Permit CITY OF TIGARD MECHANICAL PERMIT
' P l COMMUNITY DEVELOPMENT Pe
COMMUNITY MEC2009 -00221
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 05/22/2009
Parcel: 25111 CA08100
Jurisdiction: Tigard
Site address: 9945 SW KABLE ST
Subdivision: Lot: 0
Project: Doyle
Project Description: Replace gas furnace.
Owner: FEES
DOYLE, MICHAEL P & CENDY L Description Date Amount
9945 SW KABLE ST Furnaces < 100K BTU 05/22/2009 $14.00
TIGARD, OR 97224 Fuel Piping 05/22/2009 $5.40
PHONE: 12% State Surcharge - Mechanical 05/22/2009 $8.70
Minimum Fee Adjustment - Mechanical 05/22/2009 $53.10
Contractor:
A- ACTION HEATING
18245 SW TV HWY
ALOHA, OR 97006
PHONE: 503 - 649 -3524
FAX: 503- 649 -6095
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
Issued By: / e Permittee Signature: Qic/ 6 Lac
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.
0.9/4/2014 08:48 FAX 0001 /002
Mechanical Permit Applicatio 1 E CE V EC FOR OFFICE USE ONLY
U
City of Tigard . Permit No.:
mt 13125 SW Hall Blvd., Tigard, OR 97223 MAY i. 2 00 9 Da Re ii !� l /� r Q Op
Plan Review
Phone: 503 639.4171 Fax: 503.598.1960 Date/By: Other Permit
T I G CR U
Inspection Line: 503.639 CITY OF T Date Ready/By: 61 See Page 2 for
Internet: www.tigard- or.gov
BUILDING DIVISION N otified/Method: gin Supplemental Information
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Mechanical permit fees* are based on the value of the work
❑ New construction 1 Addition/alteration/replacement
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
❑ Other mechanical mater) equipment, overhead,
" f,Pati' �'?i�ee5l i i " +'•�' K!� " . k+t. x":C:u:'�^'. Let a .. > profit.
Value: $
we .11 kt t"ei1PF to ngtai s.,i: zEi r•� il ,t*asal��iFgws o r i. r ....1...=...a" �r e k. s1 q altar
s 2 i labor, o ead and r fit
'rid - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ~ . ' l � ` •- - •• :� • 1t 14 :..4 01 ',"
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
"13a dlu'9g..c.tiJ., raa 'ttx ;e rn crmraa r .�., @
Description
� cafl+t: ,. rca�a" a6" 1 ;alHi " i 7 . > v Y I a 5' - fit - P Qty. Ea. Total
i":aaitsvk" _ .Pb c t`f 4•.t t i�i. �h"6`l,t tat•! g n'` �. : ix s
>.._ .1146 ..4i.ii.,, ' _ .. . . _.'+s t9''�,,ftuuatwa}uuf¢u :_b$t ; : . . W _ E, .. ':s"., An conditioning Heating,/cooling
Job site address: 9q `^ J . . p S Au conditioning or heat pump
1 `P v t (requires site plan showing placement) 14,00
City/State/ZIP: T )r . e " CIP. 11 - l Fumace 100,000 BTU (ducts/vents) ' 14,00 ' Li '
co
Suite/bldg. /apt. no.: f Project name: Furnace 100,000+ BTU (ducts/vents) 17.90
Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
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. 14.00
Subdivision: 'Lot no.: Flue /vent for any of above 6.80
Other' 10.00
;"pa ,nic.T+1"F rnx.3@u .rsi1'tt. allillf v "2r i!rrrtnmt''tI*sti "H` tc.M2 ^ ' , ?;;i!�a?it!31d8 ANR Other fuel r appliances
,
Tax map /parcel no.:
ppli
siiiikl }�"!!it mwi� '^r.t ligl ',frr .aSaieg i`Izl`.? t' , 44 �. pitioi , r a . ec?4l tl�'`etv". lr� ! Water heater 10.00
........ �!�.n�n..r .��..r .,,an.,ee.. ��:rG__x =__. _sctt�;�9it Am6N Y. nx:�:z:rttsait,7K #4§TF . w.,. .- ;:.: >:,..,. ,.Y..
