Permit CITY OF TIGARD MECHANICAL PERMIT
:1111 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00685
-r L GARr) 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/31/2012
Parcel: 2S103AA01002
Jurisdiction: Tigard
Site address: 10940 SW WALNUT ST
Project: Orozco Subdivision: ECHO HEIGHTS Lot: 5
Project Description: (1) furnace replacement and (1) flue /vent
Contractor: TRI COUNTY TEMP CONTROL INC Owner: MERCADO, FRANCISCA OROZCO
13150 S CLACKAMAS RIVER DR 10940 SW WALNUT ST
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503 - 557 -2220 PHONE: 971 -245 -5332
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 12/31/2012 $46.75
Type of Use: SF FlueNent For Any of Above 12/31/2012 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/31/2012 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 12/31/2012 $19.93
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 OUNC by calling 503.232.1987 or 1.800.332.2344. I /
Issued By: d l.L Permittee Signature: OK( Li
P1/ D
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.
DEC -28 -2012 09:32A FROM: TO : 50359819613 P.1
Mechanical Permit Application RECEIVE 1 i I li[ I li I ii t 1 4, i I'NI 1
City of Tigard y; / permit No
III
13125 SW Hall Blvd., Tigard, OR 97223 Received
Pla Re �°� f 31 11-- �� �U 0�
Phone: 503,439,4171 Fax: 503.598.1960 DEC 31 2012 aria w odtcrPermit:
, i , , \ i , 1 , Inspection Line: 503.639.4175 Date Ready/By. Leis B See Page 2 for
Internet: www.tigard - or.gov CITY OFTIGAR' Notified/Method: (o
Supplemental Information
RI III.DING DIVISI I N
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees' are based on the value of the work
El New construction ® Addition/alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: S
1 - and 2 dwelling RESIDENTIAL EQUIPMENT /SYSTEMS FEES"
® y g ❑ Commercial /industrial ❑ A ccessory building
Multi For specia ligfnrmationrrsechecklist.
El y ❑ Master builder ❑ Other: Description l Qty. I EL I Total
JOB SITE INFORMATION AND LOCATION nesting/cooling
Job site address: {O Ow (k�f ` Air conditioning
(requires site plan showing placement) 46.75
City/ State/ZIP: lei Ci Furnace 100,000 BTU (ducrs/vcnie) 1 46.75
Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldg. /apt. no.: 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 (fbel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: (lot no.: Flue/vent for any of above 1 23.32
Other 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
Flue vent for water heater or gas
4 I ., ,te arc fireplace 23.32
��,[ 1 �t.1C�1, Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace/insert 23.32
X PROPERTY OWNER I ❑ TENANT Chimney/liner /flue/vent 23.32
_ . ( Other. 23.32
Name: '�i1i Environmental exhaust and ventilation
Address: c (lJ t N Range hood/other kitchen
equipment 33.39
City / State/ZIP: Clothes dryer exhaust 33.39
(�� Single -duct exhaust (bathrooms,
Phone: 5 Fax: ( ) toilet compartments, utility 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 S14.15 for first four; $4.03 for each additional
Address: Furnace, etc.
Gas heat pump
City/ State/ZIP: Wall/suspended/unit heater
Phone: ( ) 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
-- - Minimum permit fee ($90.00)
Phone: (503) 557.2220 Fax: (503) 557.0919 Plan review (25% of permit fee)
CCB lie.: 72623 State surcharge (12% of permit fee)
TOTAL PERMIT FEE i
7'b is permit application expires if a permit is not obtained within Ina
Authorized signature: �� days after it has been accepted as complete.
[Print name: VI a c, Mifon Date: 31 it • Fee methodology set by To- County Building Industry Service Board
I Building ermits\MEC•PernntApp.doe 10/01/09 440- 4617T (I1/02/COM/WEa)