Permit _ ,, CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00070
• T fGrAg D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/07/2012
Parcel: 25111 BD00406
Jurisdiction: Tigard
Site address: 9675 SW MARILYN CT
Project: Fannie Mae Subdivision: DARMEL NO.3 Lot: 27
•
Project Description: Furnace replacement.
Contractor: AMERICAN CONTRACTING Owner: FEDERAL NATIONAL MORTGAGE ASSN
7855 SW OLESON RD BY RECONTRUST CO
PORTLAND, OR 97223 400 NATIONAL WAY
SIMI VALLEY, CA 93065
PHONE: 503 - 407 -8538 PHONE:
FAX: 503 - 244 -9556
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/07/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/07/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/07/2012 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types:
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.
Issued By: � J` Perm ittee 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.
2012-02-07 10:43 AMERICAN CONTRACTING 5032449556» 5035981960 P 213
Mechanical Permit ApplicatiREn,lir L -
ruR01,1:1( F 1
SW Hall
'P Blvd., !•:1•. ()NIA
---- P
City of Tigard Tigard, OR 972 U :El i g:
- iii 13125 23
* I - Phone: 503.718.2439 Fax; 503.598,1960
FEB
- 7 2012 Date/Fly Other yentlit .
. Inspection line: 503.619.4175 sv Date Ready/13y: e See Page 2 for
t it.Aki)
Internet: ww.tigard-or,gov Notifled/Method: Supplemental Information
CITY OF TIGARD ingi
lawrrwiltr.-..i...., , • , :..
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L:. . ' Mechanical permit fees arc based on the value of the work •
0 New COnstruelion ddition/alteration/replaccmcnt performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition Other: mechanical materials, equipment, labor, overhead, and profit.
, ' , 0 • 0,6,
' Itit006001.;• "-..'• .. ::It ;:1:11,1;.`i'; •• .-.,,. ., „ „ .. .. ,,.. ...
•• . :.•:" 1 •• 1 •• 1 ' 41 40 1 .gttiOrii#A#1 1 ; . ..,, _ • -, - ....;:±... ,,,;.• P . '0',4;1.:.:..,:.,
. ), ' ' bail ' allele teluiraliantii r.V1 , .-taiei .''' ''':',:!" ' •
- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
Multi E] Master builder 0 Other: Description
_
I Qty. I Ea. 1 Total
: . : ' • ...,' • .; , 71• 1 41iiiiiiii:.;••""•" i ''..;' ; '.7i" 'V ,i t4;,; Heating/cooling:
• • .;'•;• ; •• '.,• L:,..,„'.1 „?1.,. , .' ,..;Ar,, serstrRinros .romf , ,,, Air conditioning
Joh site address: it,.-7 6 ct...0 a., r i 1, (requires site plan showing placement)
Fumace 100,000 BTU (ducts/vents) I 4 Yrc-
City/State/71P: -- c - k_ G r I 0 R. C i 2 Furnace 100,000+ BTU (ducts/vents) 54 91
/
Suite/bldg/apt, no.: Project name: Ei a j fni... s r feat pump
(requires site,plan shuwina placement) 61 06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel-type, not electrir,),
in in suspended, etc, 46,75
Subdivision: IA no,;
Flue/vent for any of above 23.32
1
Other; 23.32
,
Tux Map/parcel no,: a , 114_ .t 00 Lto - Other fuel appliances: _
• • •;..••; '1.':"i1,••!;;' 4 : • - i• ; .; ' ;; ;•;:..., ; ,, ..':;:i :1•,1-1•;' Water heater 23.32
0-
,, • - .
a Gas fireplace 33.39
buytia....e. y-t...p la- e.,.evvReilid 0.. „,„, for water heater or gas
fireplace 23,32
Log lighter (gas) 23,32
Wood/pellet stove _ 33,39
Wood fireplace/insert 23.32
. Chimney/liner/flue/vent 23.32
t."L'1;ii' Pt04' : :J',":' , i 1 e' 1 ''1 !:i fa 404417 ;J:4`;.";:!:4A oth
23,32
Name;
Environmental exhaust and ventilation:
Address: Range hood/other kitchen
_ equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33,39
Single-duct exhaust (hathmorns,
Phone: ( ) Fax: ( ) Lioilet compartments, utility rooms) 23.32
. • • 4:3! A,101Willtifi . 1;' ..,, %I!' ■• Attichrawlspace fans 23.32
Business name: Other — - 23.32
Contact name: E.44 .---
).1* ,,,,,,,
—
Fuel piping:
,
s14.15 for first four: $4.03 for Nth additional
---,
Address. Furnace am
—. . .— Gas heat pump
City/StateIP:
Wall/suspended/unit heater _
Phone: CO6) L ?O 5 ‘,, I Fax; ; ( ) Water heater
E-mail:
Fireplace
Range
. .. ... . ... . . ... . . .. ,--
• 1 :•, ;••• •• '- 1,1,,, i,!,■;,:■.:....:.•:",,.44'4 Barbecue
Business name: P v - M e nt a vi . i A4 v g cft /' Clothes dryer (gas)
Other;
Address: -- 75- ,
5 s o 1 -..g 0.-yi. ( :.,v,...4'
City/State/ZIP: 0 I / Ct „A.A./Mt )2._ ....- ..0 Subtotal 1 0 :71
Minimum permit fce ($90.00) 410. v0
Phone: (S p 4 0 -7 - FLi, c5).3) a IN 9 5
Plan review (25% of permit fee)
CCB lie.: 401',D)7'7 7 Statc surcharge (12% of permit fee)
_ Torkl. PF.R/141T F. - /DO ,,fl) -
, , , This permit a pplIcation expires if a permit is not obtained within ISO
Authorized signaw—ek a • A / , (, , U. . . , days alter It has been accepted as complete.
0 '
Print name: .
• Fee elethodelogy set by Tri Building Industry S. vies Round
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I atiltlinkaermits\ MEC-Per' App dm owoon n i 440.4517T (I I in/COM/WEB)