Permit CITY OF TIGARD MECHANICAL PERMIT
6
COMMUNITY DEVELOPMENT Permit #: MEC2009-00371
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/23!2009
Parcel: 2S 102AD00401
Jurisdiction: TIGARD
Site address: 12625 SW HALL BLVD 27
Subdivision: Lot: 0
Project:
Project Description: Replace vent for pool heater.
Owner: FEES
THOMPSON, J RONALD & CECILIA Description Date Amount
1847 N 150E Permit Fee 07/23/2009 $72.50
CENTERVILLE, UT 84014 12% State Surcharge - Mechanical 07/23/2009 $8.70
PHONE:
Contractor:
HEAT RELIEF CO
13122 NE DAVID CIR # 800
PORTLAND, OR 97230
PHONE: 503 - 261 -9915
FAX: 503 - 261 -9814
Type of Use: MF
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories: •
Fuel Air Handlers
Fuel Types: Units < 10000 cfm:
Gas Pressue: Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $81.20
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces:
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work: 1
Fire /Smoke Dampers:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: (j�(�p w a1 p (1 1 .I 111 V t JILL, Permittee Signature: l �L `,0,
v + I ` X >�S Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
NMI
V F; 4' *
Mechanical Permit Applicati e t Er\ • FOR OFFICE USE ONLY
City of Tigard Received • I % Permit No.: ��yy
v 13125 SW Hall Blvd., Tigard, OR 97223 DDate/By: 1► 1k�2 4:2)(13 4:2)(13 1
■
l Phone: 503.639.4171 Fax: 503.598.1960 JUL 2 1 2009 Review
Date/By:
Other Permit:
TIGARD Inspection Line: 503.639 Date Ready /By: H See Page 2 for
Internet: www.tigard or.gov
CITY OF TIGARD Notified/Method: Supplemental Information
• 1a r1 ISION
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Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
_„ c " `` GO ssza�.-7r �' z . U. F :Ja 'krsf.` r for..€+ - .
Value:$
' �Y� ..
❑ — and 2- family dwelling /; ommercial /industrial ❑ Accessory building , ' ""' ' �`°' "�` - - ' k4 � -- " - -
, f
For special information use checklist.
iL V ulti-family ❑ Master builder ❑ Other:
Description I Qty. Ea. I Total
OB I I I tt e3 ,
...' r,.:.w,,, _ `. <„,.. =��t n. , '. ,, :: Heating/cooling
Job site address: / to c . 5 4--/-
(.(J ail �/ Air conditioning or heat pump
U t^'� (requires site plan showing placement) 14.00
City/State /ZIP: ` . /��� 9? �� Furnace 100,000 BTU (ducts /vents) 14.00
`� // Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: (Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
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. 10.00
Subdivision: I Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances -
"`" `- Water heater 10.00
i I Gas fireplace 10.00
— t i Flue vent for water heater or gas
��' W 1 11 ,, I �I- / /l � fireplace 10.00
`.
Log lighter (gas) 10.00
' t 111 t! I I I Wood/pellet stove 10.00
Wood fireplace/insert 10.00
$4 = y - ,� it Y . Chimney /liner /flue/vent • 10.00
F� a P E i f .
." ss —�:. � ',_. ' -i � s sae Other. 10.00
Name: 9.0 it/ I' / 0Y Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 10.00
City/ State/ZIP: Clothes dryer exhaust 10.00
Phone: ( ) Fax: Single -duct exhaust (bathrooms,
( ) toilet compartments, utility moms) 6.80
. ;(.; , , '. 5�� "` ' a is • ,s Attic /cravils.ace fans - 10.00
, ,� : spa r+
Business name: HEAT RELIEF Other: ��% �� /�� 10.00
Fuel piping
Contact name: MARK DEFRANCISCO $5.40 for first four; $1.00 for each additional
Address: 13122 NE DAVID CIR DR # 800 Furnace, etc.
Gas heat pump
City/State/ZIP: PORTLAND, OR 97230 Wall/suspended/unit heater
Water heater
Phone: (503) 261 -9915 I Fax: : (503) 261 -9814
Fireplace
E -mail: Range
., _ Barbecue
Business name: HEAT RELIEF Clothes dryer (gas)
Other
Address: 13122 NE DAVID CIR DR # 800 : i 35% * °:
City/ State/ZIP: PORTLAND, OR. 97230
Minimum permit fee ($72.50)
(
o Subtotal % /j, �9
Phone: (503) 261-9915 Fax: (503) 261 -9814 Plan �
an review (25% of permit fee) t
CCB lic.: 122424 State surcharge (12% of permit fee) rj
TOTAL PERMIT FEE li This permit application expires if a permit is not obtain in 180
Authorized signature: 27/4 �- days after it has been accepted as complete.
Print name: MARK DEFRANCISCO Date: * Fee methodology set by Tri -County Building Industry Service Board
I:\ Bui lding\Pennits \MEC- PermitApp.doc 04 /06/06 440 -4617T (I t /02 /COM/WEBI