Permit CITY OF TIGARD MECHANICAL PERMIT
RI
1 • COMMUNITY DEVELOPMENT Permit #: MEC2012 -00488
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 09/25/2012
Parcel: 2S102DC01303
Jurisdiction: Tigard
Site address: 8855 SW MCDONALD ST
Project: Lung Subdivision: EDGEWOOD Lot: 10
Project Description: (1) furnace replacement, (1) vent chimney (1) gas pipe
Contractor: TRI COUNTY TEMP CONTROL INC Owner: LUNG, DAVID W
13150 S CLACKAMAS RIVER DR 8855 SW MCDONALD ST
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503 - 557 -2220 PHONE: 503 - 639 -6642
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 09/25/2012 $46.75
Type of Use: SF Chimney /Liner /FlueNent 09/25/2012 $23.32
Class of Work: ALT Type of Const: Fuel Piping 09/25/2012 $14.15
Occupancy Grp: 12% State Surcharge - Mechanical 09/25/2012 $10.80
Stories: Minimum Fee Adjustment - Mechanical 09/25/2012 $5.78
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: oAt APPlaC 7 A l
___,ijln.Lej+jAtget_ Call 503.639.4175 by 7:00 a.m. for the next available inspection date. /
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
4
Mechanical Permit Aar
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Received Pe No.:
City of Tigard SEP 2 4 2012 Rec 1 is la-- Sn t;dig, 004N
• 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax; 503.5e$t. ur ,""- ; fGARD Dam/By: Other Permit:
1 1 c;.� u u Inspection Line: 503.639.4175
BUILDING r ! Date Ready/By. RI See Page 2 for
Internet: www.ti ardor. ov t, ? tll� f Notified/Method: Co Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are bused on the value of the work
❑ New construction ®Addition /olteration/replaeement
performed. Indicate the value (rounded to the nearest dollar) of all
Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
CATEGORY OF CONSTRUCTION ,
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® I and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building For special triformarfan use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qry. I Fa- I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
ts ^ _ , 1.r _ Air conditioning
Job site address: ew ki (requires site plan showing placement) 46.75
City /Statc/ZIP: - r434d ql / Furnace 100,000 BTU (ducts/vents) 46.75
J Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: I Project name: Heat pump 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 electric),
in wall, in-duct, suspended, etc. 46.75
Flue/vent for any of above I 23.32
Subdivision: I Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 2332
. ' l O� KA lo� Fl
Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
" Log lighter (gas) 23.32
c CJ tl l I t Li n e r N Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
PROPERTY OWNER 1 ❑TENANT Other: 23.32
Name: David V Environmental exhaust and ventilation
f Kange hood/other kitchen
Address: Saner equipment 33.39
City /State/ZIP: Clothes dryer exhaust 33.39
65q-04f, Single-duct (bathrooms,
Phone: ( ) Fax: ( ) toilet t compartments, artmrtments, utility ity rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Other: _ 23.32
Business name: Same as contractor Fuel piping
Contact name: Diane Mason $14.15 for first four; $4.03 for each additional
Furnace, etc.
Address: Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue ,
Business name: Tri County Temp Control Clothes dryer (gas)
Other:
Address: 13150 S Clackamas River Drive MECHANICAL PERMIT FEES'
City/State/ZIP: Oregon City, OR 97045 Subtotal
Phone: (503) 557.2220 Fax: (503) 557.0919
Minimum permit fee ($90.00)
Phone: (25% of permit fee)
Plan review
CCB lie.: 72623 State sur charge permit fee)
• TOTAL PERMIT FEE t
— u This permit application expires if a permit is not obtained within 180
Authorized signature: Print name: i""` )) gy days after it bas been accepted as complete.
D (afe Mason I Date: C f r / ie_ • Fee methodolo set by Tri- County Building Industry Service Board
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