Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00679
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/24/2012
Parcel: 2S 104CA04600
Jurisdiction: Tigard
Site address: 13556 SW MICHELLE CT
Project: Morgan Subdivision: HILLSHIRE Lot: 46
Project Description: (1) gas furnace replacement
Contractor: ARROW MECHANICAL Owner: MORGAN, STEPHEN T
10330 SW TUALATIN RD 13556 SW MICHELLE CT
TUALATIN, OR 97062 TIGARD, OR 97223
PHONE: 503 - 692 -1565 PHONE:
FAX: 503 - 691 -1879
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/24/2012 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 12/24/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/24/2012 $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 / O � U N N C / G(/1 callinng 503.232.1987 o �
Issued By: / 1/ Permittee Signature: ad / r /� PPUC/4/ T!
OIL
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.
12/24/2012 09:06 5036911879 ARROW MECHANICAL PAGE 02/02
Mechanical Permit Application RECEIVE
1,1 City Received Tigard DatoBy: f ? .I -3-- - Pcwnit rte - ?E' C OD/ r} -c% 4'
w 1312e 5 SW Hall Blvd., Tigard, OR 97223 (' r
Phone: 503.718.2439 pax; 503.598.1960 2 4 20 2 p p `�
Other Permit:
T 4; A , 1-, Inspection Line: 503.639.4175 ti Dalc Ready/Br Iona I� Sec Page 2 for
Internet: www.tigardatr.gov CITY OFTIGARD Notified/Method: H Ci Supplemental Information
BUILDING DIVISION' -
TYPE OF WORK COMMERCIAL FEE* SCREERJLE - USE CI1EC1CLtS't
tL� Mechanical permit fees* are based on the value of the work
❑ New construction IaSI Addition /altet'atio plplaccmcnt 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*
gi 1- tend 2- family dwelling 0 Commercial /industrial ❑ Accessory building For. special Information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description J Qty. i Ea. 1 Total
.1'(.113 SITE INFORMATION AND LOCATION flex flex tin cooling:
Mr conditioning
Job site address: 13 J � W At. it. #e LLD e- T; _(requites site plan ;bowing placation) 46.75
City/State/ZIP: T./14. � - Furnace 100,000 BTU (ducts/vents) 46.75 46-75 •7�
°' 41 7 7 -13 Furnace 100,000•- I3TU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: Heat pump
�'� �`0614 6 -6 (requires site plan sl+owingpinccmau) 6I.06
Cross street/directions to job site: Duct work 23.32
Hydmnic 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
Subdivision: Jot no.: Flue /vent for any of above 23.32
Other: 23.32 L
Tax map /parcel no.
Other fuel appliances:
N O1 W Water heater 23.32
,00 Gas fireplace 33.39
1�b` is CAA' f. l &MPo £.e Flue vent for water heater or gas
fireplace - 23.32
Log lighter (gas) 23.32 .
Wood /pellet stove 33.39
Wood fireplace /insert 23.32
,�, Q Chimney/liner /flue /vent 23.32
` Other: _ 23.32
Name: /_ ,J& V C- /yL a IC 6. Environmental exhaust and ventilation:
Rang
Address: ✓J (' , ( '. , (7 AA, tcrFe it j; C---J, equipment 33.39
City /State/ZIP: Till, it w QR.. 172.7.3 Clothes dryer exhaust 33,39
Single -duct exhaust (bathrooms.
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) , 23.32
i c ., , . . 1 A' 'M9 A , r : ` "tyyrkei t ' c `'r. -i Athc/crawl pace fats 23.32
Other: _ 23.32
Business name:
Ae )&c,itt l's�. trr{r 4A / Fuel piping:
Contact nam 514.15 for first fears $4,03 tor Caen Additional
�� Furnace, etc.
Address:
1 0330 S„,,) `�"„
J rp Gas heat pump
City/State/ZIP:
t9A bi TINI (91 g7c2 z Wall /suspended/unit heater
' Phottc:(923) Fax ::( ?,) R( -187q. Water heater
E-mail:
Range
J . . „ _. . ...,, * "}i,a:"Ik. ` f , , ,T;4 1 ;iN ,.� W�., . P t .4 ' , , ,4 I ,'PP :,, : ;, i : i `I .f' ; ,, t i. , _
Business name: Clothes dryer (gas)
t / I
Address: ` p `J C> J v-r 1 (o R+ IIA 1 !"+f car . r .. �� ePAI S ... ti ::'' ,a t
City/State/ZIP: -, - 7 , Subtotal . '' ,, 416.76
t is 614-...0,7 a q
Phone: (503) (, `/� 2 u? Fax: (C9 )(b1(.- E. 7 e( Minimum permit fee ($90.00) C;pt
t Plan review (25% of permit fee) ,--....
CCD lie.: I ,/ ? ( .I 1 31114 State surcharge (12% of permit fcc) io. 6°
TOTAL PERMIT FEE 1 150
Authorized signature 4/_v This permit application expire if a permit in not obtained within 1110
days after it has been accepted III complete_
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