Permit q CITY OF TIGARD MECHANICAL PERMIT
11 1 COMMUNITY DEVELOPMENT Permit #: MEC2009 -00157
Date Issued: 04/15/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S126DC01004
Jurisdiction: Tigard
Site address: 9445 SW LEHMAN ST
Subdivision: Lot: 0
Project: Roth
Project Description: Replace gas furnace.
Owner: FEES
ROTH, JEFFREY A & BETTY A Description Date Amount
9445 SW LEHMANN ST Furnaces < 100K BTU 04/15/2009 $14.00
TIGARD, OR 97223 Flue/Vent For Any of Above 04/15/2009 $6.80
PHONE: 12% State Surcharge - Mechanical 04/15/2009 $8.70
Minimum Fee Adjustment - Mechanical 04/15/2009 $51.70
Contractor:
AAA HEATING & COOLING
2915 NE MLK JR BLVD
PORTLAND, OR 97212
PHONE: 503 - 284 -2173
FAX: 503 - 284 -1552
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 Notificatio enter. Those es are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
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Issue By: 11,1(2/0/L0-41 Permittee
_- _ 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
Approved plans are required on the job site at the time of each inspection.
poi 04/06/2009 14:33 #065 P.001/002
Mechanical Permit Applicati '-
rolt of hlc l use (')NIA'
Receives
g /,
Ipl : City of Tigard Date/By: �` `.:. , 7
• 13125 SW Hall Blvd., Tigard, OR 97223 APR - 8 200 y -�.
' Phone: 503.639,4171 Fax: 503.598,1960 Plan
ateB Other Permit:
Inspection Line: 503.639.4175 CITY OF TIGARD y
•1 -1 GAF: U p Date Ready/By: VI See Page 2 for
Internet. www•tigard- or.gov BUILDING DIVISION Notified/Method: rin Supplemental Information
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ID New construction Addition /alteration replacement 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.
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1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
ID ❑ Master builder ❑ Other: For special information use checklist.
t � z ,a p , i e _S - f -r Description I Qty. I Ea. Total
, 1i e 3 . 1 „t AND 1�'jI t " R'vrti�'-?As�° kr, Nr 1 I Mi'
d. � ' c i : Heatin>/coolin
Job site address: ( �y s A., 4‘ 4.4, Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State/ZIP :. ,t r Oil 972 2 3 Fwnace 100,000 BTU (ducts/vents) t 14.00 r y
Suite/bldg. /apt. no.: / d I Project name: -M Furnace 100,000+ BTU (daces /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: I Lot no.: Flue/vent for any of above 6.80 (, �,
Ot 10.00 _
Tax map /parcel no.: Other fuel appliances
1 tY ' 11 a`` `' S,4trti; , ' , ,. = i f,. (, : `t i T em w Water heater 10.00
IP
/ t Gas 10.00
• 0.�_ " "t 4.- - Flue vent for water heater or gas J
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
-.!' _ tQ> TYr ', ,..a! y ) , :� a FS: y'3 i 't . Chimney/liner /flue/vent 10.00
tc'� - s ", ti •. Other:
Name: 4 47,F Z 10.00
Environmental exhaust and ventilation
Address: 9544 5- SW l 1.4.... p i,� cif- Range hood/other kitchen
equipment 10.00 •
City/State/ZIP: a j? y y . / " a 9 i L j Clothes dryer exhaust 10.00
Phone () 2, 8 �S 1 Fax ( ) Single -duct exhaust (bathrooms,
Q # s toilet compartments, utility rooms) 6.80
- s 0 iS: ,.,.�. a 0 r.A t : f Attic /crawls ace fans
r , �:. , ���':r.�:u:, :...� p . 10.00
Business name: Other: 10.00 _
Fuel piping
Contact name: St1L4 S9wZ
7
$5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/State /ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax:: ( ) Water heater
E -mail: Fireplace
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p _ sT Range
}" ,tap ✓ .. Y t :' y i P 1:, �. e. e, n ,- - 1 -,. W.. - J i L °�� ,; �' ' t v _;t . .• ' 4 ,
Barbecue
Business name: }if rA t 0 .- m _ 4 t,c)D l`■Ai Clothes dryer (gas)
Address: �Ser ae. Other:
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City/State/ZIP: ` t'��`. \� Z. a+xa+i - ... - .its
Phone: ��) '2.'75(4 *, F ax: ( - 2_24.- I 2 _ Minimum permit fee ($72.50) - 72, ID -
�� KS) 74
Plan review (25% of permit fee)
CCB tic.: 2.727._ State surcharge (12% of permit fee) �t t 7
TOTAL PERMIT FEE {
Authorized signature: T hu permit application expires if a permit Is not obtained within 180
days after It has been accepted as complete.
•
Print name: VI (k - ka - lik Date: itie4 -,b 7 • Fee methodology set by Tri -County Building Industry Service Board
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