Permit i .. CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2013 -00254
r•,3, Date Issued: 05/15/2013
G
TIARL) 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439
Parcel: 2S104BA02000
Jurisdiction: Tigard
Site address: 13869 SW HINDON CT
Project: Steele Subdivision: COTSWALD MEADOWS NO.3 Lot: 101
Project Description: (1) furnace replacement
Contractor: TRI COUNTY TEMP CONTROL INC Owner: STEELE, GEORGE E & PATRICIA R
13150 S CLACKAMAS RIVER DR 13869 SW HINDON CT
OREGON CITY, OR 97045 TIGARD, OR 97223
PHONE: 503 - 557 -2220 PHONE: 503 - 524 -9087
FAX: 503 - 557 -0919
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 05/15/2013 $46.75
Type of Use: SF 12% State Surcharge - Mechanical 05/15/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 05/15/2013 $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: / Permittee Signature: act 4 /Cj9 -f DAt
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.
MAY -15 -2013 07:10A FROM: TO:5035921960 P.1
Mechanical Permit ApplicatiorRECEIVED ......i. .... t .I.. II\ 1.1
City of Tigard MAY 15 2013 Received
II
13125 SW Hall Blvd., Tigard, OR 97223 Date/By: Phone: 503.639.4171 Fax: 503.598.1960 Plan Review S I / 3 P e rmit No .: 4 4 .,),01 3 - ocas
Other Permit:
Date/By:
r 1 c A R n Inspection Line: 503.639 CITY OF TIGARD Data Ready /By: ,aria ® Sec Pngc 2 for
Internet: www.tigard or.gov BUILDING DIVISION Notified/Method: 1(7 Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction E 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: $
® 1 - 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial /industrial 0 Accessory building
❑ Multi- family ❑ Master builder 0 Other: For special informal/an use ckecklisi.
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
lob site address:
ei 69 evJ Ni r?do C3'' Air conditioning
(requires site plan showing placement) 46.75 _
City/StntclZlP: Tieard 47223 Furnace 100,000 BTU (ducts/vents) I 46.75
l Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/b1dg./apt. nu.: 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
Subdivision: I Lot no.:
Flue /vent for any of above 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
PCP Gr p Log fireplace igh 23.32
f`! it r��l Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 2332
Chimney /liner /flue/vent 23.32
PROPERTY OWNER ❑ TENANf Other: 23.32
Name: acWrx effJe Environmental exhaust and ventilation
Address: Range hood/other kitchen
equipment 33.39
City /State /ZIP: Clothes dryer exhaust 33.39
` 87 t
Single-duct exhaust t ts (bathrooms,
Phone: ) b Fax: ( ) toilet t compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Anic/crawlspace fans 23.32
Other: 23.32
Business name: Same as contractor
Fuel piping
Contact (tame: Diane Mason $14.15 for first four; S4.03 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
Phone: (503) 557.2220 I Minimum permit fcc ($90.00) Fax: (503) 557.0919 Plan review (25% of permit fee)
CCB tic.: 72623 State surcharge (12% of permit fee) q
TOTAL PERMIT FEE 1000)
Authorized signature: " S"'^'" This permit application expires if a permit Is not obtained within 180
days after it has been accepted as complete.
Print name: V IQfC Meon Date: Oil i • Fee methodology set by Tn- County Building Industry Service Board
I. \0uilding\Permits \ MEC•PermiIApp doe 10/01/09 4 ( I /02/COM/WEa)