Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009-00529
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/07/2009
Parcel: 2S114BA15700
Jurisdiction: Tigard
Site address: 16175 SW COPPER CREEK DR
Subdivision: Lot: 0
Project: LL T
Project Description: GAS FH�u� ct R />_
Owner: FEES
LEONHARDT, CHRISTY D & FRED W Description Date Amount
16175 SW COPPER CREEK DR Air Conditioning 10/07/2009 $46 75
TIGARD, OR 97224 Furnaces < 100K BTU 10/07/2009 $46.75
PHONE. 12% State Surcharge - Mechanical 10/07/2009 $11 22
Contractor:
TRI- COUNTY TEMP CONTROL
13150 S CLACKAMAS RIVER DR
OREGON CITY, OR 97045
PHONE 503 - 557 -2220
FAX• 503- 557 -0919
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types
Gas Pressue.
Total $104.72
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: MA >J Permittee Signature: SkE
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.
OCT -6 -2009 07:39R FROM: TO:5035981960 P.1
Mechanical Permit Application . 1 tole 1)1.1,1(1: I .' I. fi \l'i
• c��D Received
City of Tigard DJ Date/By: Permit No.: ‘P 5
• 13125 SW Hall Blvd., Tigard, OR 97223 plan Review
' Phone: 503.639.4171 Fax: 503.598.1960 O C T 2009 Date/By: Other Permit:
t I (.° tt e, Inspection Line: 503 639.4175 Date Ready /14y: Lurie: VI See Page t for
Internet: www.tigard -or gov CITY OF TIGARD Notified/Method Supplemental Information
'`' . - . , „ : T L pP, 'c , 1t'1�'1` .R IA1.1g�F:'^ *40.4 ' 40 ,,
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Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
... ,. R'fi I FNRT 1j $lGIV7' 1„ , ��,Y$T.I MS �._. ,EE i ' - .. _
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building " "`
For special information use checklist.
❑ Multi - family ❑ Master builder 0 Other: Description I Qty. Ea. , Total
JQB S1TE 1YFO1;1vtATION AND F OCATION Heating/cooling
Job site address: +► OW GfAi RPY' S J +l.� -To l 1 Ve) Air conditioning or heat pump
(� V +, ^^^^���� `"'�, (requires site plan showing placement) i 14.00
City/ State/ZIP: Tigard, OR Furnace 100,000 BTU (ducts/vents) 1 14.00 ,
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: 1 Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work . 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: I Lot no.: Flue /vent for any of above 1 6.80
Other: _ 10.00
Tax map /parcel no.: Other fuel appliances
} r t. �.M,m,r g -••., Gr p. + .n _ Water heater 10.00
• ' Gas fireplace 1 0.00
• Flue vent for water heater or gas
• tv1 r 1 U r 1 6 t p t / 1 fireplace 10.00 • -
71�-W 1 0.V Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace/insert 10.00
�_ , ._ ,,(� 4 ,,_, Chimney/liner /flue/vent 10.00
_.:ri,, 'aPlifw 2ltSl� ' ` \ , . ; a Other: 10.00
Name: fr(/j h � Environmental exhaust and ventilation
�{�-� Range hood/other kitchen
Address: �j equipment 10.00
City/State/L11': Clothes dryer exhaust 10.00
W z4 � -, ' / 1 _ Single-duct (bathrooms,
PhonePhone: ) ^7 I Fax: ( ) toilet compartments, , utility ility rooms) 6.80
.,• •w".;l'"'' '''''' ' ; - *:.w5v: '"' '' 8' ";''''''' -- '^rrr''' . 10.00
�e r Attic/ fans
,A ;ji' . ", -; ;' ., -y alf AN , . . ,, , . F ',, � >'; • '.:c. �' OT -M"; 10.00
Other: -
Business name: Same as contractor Fuel piping
Contact name: Diane Mason $5.40 for first four; SI.00 for each additional
Furnace, etc
Address: Gas heat pump ,
City / State/ZIP: V Wall/suspcnded/unit heater _
Fax: : Water heater -
Phone: ( ) ( ) Fireplace
E -mail: Range
r. wr- 'GNP• Barbecue
Business name: Tri County Temp Control Clothes dryer (gas)
Other: .
Address: 13150 S. Clackamas River Drive M> a' CIYA ?I�i�I1���RM1`1�`�j'E�.�'" • •
City /State/ZIP: Oregon City, 97045 Subtotal it co9
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Minimum permit fee ($72.50)
Phone: (503) 557.2220 Fax: (503) 557.0919 - Plan review (25% of permit fee IIIIII
CCB lie.: 72623 State surcharge (12% of permit fee) / , if , .
TOTAL PERMIT FEE
This permit application expires if a permit is not obtained ' . . 1 1
Authorized signature: , A714) 71 - 41 days after it has been accepted as complete.
Print name: Diane Mason Date: 1010101 • Fee methodology set by Tri- County Building Industry Service Board
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