Permit CITY OF TIGARD MECHANICAL PERMIT
1111 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00107
Date Issued: 02/29/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S111AD15200
Jurisdiction: Tigard
Site address: 9059 SW REILING ST
Project: BURR Subdivision: MALLARD LAKES Lot: 18
Project Description: Gas furnace replacement.
Contractor: TRI COUNTY TEMP CONTROL INC Owner: BURR FAMILY LLC
13150 S CLACKAMAS RIVER DR 9059 SW REILING
OREGON CITY, OR 97045 TIGARD, OR 97224
PHONE: 503 - 557 -2220 PHONE:
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 02/29/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 02/29/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/29/2012 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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: 4111 / Permittee Signature: s:z ___R s.
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.
FEB -27 -2012 10:20A FROM: TO: 50359E11960 P.1
Mechanical Permit Application 1.()1; ( ) I I I ( I 1'N I e I. i
"I 13125 Of Tigard � Date/By: ,, Permit No.: _ `0 _ 0 ■
.
13125 SW Hall Blvd., Tigard, OR >+ ., , . Plan mew
Phone: 503.639.4171 Fax I c ,: y . ma
. Other Permit
I t I cl %� Inspection Line: 503.639.4175 V r P Date Ready/By: Jurir ® See Page 2 for
Internet: www.tignrd- or.gov .( O � • \v `,\ C ) Notified/Method: SapplemeaMlloformation
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❑ New construction ® Addition/alteratio '1 tacement Mechanical permit fees* are based on the value of the work
pe>rfor< reel. lndicate the value (munded.to the nearest dollar).ofall
❑Demolition ❑ Other:
mechanical materials, equipment, labor, overhead, and profit
"••< :F; .. , . ..CATEGQRS 'OF ;lrOSI UCT1ON - ' , _ _ Value: $
, ® 1- and 2- family dwelling ❑ CommerciaVindustrial ❑ Accessory building
R lODEITil kiQ*44- NT / 00E1 r�. p'L''GS+.. _ '
. For spectatkeorma lan use cha
❑ Multi- family 0 Master builder H
❑ Other: Description [ Q. 1 Ea. I Total •
-- -:., 408 -SITE . INVORMAfiok AND.LOCATIO$ He tindcaeling
Q5(y
Noll; 81" Air conditioning
Job site address: ' t l t W V 1 (requires site plan showing placement) 46 :75
City /State/ZIP: �, e 41224 Furnace 100,000 BTU(ducts/vents) 1 46.75 4(. - 75
Suite/bldg./apt. no.: v I Project name: Furnace 100,000+ BTU (ducts/vents) 54.91
gf A('r Heat pump 61.06
Crow street/directinns to jnh site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
ini wall; induct, suspended, etc. 46.75
Subdivision: I Lot no.: Flue/vent for any of above - 1L1,,�i1:3 - —
Other: - 23.32
Tax map/parcel no.: Other fuel appliances • . ` `'. DFSCRIPTIOIi OF _WCRK Water heater ,
Gas fireplace 33.39
Flue vent for water heater or gas
�y �p �� f� r ,�yl q /�y l Log lace 23.32
LI J►J 1 �UAJ�/ Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert • 23.32
' Chimney/liner/flue/vent 23.32
• • A)'tQp)ntT1 - PIER_ . • I . ._ : Q.:TESAtz`t' , Other 23 :32
Name: Norman burr Environmental exhaust and ventilation
Address: Range hood/otherkitchen
equipment . 33.39
City/State/ZIP: . Clothes .dryer exhaust . 33,39
� Single -duct exhaust (bathrooms,
Phone: (.
) (20 - I Fax: ( ) toilet compartments, utility rooms) 23.32
®'.APl'1;ICA'NT :. 11 . 1 ‘. c oN 'ACTIiRRSON ` Attic/crawlspace fans 23.32
' Business name: Same as contractors 23.32
Fuel piping
Contact name: Diane Mason $14.15 for first four; $4.03 for each additional .
Address: Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater
Phone: ( ) l Fox: : ( ) . Water heater . ` •
Fireplace
E-mail: . 1
CONTRACTOR . ... Barbecue - ...
Clothes•dryer (gas)
Business name: TO County Temp Control -
- Other:
. Address: 13150 S Clackamas River Drive . ME( HAN.ICA�L PERMIT fEB' `. :.; ,
City/State/ZIP: Oregon City, OR 97045 Subtotal 4 ,75`
Phone: (503) 557.2220 Fax: (503) 557.0919 Minimum permit fee ($90.00) '1v. (JO
Plan review (25% of permit fee)
CCB lic.: 72623 State surcharge (12% of permit fee) 1 jeA' Aril
,., TOTAL PERMIT FEE 1
Authorized signature: 4,ry,/J
'MIS permit application expires If a permit it not obtained within lea
days after it has been accepted as rnwpiete.
Print name: vox, mason I Date: fig/ (2.. I • Fee methodology set by Tri -County Building Industry Service Board
I:UtuildineermheM�EC -Pen IiApp.doe 10/01/00 44 617T (II/0'LCOM/W ®)