Permit CITY OF TIGARD MECHANICAL PERMIT
I o COMMUNITY DEVELOPMENT Permit #: MEC2009 -00540
T I G A RD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/14/2009
Parcel: 2S103DA06900
Jurisdiction: Tigard
Site address: 10925 SW MIRA CT
Subdivision: Lot: 0
Project: Reiney
Project Description: Install gas furnace and a /c.
Owner: FEES
REINEY, MICHAEL G Description Date Amount
10925 SW MIRA CT
TIGARD, OR 97223 Air Conditioning 10/14/2009 $46.75
Furnaces < 100K BTU 10/14/2009 $46.75
PHONE: 12% State Surcharge - Mechanical 10/14/2009 $11.22
Contractor:
FOUR SEASONS HEATING & A/C INC.
1005 INDUSTRIAL PARKWAY
NEWBERG, OR 97132
PHONE: 503- 538 -1950
FAX: 503- 538 -0165
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Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas .
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Gas Pressue:
Total $104.72
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 p503.246..66`6999npor 1.800.332.2344.
Issued By: C 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.
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Mechanical Perini Application D� I41k 41'1 1l 1 t �I. I \1 1
City of Tigard RECEIVED Dale/By: / O i ' •1y Permit No.: A. P- OD ,
13125 SW Hall Blvd., Tigard, OR 97223 p Review
' Plan • Phone: 503.639.4171 Fax: 503. 598.1960 Date/By.. Other Permit
on Line: 503.639.4175 O C T 1 '' -
F 1 1.: •• i ; i ., Li 1 2 / 'i , � Date Re�dyBy. ® ties Page x for
Internal: www.tigard- or.gov Nceified/Methcd SepplementalInformaton
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❑ New construction 11 Addition/alteration/replacement Mechanical permit feels are based on the value of the worst
pe nned Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ ■ cr: mechanical materials, equipment, labor, overhead. and profit
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I- and 2 -family dwelling ❑ CommerciaUindusirial 0 Accessory building
Multi-family Other For special information tinformation Q Y ❑ Master builder 0 Othe _ Description ,r���y / },• ` ��. `' Total
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Job site address: • S 1 l '1, \ 1 C. Air conditioning or heat pump 16:161
City /State/ZIP: , 1 a ti `� I► qi �� Furnace 100.000 BTU (• • .. -, �11U,V~10
Suite/bldg /apt no.: Project arena: Furnace 100.000+ BTU (ducts/ . . 1 17.90
i ,`e - h ` - 1 Gas heat pump 14.00
Cross street/directions to job site: butt work (T 0
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronio) 14.00_ _ _
Unit heaters (fuel -type, not electric).
in wall, in -duet, suspended, etc. 14.00
Subdivision I Lot no.: Flue/vent Ear any of above 6.80
Other. _ 10.00
Tax map /parcel no.: Other fuel appliances
.';, ::,;:. 1 .v" , : :•�,:t..;c4r Water heater 1 0.00
1::- , ,j,3 , � Nnf d ,,,Tryd ' a . ; , .. i - ' ^'. - � ' � 6 ... ... ; d�' i ' r. ,
' :....4 :Y s•19 :' o.,, f.h d;
Gas fireplace 10.00
immiiri
( t..0.,-. i1 �ZL L. ' _. )4_,L5- Flue vent for water heater or gas
r fireplace 10.00
..� l..I ! _ Lore lighter (ess) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
- Chimney/liner/flue/vent 10.00
sr ,au./r.�a®pr'e r m.i :. Other 10.00
Name: , k `. � ►.
��� r - �`� Environmental exhaust and ventilation
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Range hood/other kitchen
Address: ` O �j I ► - ._ • / equipment 10.00
City/State/ZIP Clothes dryer exhaust 10.00 •
t �Cl Single-duct exhaust (bathrooms, '
Phone: ( ) -0 (p s O . 84 Fax: ( ) toilet compartments. utility rooms) 6.80
,� .,. , ^. •y iyy (7n." .... r. .. ? ,� ... } Atlic/crawl5PUCe am8 1 10.00
Y�t *'' n !n ��tf� � xK.u.i.ii'ei., 24 c :o m', Urs..:a o4uxiva v.�: �u/ r 10.00
Business name: Fuel piping
Contact name: ■ - ■ • $5.40 for first four; 51.00 for each additional
Address: 1005 INDUSTRIAL PKWY cbc -
NEWBERG, OR 97132 Gas Ire p""'1'
City/StatefzlP: Wall/suspeaded/unit heater ,
Phone: (5 05) l' 50 1 Fax:: ( So` 53 R--016v Water heater ,
Fireplace
E -mail: Renee
i f, n - " Y'. r ' .., r , :,L 1 -� _ . i �:.4� f N,477> T :' N/: . yr .4 Barbecue
�• cr. • � ?'G;''r : •�' ��': .'' +'. � .� �•:r , � ,T.\ 4 ., ,..vYy:? t v '+ �Barbecue ' Clothes drYet (Ms)
Business name: FOR SEASONS MEAT Other.
Address: AIR CONDITIONING INC. : " "! `" : : :>
1006 INDUSTRIAL � x ° '" . �,;.',
City /State/ZIP: NEWBERG. R 97132 S $72 50) Q� 5
Minimum permit fee (57/50)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lie.: q ' 1 5-)...._. State surcharge (12% of permit fix) - -11.1-2,
TOTAL PERMIT FEE
7Lis permit application expires NA ear nit 4 not o whsle 80
Authorized signature: , days after it has been accepted as comp /(� 7 ` Z -
Print name; ` � r - - Date: o fi 0' • Fee methodology set by Tri•Cormty Building Industry Service Boar e.-- ■
' li ui{dil�g.Pa nfEC- PamiApp•400 out9ar . 4404417r(I UOa/coM/Wm) C �.
C00 /E002] XVJ 6O:LL 600Z /60 /OL
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A/C-HEAT PUMP---UNIT SITE PLAN - . t ,
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ROPER`TY LINE S°S6
FEET TO FRONT P _ � • - AF S: la.� s Nn� n . e - , ...., cc �az - - •
PLEASE .REFAX APPL ITH SITE PLAN
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