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Permit CITY OF TIGARD MECHANICAL PERMIT 111 1- ` ' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00505 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/09/2011 Parcel: 2S 111 BA03200 Jurisdiction: Tigard Site address: 14125 SW 98TH CT Project: DAVIS Subdivision: MCDONALD ACRES Lot: 7 Project Description: Gas furnace replacement. Contractor: CHASE HEATING CO Owner: DAVIS, LINDA A & SHAWN M 2236 NE 82ND AVENUE 14125 SW 98TH CT PORTLAND, OR 97220 TIGARD, OR 97224 PHONE: 503 - 254 -1274 PHONE: FAX: 503 - 254 -1816 FEES Specifics: Description Date Amount Furnaces < 100K BTU 11/09/2011 $46.75 Type of Use: SF 12% State Surcharge - Mechanical 11/09/2011 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/09/2011 $43.25 Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas Gas Pressure: Total $100.80 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. 1 Issued By: Permittee Signature: Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. • Mechanical Permit Application — _ -_ _,•( -)R ()1.11( -4 1 s>- (o-; — -- — City of Tigard ��� it�ived _,/f /I pen,i;t No It • 13125 S W Hall Blvd -, Tigard, OR 97223 �� Date/Bv: �� /�/ � � t 1 "' l�}c�(1 _ Phone: 543.7!8.2439 Fax 503 "5J$,1' f �j ^©1I\ Date/13y: `� OtherPerntit: • I lC:.a 1,. 0 Inspection Line: 503.639.4175 %9j t' Date Ready/By:- Jade; 6d See Pie 2 for , Internet: www.tigard- or.gov ,PiotifiedlMethod: �j ~ A j2 Supplemental • r -! is lem Information r:; -.< (., , a5 � ���y,.�,�rt %'. � ` � gr, s � '�,. { � , . ru ta. � ✓a n ' tr fry, l "l' , N ..` < { \ .,, , .,' ��' " „ i:1. Vl .f" ;' 6 4 ''' y ik.,:1,; : ) ; + ,: c } ' 1 ' �xr • s1t i a '.. -: rl�ad 0,, . , ,�, .. Ntipt -. rvr Mechanical permit fees' cue based on the value of the work ❑ New construction iiJ Addition/altciatio' exit performed. Indicate the value (rounded to the nearest dollar) of all ❑ 1)emotitiOn ❑ Other mechanical materials, equipment, labor, overhead, and profit. rr n : -.: i. \: i.: .::., • . : ^.. �..,.. r .:l,, ^,' `x . ' fs : it:: ;s; 1 - ., e 'c } .,. � w � .- '''{,; " , ° .�n,, 9 „ p . • •�� ,{�',� ,i( �":. s; �A'p\;4, /, � w'`' 11 e. y�� Ml 1 ' ,- .n. ;. A 11. and 2- family dwelling ❑ Comtnercial /industrial 0 Accessory building Fur special ipfor/itatiolt 40 akecklisL ❑ Multi - family ❑ Master builder 0 Other: Description I Qty. l Ea, I Total w „ +q Heating/cooiing: . •. �! AtT COr/dttiorinlg .Job bite address: 1410,5 ,50 'vh ci (requires Site plan showing placeme 46.75 _ City /State/Z1P: nn f -9 a p ace 100,000 BTU (ducts/vents) ' 46.75 4 # p • �� .,4 ,r. i 0. C t s Furnacc 100,000'!• B TU (ducts/vents) 54.91 Suite/bldg. /apt- no.: 0 Project name: 44111 bleat pump • (requires site plan showing placement) 61.06 Cross street/directionS tO job site: Duct work 23.32 I�ydronic hot water system 23.32 } Residential boiler (radiator or hydroriic) 2332 • Unit heaters (fuel-type, not electric), i in -wall, in -duct, suspended, etc. 46.75 Subdivision: Lot no.: Flue/vent for any of above 23.32 • Other: 23.32 Tax map/parcel no.: Other fuel appliances: ow,:,`;:n j 7,N' . r ,. r : y " :.::i ,� , : , . 1 ,4 : / , • , - , '. "r l ,M .{ b , ' �' 'IYi :. ,to! : A i e „e : P r t" , . ,+S {�a ; ; 3, idiu _f D (7 WatBt heater 2332 I - ..; *. " n � Gas ijlreplace 33.39 1 / (7' .S , . N Q ( Gas f i epla r water heater or gas fireplace 23 -32 - 1- (7Z (gas) 23.32 Wood /pellet stove 33.39 Wood fireplace /inert 23.32 ,75 ., . - -• ,, „,, „,,,,,, „” d ,,,.......,rr :n.,� , ., :. : ,, ( ,:,;' 23.32 ' + ' ; r,� „� ;"� r Chimney/liner/flue/vent • �r� • • ., 3 {, '� ,...,r•, }r 23.32 _ Other; Name' (j 1 ZL1 )i: Environmental exhaust and ventilation: Address: , � q g (Y Range hood/other kitchen f equipment - 33.39 City /St *teJZIP: 6 0 I , / if f 4. r +, -14 Clothes dryer exhaust . • - 33.39 , ,.., Single-duct exhaust (bathrooms, Phone: `” / : toilet compartments, utility rooms) 23,32 v .1 ' i i el :, 1�.. . 1.., „ :r,. I ,., >,i �N • � ' •i: ",,, . p �,� r, Attic/crawlspace fans 23-32 •'U 5 ' '� J1, ,,� , x , ' : r, \ - y : rr s , � ). ! . 'g... F ru F /, ,0 •;' ;r +ti ... Other: I 23.32 Business name: Fuel piping: . Contact name: $14.15 for first four; 54,03 for each additional Address: Furnace, etc. -"--- . , - .. Gas heat pump , —. City /State/ZIP: - Wall/suspended/unit heater Phone: ( ) Fax! : ( ) Water heater - _ Fireplace • E -mail: _Range 't�,�,,an, q mt: ' +1''; t w v ;a a %'. +t'. ',�., yy.{ ".. ,y r. , �i}�p . {. ;•:� j' i '1 _ i ,� 1 �)y e NS ( 1 �y �� i qi �'� w � ,� 1 , P n . i;'a }A ," ,' Barbecue Business name: Al / _• ,.r.4 _.. / ' ,),, /.,/ 4-.. Clothes dryer ($ ? . , O r ,l /lion der Address: I ti ) . ,' i� " ws t oakmaaa3Y T ; 7 City /State/ZIP': de, � c17- a - - . Subtotal .. Z -> Minimum permit fee ($90 -00) 4 . � - Phone: (50 �` Fax: ( , ; y a 0 _ Plan review 5% of penult fee) ---- CCB lie -: 1 _ - • 5 0 State surcharge (12% of permit fee) JO • d 0 y TOTAL FERMII• FEE /O a, :.. Authorized sigria - +� ' / / ti This permit application expires if a pernrit is not obtained within 1. , 1 / days after it has been eceepted a6 complete. - Print name: / Date: /, • • ' ' * Fee methodology set by Tri- County Building Industry Service Board • i:\Building\Permits\n c - PPmzknpp 09/09 /10 440 -46177' (I1 /02 /COM/WEB)