Permit .•,,,
n CITY OF TIGARD MECHANICAL PERMIT
- `' COMMUNITY DEVELOPMENT Permit #: MEC2013-00066
T [ GAR D` 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/29/2013
Parcel: 2S103DD05600
Jurisdiction: TIGARD
Site address: 10915 SW GARDEN PARK PL A
Project: Ottoman Subdivision: GAARDE PARK Lot: 39
Project Description: Replace electric furnace
Contractor: TRI COUNTY TEMP CONTROL INC Owner: OTTOMAN, NORMAN R TRUST
13150 S CLACKAMAS RIVER DR BY OTTOMAN, NORMAN R TR
OREGON CITY, OR 97045 PO BOX 1569
SHERWOOD, OR 97140
PHONE: 503 - 557 -2220 PHONE: 503 - 625 -7735
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 01/29/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 01/29/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/29/2013 $43.25
Occupancy Grp:
Stories:
Fuel
Fuel Types: Electricity
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 No' . - •• 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 dire questions • • UNC • calling 503.232.1987 or 1.800.332.2344.
Issue By: . dr, Permittee Sign ture: ,: •
Call 503.639.4175 by 7:00 a.m. for the next available insp= ion 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.
JAN -29 -2013 08:11A FROM: TO:5035981960 P.1
Mechanical Permit Application RECEIVE I I cllt I if l 1c l t tir t ).1.,
II •
City of Tigard Received
JAN 2 8 2013 Re e ive i � ' PemdtNn.: // , /s . 0DD .
. 13125 SW Hall Blvd., Tigard, OR. 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
"I 1(' A t(I) Inspection Line: 503.639.4175 CITY OFTIGARD pme/By Date Reaefy/ey: runs. RI See Page 2 for
Internet www.tigard- or.gov BUILDING DIVISI.1 • otifietUMethod: Supplemental Information
TYPE OF WORK COMMERCIAL FEE' SCHEDULE — USECHECI LIST
❑ New construction ® Addition/alteration /replacement Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
® I - and 2- family dwelling CI Commercial/industrial RESIDENTIAL EQUIPMENT /SYSTEMS FEES"
❑ A ccessory building
❑Mtlti- family ❑Master builder . For special information use checklist.
❑ Other: Description I Qt I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: ' QQ 1 M W aa d ` Parr- Rd • Air conditioning
(requires site plan showing placement) 46.75
! 1
City / State/ZIP: m (tub Furnace 100,000 BTU (ducts/vents) I 46.75
Furnace 100,000+ BTU (ducts/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 (fuel -type, not electric),
in -wall, induct, suspended, etc. 46,75
Flue/vent for any of above 23.32
Subdivision: I Lot no.: 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
___ U ei -tr /+ fa tir}/1/ c fireplace 23
[1 Gb�� I V '' u,l 1 Ci�iKJ4 Log lighter (gas) 23.32
Wood /pellet stove 33.39
Wood fireplace/insert 23.32
X PROPERTY OWNER ❑ TENANT Chimney/liner /tlue/vent 23.32
I ron 11�J 1° I I IIJ,.J' J Other: 23.32
Name: Environmental exhaust and ventilation
n A „�,� „` Range hood/other kitchen
Address: ?[f r equipment 33.39
City / State/Z1P: Clothes dryer exhaust 33.39
6 L L comp
Single-duct ens (bathrooms,
Phone: ) Fax: ( ) toilet compartments, utility ty rn rnnms) 2732
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
Other. 23.32
Business name: Same as cantractor
Fuel piping
Contact name: Diane Mason $14.15 for first fnur;$4.03 for each additional
Address: Furnace, etc.
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 I Fax: (503) 557.0919 Minimum permit fee ($90.00)
Plan review (25% of permit fee) _
CCB Iie.: 72623 - State surcharge (12 %ofpermit fee) Imo
TOTAL PERMIT FEE
Authorized signaturd: This permit application expires if a permit is not obtained within 180
y�p �Q,S 1 • da af ter it has been accepted as complete.
I Print name: I C O. 1C. 'l Date: 1( j 1' 3 • Fee methodology set by Tri- County Building lndustiy Service Board
I :\Buading\Permits'MEC- Penni!App dos 10/01/09 440-4617T 17T (I I /02/COM/WEB)