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Permit _ © CITY OF TIGARD MECHANICAL PERMIT 11 '! ` COMMUNITY DEVELOPMENT Permit #: MEC2009 -00107 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/16/2009 Parcel: 2S104CB02700 Jurisdiction: Tigard Site address: 13076 SW ASCENSION DR Subdivision: HILLSHIRE WOODS Lot: 73 Project: Hagen Project Description: Replace gas furnace. Owner: FEES HAGEN, SYDNEY Description Date Amount 13076 SW ASCENSION DR Furnaces < 100K BTU 03/16/2009 $14.00 TIGARD, OR 97223 12% State Surcharge - Mechanical 03/16/2009 $8.70 PHONE. 503-349-6304 Minimum Fee Adjustment - Mechanical 03/16/2009 $58.50 Contractor: CHASE HEATING CO 2236 NE 82ND AVENUE PORTLAND, OR 97220 PHONE: 503 - 254 -1274 FAX: 503 - 254 -1816 Type of Use: SF Class of Work: ALT Type of Const: 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 Utilit ► . • _ . in Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952- 001 -0100. You may obtain a copy of the rules o c erect questions . OUNC by calling 503.246.6699 or 1.800.332.2344. sued By: Permittee Sig i ` • dllIllik Call 503.639.4175 by 7:00 a.m. for an inspection that b . • • -ss 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. • , - - .- ' Mechanical Permit Application FoR 01 1,.si,.. om,y .. . 11,E,CErVED . Received 2 er,: . ..---- 4 13125 SW Hall Blvd., Tigard.. OR -23 Pmit No 1 , : III • City of Tigard . ' . Phone: 503.639.4171 PIM: .503-598-196A i 6 2009 Date/By: ei Affe I Flail Review Date/13y: • Other Permit . . . Inspection Lino; 503.639.4175 MAI'S 1 rt t_i A 1 0 pate Ready/By: • E11 Ef See Page 2 fur Int www.t-cr.gov www.gard-or.gov Noti5ed/Metliod: Supplemental Information rry OF TIGARD . , .i,,i'. , ..1.) . 1)1A9 , ,; ,,,, , , " . fy):,: , :i,I . :i:.:1:. , 4i. ,.,, k':..,..v' , .., ,, ,00, ' ,r.i. .t14.vittvnigtrzeoti*44i$1g**6414T4 ' ' ------------M- Mechanical permit fees* are based on the value of the work D New construction Addition/alteration/replacement performed_ Indicate the value (rounded to the nearest dollar) of all 0 Demolition D Other: mechanical eaaterials, a . ui .mentiabor, overhead, and profit. Value $ .:. '..I:•'„! 0A 0, T i b0,0 f,.001 -,,;, •,.;'..;,;.;,..:',•,,,„,-..,.,, ::,,,,, . . ... , . ,, . .., ;_,__,,, , ,, .,..,._', , .,,___-,,,,,,,,,„„. ..,:,,:,,..,,,,.,,,. • ... ,,,..,..,;,—• „ ,,,,,..,,,,, ., -,.....4 , • • ,,.. • . • .. .'...,. . ', - - ,'-.. • .....' • ' - . . •.-- ' - '.' - - '-' , it ■' , ,: 4)E11:9PAIXlitil'iMsilT.W6t''';'''''';'''''' X 1- and 2-family dwellius El Commercial/iwinstrial 0 Accessory building For sfctal Piformatton use checklist. El Multi-family 0 Master builder 0 Other: DC5CTiption --- Qty. j Ea. Total -- —..,_,_ , Air conditioning or laeat pump Job site adduces; 1 50 P1• f‘OY '-- br'LL, 1 12 _ tikes sit_jm_ e I_E____nLE.stn shovi localuetat) 14.00 - „ City/StatelZIP: - 1 era on Q....