Permit CITY OF TIGARD MECHANICAL PERMIT
{' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00503
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/08/2011
Parcel: 2S102DB00700
Jurisdiction: Tigard
Site address: 13160 SW ASH AVE
Project: McCadden Subdivision: BURNHAM PARK Lot: 1
Project Description: Replace gas furnace
Contractor: FIRST CALL INSTALLATION COMPANY Owner: MCCADDEN, JAMES & ONALEE
13150 S CLACKAMAS RIVER DR 13160 SW ASH AVE
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503 - 231 -3311 PHONE: 503 - 443 -1760
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 11/08/2011 $46.75
Type of Use: SF FlueNent For Any of Above 11/08/2011 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 11/08/2011 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 11/08/2011 $19.93
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
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 Notifi ion Cen - . 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 estions to OUNC b • t • g 503.232.1987 or 1.800.332.2344.
Issued
Y Permittee Sig. 4
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.
NOV-8 -2011 11:46A FROM: TO:5035981960 P.1
Mechanical Permit A licati CEIVED
City of Tigard DReceiyd if g // 13, Permit No.: ilte44/ /Otei 2)3
IN a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
. Phone: 503.639.4171 Fax: 503.598.1960N O V 0 8 2011 Date/By. Omer Permit.
I it , RI) Inspection Line: 503.639.4175 Date Ready /By: lures. BI See Page 2 for
Internet www,tigard or,goV CITY OF TIGARD Notified/Method: Supplemental Information
TYPE OF 1WNG DIVISION
COMMERCIAL FEE* SCHEDULE USE CHECKLIST
❑ New construction ® Addition /alteration /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
1- 2 -famil dwelling RESIDENTIAL EQUIPMENT/ SYSTEMS FEES*
® y g ❑ Commercial/industrial ❑ Accessory building
For special information use checklis
Multi-family M builder t.
El y ❑ ❑ Other: Description Qty. I Ea. } Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: i n.40 V W Ash -W u° ) Air conditioning
(requires site plan showing placement) 46.75
i City /Slate / po -t an d q Furnace 100,000 BTU (ducts/vents) J 46.75
Suite/bldg. /apt. no.: I Project name: Furnace 100,000+ BTU (duets/vents) 54.91
Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
jydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in wall,-in-duct; suspended, etc. 46.75
Subdivision: Lot no.: lrlue/vent for any of above _ 23.32
Other: '23:32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Rep [VC 866 I - Gas fireplace 33.39
Flue vent for water heater or gas
fireplace , 23.32
Loglighter (gas) 23.32
Wood/pellet stove 33,39 ,
Wood fireplace/insert 23.32
PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
WgiteaCtan Envir 23.32
Name: nvirunmentat exhaust and ventilation Address: Range hood /other kitchen
equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
( 9;))440 1T�� Fax: ( ) compartments, Single-duct ents (bathrooms,
Phone: toilet com tm ut ility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawispace fans 23.32
Other: 23.32
Business name: Tri County Temp Control
Fuel piping
Contact name: Diane Mason $14.15 for first four; $4.03 for each additional
Address: 13150 S Clackamas River Drive Furnace, etc.
Gas heat pump
City /State /ZIP: Oregon City, OR 97045 Wall /suspended/unit heater
Phone: (503) 557.2220 Fax: : (503) 557.0919 Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: First Call Installation Clothes dryer (gas)
Other:
Address: 13150 S Clackamas River Drive MECHANICAL- PERMIT -FEES*
City/State /ZIP: Oregon City, OR 97045 Subtotal
Minimum permit fee ($90.00)
Phone: (503) 557.0230 Fax: (503) 557.0919 Plan review (25% of permit fee)
fiv
CCB lie.: 182714 State surcharge (12% of permit fee) 1
TOTAL PERMIT FEE QO�� d
signature: This permit application expires it a permit is not obtained within 180
Authorized si
gn �� G4•v/ .6k 6 ! ( days after It has been accepted as complete.
Print name: Diane Mason Date: 48/H 1 ' Fee methodology set by Tri-County Building Mushy Sc, vice Bo ord
P \Ouilding \Permits\MEC.PennitApp doe 10/01/09 440.4617T (I I /01/COM/WEB)