t� Gas fireplace 10.00
,� IA • T--- 1 Fl Flue vent for water heater or gas
3• a F r et �� fireplace 10.00
Vu 1" Log lighter (gas) 10.00 •
- Wood/pellet stove 10.00
. {p@-{ Wood fireplace/insert 10.00
1�p{1ta?<:la ', , 1 m' �,t>~. f =tz f ""'�'tEt tsra%�,lEtial,:at �:•��" � n "r s t Chimney/liner/flue/vent 10.00
. 1.iinuir:� l ,jii.11. ,ee .n, itr.., r.,.a: 5 , iihi $ c . J racrga(& .a i,@ ot•ra .r' w i E ur ttu., g -.,,nst ? 10.00
' °'� - rrnn °,r Other.
Name: l 1• M.D.
g hod
t • pi____ - - A � - Environmental exhaust and ventilation
Address: 4 � ���� Range hood/other kitchen
� . equipment 10.00
�• •e �� i �i Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: 5_53) 0 1M11 Fax ( ) toilet compartments, utility rooms) 6.80 ii
;;�` �•'"' ^tii9it� : -'1 fl.. !p !141:7 Xtt!' �, ,
s ib`' ra^u on .rar..ca5.;yg 'fit
i n„" lll�ipti(. r,,'�,�� frrs'i fl � t a•s �c ,�, £T,1 r , - r' a t a ? ^ e"4, 0 ' •µ- ri l're Attic /crawls ace fans 10.00
„A:a4seat ttitiaeaiA lilt �a...,..1. ;ta,aiff:i..tooC0 iit.. '•wraisa 1 ._4 A A t i9 to tiaV ks A4e1,. , :49il ii p
Business name:
Other: 10.00
A- ACTION HEATING & A/C Fuel piping
Contact name: 18245 S.W. T.V. HWY $5.40 for first four; $1.00 for each additional N0
Address: ALOHA, OREGON 97006 Fumace, etc. _......-
Gas heat pump
City/State/ZIP: WalUsuspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
E -mail: Fireplace
, uu1, spa;? w ,y1 ....._,... ., _ Range
�
.. rat i� ii ditiir^ai l " ... °F 3lil.ti h1 •!t%zi WakC;tK""ti R 1 •st« .. t i .._aMS�i i-_i.i'y''x.;ai is�' .�
? ., `la l il', 4µ11h°11 ttA i ?: .,tiaemi ',a titt`gii , r a t d t1? t " i t O c ; a1e�s� .„,,„, ri.'' k •' , " , Barbecue
' , r
i� 'S.._tE__tl'tt11`tSG rs,dw" tl»,_........, ..�,. ;...::ifa3
Clothes dryer (gas}
Business name:
Address: Other:
18245 S.W T.V. HWY i7 , Ktszn t a R , ,. � i t ! ,a
f ae' at ; ., ii. : . di 2 : is "i : t . .mawe>te.it .
City/State/ZIP: ALOHA, OREGON 970 ,t.. � _.:.,,a�f .,: , t Subtotal t . eu r. _ ..
Phone: 3)6/49 - 35,14 Fax :U3 i „ L ('_ _ C5 Minimum permit fee ($72.50)
V l 19t . J /� Plan review (25% of permit fee)
CCB lie.: "7 8 t,, 9 State surcharge (12% of permit fee
r J TOTAL. PERMIT FEE �'�
Authorized signature: k _ /t This permit application expires if a permit is not obtained wit in 180
I �x days after it has been accepted as complete.
Print name: r S ,� "CL e (u p Date: . j 18/ / 0 9 * Fee methodology set by Tri- County Building Industry Service Board
IABuilding \Permits\MEC- PermitApp.doc 01/19 /07 440-46177 ( M/WLBl