-3 . F irro,000 BTU (ducts/ventsL k 14,00 Furnace 100,000+ BTU (ductsivonm) SuitelbIdg./apt no.: Project name: ,___,_ Gas heat pinup 14.00 -- — —_—___ Cross street/directions to job site; Duet work 10-00 .. ......- ilydronic hot water system 14.00 Residential boiler (radiator or irydrotho) 14.00 - u b...t.0 (fuel-type, not electric), in-wall, in-duct, suspended, etc. 14.00 Flue/vent fee any of above 6.80 Subdiviaion: Lot no Other _ 7 10.00 Tax map/parcel no . Other fuel appliances :... \,;.;?.. '',: ',,:,'..sTP':• il.., 3 '' , ...,:j; ). ;:::;'j, :i:.,, water heater 10.00 ....-- Gas_fipylace 10.00 Q0..9\itte_0,. O L-cfLtenCll, Flue vent for water heater or gas firsilitoe 10.00 ,......- :,._ Lou lighter (g..u) 10.00 ----- Wood/pellet atove 10.00 _„.., . , Wood 5replaeefinsert 10.00 C nerfluevt hiromey/li/en 10.00 ,..,,,,;.. , -- 10.00 Name: 4 - Environmental exhaust and ventilation — - . Rangp hood/other kitchen Address: t x - j - i ( 6( ..,t.. ,vi. ! S--m ri)rvi.,,..19.....e.,_ equipment 10.00 } . _ City/State/ZIP: - of -'" Clothes dryer exhaust , 10,00 Single--dnot mthaust (bathrooms, Phone: (5C ) sq.. ...• c , c5 ,./ Fax: ( ) toilet compartments, utility rooms) 6.80 '..,7,'...‘1:',:;..',.:...,'.-':.,::',;;;,,..:1;;,;',0`,1`414iiiii;teAC,1■14.7t,i'll!;':''J';';i:;!::::,:,;',.g '.:..7,,,i'.:,'!;qr,trbtiiiiii Attio/oraWls loe fan 10.00 _ .L.,..,„;,...,,,,.,-,,':7'..'..i.?;•,1:,'!..,:;.,':',, f ,.....')124 '.:; I., , h'',"7_tA::.' . Z.;,' ;',.';‘ k Other: 10.00 13usiuess name: ,...-..,.., ....„........., ..-__ Fuel piping Contact name: S5.49 for first four; $1.00 for each additional Addrees FUMAC8, etc. • : — CAI beat Elam City/State/ZIP: Wall/suspended/unit heater _ ,_ _,... ..---,...— Phone: ( ) :-. F ax: : ( ) water heater . . Fireplace E Raw -,-- - ''.'t:'''..:1'-' `.. (.,'. ','.',..`;■ ,.. , - :' ,, e , '4 , '; , ',.,'..:. '■:.;v:■'4:', .,. 00 'Cr ,.;::. .■• 4„x.): ve 'l ., .,,," ,,!t, 1,,,, garbwie --.-- - . Clothes dryer (gas) J:lustness name: Ch ti s k _ V liglia j tur _ c Other; Addras: c a .. - _ . 3c v 1,)E, ts,D pi3O14.3 ' .iictliiikl4t -.., .,,,,,,...,.,....,,,..-...- City/State/ZIP: RcrAliA a jaCaV ) 1 02 c1-ca . Subtotal. ., Minimum permit feo ($72.50) - 1 5....) Phon ( tSt-, - l'4- L4 I Fax: (953) 0. -t- t.g 1 c. Plan review (25% of permit fee) . CCB lic.: 553 c?C, state surobarge (12% of permit fee) 15 .70 TOTAL pERmir FEE E ( _ 2-0 This permit application expkier If a permit Is not obtained whigil IRO Authorized signature: N..-1- days after h has bee. accepted as compicte- E nt name: ...e.._,.„7 j,Date3-16-(9 w Foe nictliocicAosy tel by Tri-County Building Industry Serviee Board I: \ Building Tirliii te/AlEC-Fmoitetyp,dcx 005/0 440-1617T ( I 1/02/C0MIS1i8)