Tigard, O 97223'
AT 1 1 5 ZOO + Date/By: Phone: 503.639.4171 Fax: 503.59 Plan Review
Other Permit
'hI t,. n - it ;t Inspection Line: 503.639.4175 DaRe to Ready /By: ]arts: 10 See Page 2 for • Internet; www,tjgard- ar.guv Notified /Method
Supplementnt t nn
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CITY OF TIGARD
. TYPEE('fFl trio , I 7• . . • COMMERCIAL .FEE" SCHEDULE — USE CHECKLIST
Mechanical permit fees* arc based on the value of the work
❑ New construction El Addition /alteration /replacement
performed, indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment,. labor, overhead, and prolit. _
CATEGORY OF. CONSTRUCTION ' • Value: $
•
I -tr od 2 -famil dwellin , RESIDENTIAL EQUIPMENT /SYSTEMS FEES"
® y g ❑ Commercial /industrial ❑ Accessory building — _ —
❑ Multi- family ❑ Master builder For special tryformativn use checklist.
❑ Other:
Description Qty. Ca. Total
JOB SITE INFORMATION •AND LOCATION . : Heating/cooling
Air conditioning or heat pump
Job site address:
—1 4.L (requires site plan showing placement) 14.00
C try /Stale /ZIP: 5 r- Furnace 100 BTU (duets/vents) 1 14,00 1 L I
Suite/bldg, /apt. no.:. Project name: r
Furnace I00,000+ BTU (doeta /vents) 17.90
GAS heat pump 14.00 _
Cross street/directions to job site: Duct work 14,00
Nydronic hot water system _ 14.00
Residential boiler (radiator or
hydronic) 1 4.00
Unit heaters (fuel-type, not electric),
in -wall, induct, suspended, etc. 10.00 J
Subdivision:
Flue/vent for an of above 10,
Lot no -
— Other. 1 0.00
Tax map /parcel no.: Other fuel eppliAncca
DESCRIPTION OF :WORK ' . . Water heater 10.00
— Gas fireplace 10.00
Flue vent for water heater or gas ` -
fireplace 10.00
Lam; lighter (gas) _ 10,00 .
Wood/pellet stove 10.00
WOOd fireplace /insert 10.00
PROPERTY OWNER [ , X ram. Chimne�llincrlftue /vent _0.0
Name; Other; 10,00
r a _b L/Ji 3 Environmental exhaust and ventilation
Address: Range hood/other kitchen
e _iipmcnt 10.00
City /State /ZTP: Clothes dexer exhaust 10,00 _
Phone: ( ) — Single -duet exhaust (bathrooms,
3 &a F ax: ( ) te toilet compartments, utility rooms 6.80
® 'APPLICANT ' 'In CONTACT' PERSON. Attic/crowlapace fans _. 10.00
Business name: SEE BELOW Other; 10.0(1
Fuel piping - --
('untact name: 55.40 for first four: 51.00 for, each Additiona
Address: Furnace, etc.
City /State/Z1P: .�-- Gas heat pump _
Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
L -mail: Fireplace �
Ran__ —
COiV I RACTOIt Barbecue -
Business name: SKY HEATING & A/C Clothes dryer (gas) i
Address: 1635 SE NEHALEM Other .
MECHANICAL IIMIT •FEJES*
City /State/7TP: PORTLAND OR 97202 Subtotal f Lf
Phone: (503) 2359083 Fax: (503) 2340454 Minimum permit fcc (572 50) •] D., s `) .
CCB tic,; 5024-4 'L t _ Plan review (25% of permit fcc) _
Z State surcharge ([ 2 "/n Of permit lee) rj
p 0
Authorized signature: TOTAL PERMIT FF.F
Thia permit application expires If a permit rmit is not obtained witliM IAO
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