Permit Support Document CITY OF TIGARD MECHANICAL PERMIT
s COMMUNITY DEVELOPMENT Permit#: MEC2022-00200
Date Issued: 3/14/2022
T I G A R D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 parcel: 2S103CB13000
Jurisdiction: Tigard
Site address: 12194 SW JAMES ST
Project: Fulkerson Subdivision: 2012-001 PARTITION PLAT Lot: 2
Project Description: Vent hood with make up air. 3/31/22:REPRINTED to include(1)gas fireplace insert,(1)duct work,and gas
piping for fireplace and range
V2 C
Contractor: ABSOLUTE HEATING AND COOLING SOLUTIONS LL Owner:
614 NE 105TH ST
VANCOUVER,WA 98685
PHONE: 503-521-5355 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Duct Work 03/14/2022 $23.32
Type of Use: SF Gas Fireplace 03/31/2022 $33.39
Class of Work: NEW Type of Const: Range Hood/Other Kitchen 03/14/2022 $33.39
Occupancy Grp: Fuel Piping 03/31/2022 $14.15
Stories: 12%State Surcharge-Mechanical 03/31/2022 $12.51
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $116.76
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
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 Application RECEIV, r'-. . --,,i, ,rr EtIE OlTIl'F: ('Si:I1\I V . }"•:•'.
6, City of Tigard Received
.� 1312s sw xell Blva.,Tigard OR 97223 MAR ; 4 '' � "°ss"N°': �leC6Na -00,cc
Phone: 503.718.2439 Fax: 503.598.1960
WAR!
Inspection
no Line:t 75 11 CITY OFF TIGA. o Pamit:e See ragesror
etS j ig* (bt�r +4(30 1LFlo•i Notified/Method: gapp adl Information
TYPE OF WORK colotaaaAt FEE, sc)m,E—USE Magian
Mechanical permit fees*are based oo the value of work
❑New construction RAddition/alteration/repl:•
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: I 1 A mechanical materials,equipment,labor,overhead,and profit
CATEGORY OF CONSTR l s', .., R. �/'' Value:S
RIDRt4'nAI FQv7P►lP1r1/tiYSI1®tsrPZ5
013 I-and 2-family dwelling 0 Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi.-fi,mily ❑Master builder 0 Other: Description Qty. I Ea. Total
Jos mu noro>usATcorx ANn rocaT>oN
Ham :
^ e r . ` Air conditioning 46.75
Job area address: 4
'!"14 U W Taints S Furnace 100,000 BTU(ducaJvemai 46.75
City/State/ZIP:1\141 0I 4'1223 Furnace 100,000+BTU(duewsent) 54.91
Suite/bldg./apt no.: Project name: Heat pump 61.06
Duct work 1 2332
Cross street/directions to job site: Hydronic hot water system 2332
' Residential boiler(radiator or
hydrant) 23.32
Unit healers(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Subdivision: Lot no.: Other. 23.32
Tax map/parcel no.: Otter fad appliances:
Water heater 23.32
DESCRIPTION OF WORK Gas fueplaceinsert 3339
S Flue vent for water heater or gas
i 01- --Qfi--, fireplace 23.32
et Li err It �s I plc" �i rz ngc an! kit P kcr Lox lighter(gas) 23 32
R4r�k k 1 hew,- rts"Sk an 2 >� Wood/pellet stove 33.32
�o�wl 2 k;r�' fireplacrJinsert 2332
Chimney/liner/flue/vent 23.32
0 PROPERTY OWNER ElT1201vi' outer: 23.32
Environmental exhaust and ventilation:
Name:
Range hood/other kitchen
Adds: equipment 2 33.39
Clothes dryer exhaust 33.39
Crtyis teLlP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 2332
0 APPLICANT 0 CONTACT PERSON Other. 23.32
Business name: C Jk til [Ike (,ea1 Sit)him, Fnel�,
t1 s'19- s14.�for�t treat;s4,03 fee each add,dsa.1
Contact name:FvG�ASCo 0,41imf , Furnace,etc.
Address: `(4 to log t4. S1 heat pump
Vagua wI, 4$Ls; Waterheater
Ph°ae:(3C°)77.1 2o2S Fax::( ) Fireplace
I
&mail: &A. e•AC 1.gio)Nifircroatai I.eedh Barbecue
I�
Clothes dryer(gas)
v
Business time: f: V fifth ft''I. r t Other Mastro ,UCA�mar FEES'
Address: f t 'l t I - ., ._ -
Subtotal
City/State/ZIP: (e 1 ( Minimum permit fee($90.00)
Plan review(25%of permit fee)
Phone:( ) t e t s Fax:( )
State surcharge(12%of permit fee)
CCB lit.: 2,0OSp$ TOTAL PERMIT FEE
This permit application espies.if a permit M not obtained within IM
days after it his been accepted as complete.
Authorized signature: tcl— • Fee methodology sec by Tri.Couaty Building Industry Service Board
Print name: rrt,,nG{sets A,, halt. Date:03/10/12
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