Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2020-00740
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/18/2020
f{„h Ei J3 9 Parcel: 1S134BD04000
Jurisdiction: Tigard
Site address: 11930 SW HAZELWOOD LOOP
Project: Weikel-Delaplane Subdivision: ENGLEWOOD NO.2 Lot: 128
Project Description: Replace wood burning with gas fireplace and add gas line.
Contractor: ENGEL REMODELING LLC Owner: DELAPLANE, CARRIE WEIKEL
PO BOX 308 11930 SW HAZELWOOD LOOP
MARYLHURST, OR 97036 TIGARD, OR 97223
PHONE: 503-706-4567 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Gas Fireplace 11/18/2020 $33.39
Type of Use: SF Flue Vent for Water Heater or Gas 11/18/2020 $23.32
Class of Work: ALT Type of Const: Fireplace
Occupancy Grp: Fuel Piping 11/18/2020 $14.15
Stories: 12%State Surcharge-Mechanical 11/18/2020 $10.80
Minimum Fee Adjustment-Mechanical 11/18/2020 $19.14
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
Mechanical Permit Applicatio L
City of Tigard L C E I V E I.. eveived
;� 17125 SW Hall Blvd.,Tigard OR 97223 Dattior /f//3/LO 4 Q pennitxo �
fE-c 70 in U 7 yp
s Phone: 503.718.2439 Fax: 503.598.1960 NOV 1 2 2020 Plan Review
T I G A R I) Inspection Line: 503.639.4175 Date/By: Other Permit:
Internet: www.tlgard-pr.gov ^ 7 t' �.'-Tit, ,.� -. Noti Rea ntlio Jude: S See Paget for
Notified eilllatd:!///.3112e 0 Supplemental Information
kAi L D"/,//CA/
TYPE. OF,WORK '-COMMERCIAL FEE* SCHEDULE- USE CHECKLIST
❑New construction Iddition/alteration/replacement Mechanical permit fees`are based on the value of the work
❑Demolition performed.Indicate the value(rounded to the nearest dollar)of all
❑ Other: mechanical materials,equipment,labor,overhead,and profit.
,,4^I-and 2-familCATEGORY OF CONSTRUCTION Value:$
�ldwellingRESIDENTIAL EQUIPMENT./SYSTEMS FEES*
Y 0 Commercial/industrial 0 Accessory building
For special information use checklist
❑Multi-family ❑Master builder
0 Other: Description
JOB SITE Qty. I Fa. I Total.
INFORMATION AND LOCATION Heating/cooling:
Job site address: 1 ' Q' V t'e co ,IAA+
l tJ s! 'conditioning 46.75
t LN0X ..—n• Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -1'``A l , l ! 1 _ - C 1 Z.L)j 4 Furnace 100,000r BTU(ducts/vents) 54.91
Suite/bldg./apt.no.: I Project name: h,_1i p Heat pump 61.06
t �1 �0.-`"'t^ Duct work
Cross street/directions to job site: 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
Flue/vent for any of above 2332
h
Subdivision: Other: 23.32
Lot no.:
Tax map/parcel no.: Other fuel appliances:
Water heater 23.32
�j ,, { 36/
DESCRIPT[.ON OF WORK Gas freplafce/insert 1 33.39 ?)3
tmove.„ Dt d- ex` J �PJB 4 b Flue vent for water heater or gas
I h�j 1 C y`Q t{ d s�Y✓s��e tt�t(fc-eSL fireplace 23.32 1�1.3
1 Log lighter(gas),. 'mil,r�.Cz.wtr t r S 23.32
L CJ Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 2332
0 PROPERTY OWNER I ❑ TENANT Other 2332
bay-
Y 1 � � � � ( � � Environmeahl exhaust and ventilation:
Name:
l61n" 4, )tit.1 IT ( Range hood/other kitchen
Address: I — equipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39
Single-duet exhaust(bathrooms,
Phone:( )7J) 65T� g y vV Fax:( ) - toiletcotnpatttnents,utility rooms) 23.32
v Attic/crawlspace fans 23.32
C3 APPLICANT ❑ CONTACT PERSON Other.
�)- 23.32
Business name: �yta {'-f. ! (e 0, l Fuel piping:
6'eac..i L.1...�-
Contact name: { _( G� J S14.15 for first four;$4.03 for each additional
Address: OD. rU/1 e5 Furnace,etc.
Gas heat pump
City/State/ZIP: i\i , D ( , , - �, Water heaended/unit heater
Phone:(�3 ) F�rY `4yt v wry r (�� "� //�,,�3 j Water heater
nge
E-mail: !(} . ( '� Fax..(eTJJ!) �� 3 (pa Fireplace - i .15 IQ.12
M t l . e.„_lc `- v(. v�t.c a,`, . ine...!j{y! Rarbe
J CONTRACTOR Barbecue
Clothes dryer(gas)
Business name: ` Other:
wtc �ttv L.t (�
Address: V ) '`.MECHANICAL PERMIT FEES*
pO C3� 7if s1
City/State/ZIP: [q s.t /Ir1 , Subtotal
(JI.�W -T LAY' �7(?3 j Minimum permit fee(S90.00) qs_
Phone:(c 3) 7 J(C7 I Fes:(� ) F Plan review(25%of permit fee) '— ,
CCB lie.: » J Ie7 tp s� , State surcharge(12%ofpetmitfee) �l13.Pt'
/!/5 TOTAL PERMIT FEE i El r
This permit application expires if a permit is not obtained within ISO
Authorized signature: days after it has been accepted as complete.
_—, R * Fee methodolotyBuilding nY Print name' ��• set by Tri-Corn lodes Service Board
lit Date: Z_} •
l:4asiIding1'ermh,lMEC Pa.nitApp_o4e1D.doc
440-4617T(1 I AYS/COMM/ED)