Permit „,
CITY OF TIGARD MECHANICAL PERMIT
;• 1 ' . COMMUNITY DEVELOPMENT Permit #: MEC2009 -00361
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/20/2009
Parcel: 2S110BC00300
Jurisdiction: Tigard
Site address: 14440 SW HAZELHILL DR
Subdivision: Lot: 0
Project: Nordt
Project Description: Replace electric furnace with gas furnace - replace tank water heater with tankless - new gas line
to both - new flues ( #2 lb gas line) Plumbing on minor label
Owner: FEES
NORDT, VERA L ESTATE TRUST Description Date Amount
2420 NW MARSHALL ST
PORTLAND, OR 97210 Furnaces < 100K BTU 07/20/2009 $14.00
FlueNent For Any of Above 07/20/2009 $6.80
PHONE: Water Heater 07/20/2009 $10.00
Flue Vent for Water Heater or Gas 07/20/2009 $10.00
Contractor: Fireplace
CLIMATE CONTROL INC Fuel Piping 07/20/2009 $5.40
16500 SW 72ND AVE 12% State Surcharge - Mechanical 07/20/2009 $8.70
TIGARD, OR 97224 Minimum Fee Adjustment - Mechanical 07/20/2009 $26.30
PHONE: 503 - 453 -4822
FAX: 503 - 968 -7224
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
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: i Ntli.ecf Permittee Signature:
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.
J 20 2009 8:32AM CLIMATE CONTROL INC 5039687224 p.2
- M echanical Permit Application
•
FOR OFFICE 1 S F O L Y
City of Tigard Received
4 13125 SW Hall Blvd., Tigard, OR 97223 I Date/By: Permit N °.• tL��'.G �U
I Phone: 503, 639.4171 Fax: 503.598.1960 Platt Review
Inspection Line: 503.639.4175 Date/By:
Other Permit:
TICCARD- Ins JUL 2 0 2009 p DateR /a • Internet: www.tigard
Ready /By: tufty I 121 See page 2 far
N°tified/hdeth°d: Supplemental Information
TYPE OF W( il�js DING DIVIS °O�I COMMERCIAL FEE" SCHEDULE - USE CHECKLIST
ID New construction g Addition /alterat - 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 S .
.g and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ Multi-family ❑Master builder ❑ pi er; For special information I use checklist
JOB SITE INFORMATION AND LOCATION Description Qty, f Ea I Total
Heating/cooling
Job site address: / L/111/ / 0 Sly f i 1., Z - p L r C/ /r j/ A2 Air conditioning or heat pump
7r`► ! (requires site plan showing placement) 14.00
City /State /ZIP: / , , A �.)(- 72-7-- Furnace 100,000 BTU (ducts/vents)
1 14.00 1
Suite/bldg. /apt. no.: Project name: K1012.137- Furnace 100,000-4- BTU (ducts /vents) 17.90
Cross street/directions to job site: Cry heat p 14,00
Duct work 10.00
• Hydronic hot water system 14.00
•
Residential boiler (radiator or
bydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended etc. 14.00
Subdivision: Lot no.: Flue/vent for any of above 1 6.80 6 •g o
Tax map /parcel no.: Other: 10.00
Other fuel appliances
DESCRIPTION OF WORK
•
Water heater 1 I 10.00 /
ft /4E'r el ECr e f M4Cr~ ' (t 1 r 7-1-1 �, Gas fireplace 1 10.00
f�- Flue vent for water hearer or gas
1� 0� I.UA t�7 m, f �, m e 7 vA � - fireplace 10.00 / V
NPLC/ / � / Log lighter (gas) 10.00
t ' r 0rh - � reties Wood/pellet stove 10.00
04,1,211 C
X I 44-s L 4e/ p /f/in 4,I oys (// / &,,/ Wood fireplace/insert 10.00
PROPERTY OWNER 1 ❑ TENANT Chimney/liner/flue/vent 10
Name: an a / Other:. 10.00 1
�" Environmental exhaust and ventilation
Address: ) L.C.) I , Z �' /)/Z Range hood /other kitchen
City /Staten /ZIP: �6 f � � q equipment 10.00
c./ / ` ! 7 Z2y Clothes dryer exhaust 10.00 1
Phone: ( ) elg9Z- 170" Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 6.80
•
APPLICANT . . 0 CONTACT PERSON Attic /crawlspace fans
) I Ib.00
: i '--
Business name - 4 11 o� Inc,
Other:
Contact name: Rot,/ rl S Fuel. piping 10.00
55.40 for first four; $1.00 for each additional
Address: ) (a S.00 - 7 .-`1') . Furnace, etc. i I I S `10
City/State/LIP: rr 9-7 Gas heat pump I
�a t� (u e � - - Li Wall /suspended/unit heater
Phone: (5a3) Li 5 2 Z-7 1 Fax:: ( ) -9(0 ( - - 7ZZ 1 Water heater 1
Email: { Fireplace
C01 ell a Ca) r) "tY P il 11)C - C4 tit. \ Range
CONTRACTOR Barbecue
Business name: e....c4 r3`i Ate` Cl n 7 J _
°�Z3 L i R Clothes dryer (gas)
Address: )42_500 S (/l) -- / ri13 & Other:
City/State/ZIP: f r (o n � 4' 22 MECHANICAL PERMIT' FEES
1 " Subtotal Vie t°
Phone: (St, `°) _
2-� + Fax: (,�) q , ...-7 Z ,./ Minimum permit fee ($72.50) 72- Sc
CCB lic.. 7 q Plan review (25% of permit fee)
v� //) State surcharge (12%ofpermit fee) Er'. 70 -
Authorized signature: K ok.1 _� TOTAL PERMIT FEE g/.2..0
This permit application expires if a permit 'is not obtained within 180
[print name: days after it has been accepted as complete.
X01 ( > s Date: 7 7 49 I ' Fee methodology set by Tri -County Building Industry Service Board
1 .\ Building1permirs us
W ,O C.perm,pp.doe 01/10/07
44 -46171 (11/02ICOMhVEB)