Permit y v CITY OF TIGARD MECHANICAL PERMIT
C • COMMUNITY DEVELOPMENT Permit #: MEC2013 -00209
T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/17/2013
Parcel: 25111 CB01000
Jurisdiction: Tigard
Site address: 14980 SW 103RD AVE
Project: Beattie Subdivision: DEL MONTE SUBDIVISION Lot: 9
Project Description: (1) forced air gas furnace replacement
Contractor: MECHANICAL INC Owner: BEATTIE, ANDREW M & KIMBERLY S
PO BOX 19569 14980 SW 103RD AVE
PORTLAND, OR 97280 TIGARD, OR 97224
PHONE: 503 - 244 -1730 PHONE:
FAX: 503 - 245 -7613
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 04/17/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 04 /17/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/17/2013 $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 OUNC by calling 503.232.1987 or 1.800.332.2344. /� /►
Issued By: /)4...k' �ji Permittee Signature: Off A PPLi C 41 100
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.
Apr, 16. 2013 2: 09PM No, 6733 P. 1/2
11iechanicaI Permit A Iicatio EcEIV
E a 1 l!It OS fit 1. 1NI? lt:\l
City of Tigard Received
e 1312s SW Rau Blvd., Tigard, OR 97223 APR 1 6 2013 Dete/By. 4f I '7 3 Penult Nowt / _nv ,c
Phone: 503.639,4171 Fax: 503.598,1960 Plan Review
1 .(-, ; it 1) Inspection Line: 503.639,4175 CITY OF TIGAR I. Datata ottier Pest:
Internet: www.tigerd- or.gov fit` /By y S See Page 2 Internet: for
BUILDING NISI twdfiedauthod: lig
+ t�.t1 6yy'�t� Supplemental iuform•tioa
>< I,:vt i ,u .'Ii } l ' 7 4kh 1:7T'', AIN tt +';. , p� a ` /' �] t
i l .1 8 �Qt 'A.t1�Y.ii�:✓04N"'IY�i1111iCL B "YI L¢L� :fY�q;,ii�
12 New Construction sddition/alteration/replaeement Mechanical permit fees" are based on the value of the W0 f V S
rk
❑ Demolition Other performed, Indicate the value (rounded to the nearest dollar) of all
rtn , ," A „ mechanical materials e•ul•men labor overhead, and .rofit.
1 I II ' � MS eS eta rp,. A o 1 �{ �' �t �,gWu �.SI r • „ Ax tll� �� li 181{ ! t � � Value: $
i� `ytil g u,�Aw n "Lfit7 c
and 2-family dwelling ❑ Commercial/industrial r 1 %iti " t " �,t�± u a e�� ' p a�5u 1 1 nat� W ..�� nb lyl�
Accessory building
` ' >f; to?;� �,,>`
CI
❑ Master builder ❑ Other:
+�� +t�t..r °fS +1'r t`ll ' � "Y y �np .0 ` DeSOd tton .
Nadltrlttb>1'u� !!,'f{>A�t,i>rx�lt`�`iit�,`1, ,l to t' e :,l 1 ! t l}itV'rIIr i . yn , �D+trdCf t i f:! 1� 1 p •
r`�li,d�t, oltTt;t>hk,tut r a tw a Vt t ' t }t ,3CSl +tY Total
l; Hearin "Win
Job site address: • S O s! , \ o � . Air conditioning �
re•ulree site •lau ehowin .lacement
Citylsia�/ W
L ' � G Q 1 7 �- _ Furnace 100 000 BTU duets/vents I _ 123M
no.; Project Hartle: , Furnace 100 000+ BTU ducts/vente 54
Suite/bldg./apt.
Cross street/directions to job site;
Duct work 61.06
eCLwA r f LL H dronic hot water s :tem MEIRMINIME
ii dronic boiler (radiator or �
Unit heaters (fuel -type, not electric),
in -wal in -duct, sus .ended etc, 46,75
Subdivision: Other for of above �
j �
Lot no,:
Tax map/parcel no.: Other: M�
761 t
�,, � tyt.t '�, :a '' : +��t't;;'"a�� i�ly� + }�`�ye'sw'tt l t d . , swxaa�+w� �, ,�, Other fuel a..Ilancea
• t.1',,; S:S)bl t,�1 a Gnt`s �a' �at 1:1,♦'t nu',nN 'ti:a 11 . t'!l' N, `L'1 Water heater
i( � t��ti ` 4�' 23.32
mi. ACCT. I't\ 4... 0.t k(0.,..-
vent fbr water heater or gas
���
1 f Flue re • 23,32
----- Lo 11: ter as MI 23.32 N
Wood/•eflet stove MI 33.39
��� t1" �^ Wood fre.lace/insert rM�
at!� '111419 '.ml`," ,W�.`, :I14 'lt t ''.�1 � '.A�'. A 1u' t { Etl' t �
Name: i k ,, vr -C1� �\1/J� ► Ju X C1 l.f; t Other __�
Address: , �� 1 Environmental exhaust and ventilation
a V
I I Q f� Range hood/other kitchen •
City/State/ZIP: ` e • ui • ment
v . 1 1... 33,39
� Clothes . er exhaust IMIBMI�
Phone: ( ) Fax ( ) Single -duct exhaust (bathrooms,
I>d �` 1 , "�e toilet com•artments
tl e l i` 11�e I utili rooms 23,32
A w .w,n�l�t�"n�,u� 6t�;, 1L' '+ tlL�� '�Si� °, � v� � �� t �e � cei e 1 1 t
Business name: "" __ 23,32 LIE
Other,
Contact nom; CC,� ,A, • 12 ,./ WA. Cr 23,32 JZI
to '✓ 514.15 for first four S4.03 for each additional
Address; r d P., I r / .� '—
17 Furnace, etc, 1.1 1...
City /State/ZIP: . �.la� 4 ' –
Phone: _ 4 ti 3Q Fax: : ( • • 'I 4 7(o 13 � ;
-
E-mail: i J tCE
aimaitcemr
•r?�G� s il�r��tt x�
,1 . ! l" ikt ;l ,lY�t! ti 1,.,A r � µ t l; Ai i , ' Barbecue MIME
Clothes 1st ,
Business name: Clothes ' er as) —
. -
Address:
Other: —
City /State /ZIP: x i t'1 ' a w '$ a !' ,o. , 7 1 n�t y ` t
Phone: ( ) Subtotal
Fax: ( ) Minimum permit fee ($90,00) `j ♦ .60
CCB lie.: 1 rk cl� ' p p q � Plan review (25% of •ermit fee)
i y `�_ s State surcharge (12% of permit fee) Q .
Authorized signature: TOTAL PE;tt.�•IIT FEE co •
.r This penult application expires if a permit Is not obtained within 180
print name: doe after It has been accepted a complete.
.4, Isrh Q ,r -12.... Date: " Fee methodology set by Tri- County Building industry Service Board
sulleinsTernetevac.seradtAp doe 10/01/09
4454K1 7T In mth.n.m.mm