Permit �) l
CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2009 -00249
Date Issued: 05/29/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S111CC22000
Jurisdiction: Tigard
Site address: 10320 SW GREENLEAF TER
Subdivision: Lot: 0
Project: Robertson
Project Description: Install gas furnace with associated gas piping and a /c.
Owner: FEES
ROBERTSON, DONALD R & CHARLENE J Description Date Amount
10320 SW GREENLEAF TERR
TIGARD, OR 97224 Air Conditioning or Heat Pump 05/29/2009 $14.00
Furnaces < 100K BTU 05/29/2009 $14.00
PHONE. Fuel Piping 05/29/2009 $5.40
12% State Surcharge - Mechanical 05/29/2009 $8.70
Contractor: Minimum Fee Adjustment - Mechanical 05/29/2009 $39.10
THERMAL FLO INC
7236 SW DURHAM RD 100
PORTLAND, OR 97224
PHONE: 503- 670 -8343
FAX: 503- 598 -6746
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
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
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: V n, , ^ „ " Permittee Signature: `i /tn, `J / ��
�{ , �( Call 503.639.4175 by 7:00 a.m..for an inspection that business day. V
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.
05+28/2008 1814 5035988748 THERMALFLO #0480 P.002/002
!..,
le - - ' . .. . . .. . ''. ' . , • •
Mechanical Permit A prIlica.tilip, ti. , - FOR OFF10E USE ONLY
, Rece Yed
•
N . City of Tia,ard H1.1 FWED ,
D.i.e,By: _ ) Permit No.: t t. 9 : . 000 g
' . 13125 Sw•I-iall'ictivd., Tigard. 0149t23 ' r" T-
' .. :: Phone: :503.639.4171 Fax: 501598.1960
Plan RevieW
Date 15y: Other Permit:
Inspection Linc: 503.639.4175 MAY 2 9 D
TIGARD ate Ready/By: See Page 2 for 2009
I nternet: : Ei
mtermt: www.tigarcl-or. gov .
Notiedwei hod: C Supplemental information
CITY OF TIGARD
...... - .. ,.......
-.. .•:.:7 - ti , 1'e. ,, i5v4A - 0G , Eltv' , $1: IN ...,.,:,,,.:...:,:..,:..... ::.:,: -:comm6t941;
Mechanical permit fees* are based on the value of the work
0 New construction XAd di tion/alterati on/rcpi ncernent
performed. indicate the value (rounded to the nearest dollar) of all
Ei Demolition 0 Other: me chanical materials, equipment, labot, overhead, and profit.
' :•:•• '':•....::.:::::- •::':,'•••••:':: .... ..'..,' TE N: ,••;' - ..'•,•'•.: l';; Y.: 7 : -..-::•,.: : • ....... ....... Value: $
. ' :•'..:ItESMENTIALk.IQUi
. .
V; 1 - and 2 dwelling 0 Commercial/industrial 0 Accessory building
For special inforrrullion use checklist.
0 Mold El Master builder 0 Other: f)escription Qty. Fa. Total
-
'•.:':...:.:.::::•::•::•;•:"•'.::..:::,"..:::.::::.:•:',': '4oli.:.: ' :::,,.]:.:.:...:...:'..:..:::::''.: Heatinekoothig
Job site address; /O —
020 dWr 1rr: Alf conditioning or heat pump —I / (reniiireR site plan showing placerneni) i 4.00 if
City/State/ZIP: PC(C/a4 d OR 17 tfl- Furnace 100.000 BTU (ducts/vents) / 14.00 /4•:"
- . Furnace 100,000+ BTU (duciN/vents) p l 7.90
Suitc/bidgJapt, no.: Project name: Gas heat pump 14.00
- .
Cross strect/directions to job site: • _ Duct work 10.00
—
livdronic hot water system 14.00
_
. . Residential boiler (radiator or
hvdronic) 14.00
_ . — Unit heaters (fuel-type, not electric),
1-- .
- 1 ' in-wall, in-duct suspended. etc.
— Flue/vent for any of above 14.00
-
6.80
Subdivision: I Lot no.:
()then • 10.00 • •
Tax map/parcel no ' Other fuelaspliaaces
IESRIFTtO OF WORK Wtcr heater -
10,00
(Jas nreplace l 0.00
. Flue vent for water healer or gas '
>lei/ at' Pktnae - r ,r_e• _______fi
Loe lighter was) 10.00
10.00
4 air CO4d1:7)0ner • Wood/pellet stove
10.00
. • ' 1._ .1 iiptc..f nsert I 10.00
10_00
g.., TRopRty., •• • •••• •i Z' ',..., : . 7 . :...:: , '...-.- . : .. :! . : . O • ; moo
41
Na Egafterfee / titr Environmental exhaust and ventilation ' , —1
- Rang hood/other kitchen
Address: Jo • . equipment 10.00
_
.
- •
City/State/ZIP: 0 / - 0 / 0 •.• • & e. , Clothes chyer C7.112U5t 10.0(1
1 single-duct exhaust (bathrooms
ph ot 4-- /146 . Fax ) ,
toilei compartments, utility rooms) 6.80 J
;,,,..,.:.: :::rm ,,,„.,,,....,st :::.:..;..-.. .;. -- . ; :1D.; : 40 i NTA,r3-' ;,'F.E.ii:'$'6 At0 fans 10.00
. ...,...., , , .• . .... -..!, I
Other: 10.00 _
Business name: Fuel V.ping
Contact name:
ginillif $5.40 for first four; $1.00 for each additional
i I .
fry. , 1
' i T - Furnace. etc. . • ,
Address: r Aff Gas heat pump
City/Stale/ZIP: • ' ili
Wall/suspended/unit heater
.
Water heater •
Fx: : ( ) '
Fireplace -
I
--IL 6A-412
E je,rte,C61.---figazi a o ffie.cont....., Range
Clothes dryer (sa.$)
Business name: 7.beie7. A t .,,, I Fit, • Clothes Other:
Address: / 49 6 A , itv • .. . ..... . „ . ....• . ...... ... . .
• • . .,.',..-,..-.• .MECHANK:A1.1?ErtlifFITEES* •• • ' ' ' • ...
CitviStautrZIP: - i ,irt,i i ag el f,4 • subto,--.-„,
- hfinnioni permit
Phonc: 0/' ,,j 0 ,.. . ,o l r f 4,p 1 Fax-41) )0 i-
! - Plan reyiel.y (25% of purnit fee)
COB lie,: i - i Ne . ' / • ! 1 Slate Surcharge (12% of permit fee) riPro
- TOTAL PERMIT •
• Auth 4.4 orized sianatur 0 :: g.
.
Ei ta
This permit application expires if il permit is not obtained within 18l)
days atter it has been accepted as eionpieu.
Print norne.gyeri c I eg ---, ,... lAil. pz . f cc .cibociolom.ser by Tri•Couaty Buildiwg Indestry Strvice BOaiti
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