Permit
CITY OF TIGARD MECHANICAL PERMIT
4
COMMUNITY DEVELOPMENT Permit#: MEC2010-00079
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/23/2010
Parcel: 2S104AC09400
Jurisdiction: Tigard
Site address: 13234 SW BOUNEFF ST
Subdivision: MORNING HILL NO. 9 Lot: 237
Project: Thomas
Project Description: Install gas insert, chimney liner and gas line.
Owner: FEES
THOMAS, BRIAN D & KATHLEEN M B Description Date Amount
13234 SW BOUNEFF ST Minimum Fee Adjustment - Mechanical 02/23/2010 $19.14
TIGARD, OR 97223 Gas Fireplace 02/23/2010 $33.39
PHONE: 503-524-6775 Flue Vent for Water Heater or Gas 02/23/2010 $23.32
Fireplace
Contractor: Fuel Piping 02/23/2010 $14.15
T & K MECHANICAL 12% State Surcharge - Mechanical 02/23/2010 $10.80
PO BOX 116
FOREST GROVE, OR 97116
PHONE: 503-844-9173
FAX: 503-846-0195
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
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 952-001-0100. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.246.6699 or 1.800.33/2.2344.
Issued By: Perm ittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
Feb 23 10 10:48a Alina wynne 503-846-0195 p.2
17~,C~aaiaW4All Il ca aam LxtUlS m;ImuUmit p-~ .R, t,.,. _rv• r~.:'~A,..
City of T' prd RECEIVE Recduod
13125 SW NnU Blvd., Tigard. OR 97M to -m Me l0' OC0 2
Phanc: 503. lnWmtiott Line:: x3(13.639.4 7503.598.1960 r p 2 c~ Z010 Plan Peview OthaPuadt
r D J Dme 11godyft: + ' E9 9ce PDV 2 tar
huemet www.iig&M-w.gov opTIGARD Wamedrmethw- E~ 4opyfamte°ealsrsrrnptiaa
CITY
rYR€.v>F'ov 1N CoA9~eciaz. •-SCHEDULE _:a1M lr•
Q ldtw oonsttvctiotl Addition/altetetion/tepheemmt Mtxhm*cW permitfccs' melw ed mn tg vahm of the svptk
❑ Ucmol ntr Other petfotmed. Indicate the wahw ovtuided to flit nearest dotla) of pit
mechanical material yquipimmik I", ovakesd m,d 6c.
CATS AM OF C011MUCTION • Valve: S
deFSm>ZlVt7AL HQ[71t>'NT.151~"[6IyfS FEFS4
1-and 2-family tiwelliltg ❑ C;onttnertasVttdustrial ❑ Actxssery building Fersperlalh1f07Ararian mw checklin.
❑ Multi-fammy ❑ M.M= builder ❑ Defier:
Description Qty. F-- Total
JOB &M AttFORMATLON AND LOCATM Hw8 ete
job sit; addras: Ait conditioning or heat pump
) 3 S ' ese U ira site glen diawi° tue+na, 14.00
City/stateflAP, ,r r Fumtns I 9D.000 BTU amid utt 14.00
Fumace 100,000+BTU ckm% mLs 17.90
SuitdbldgJapt. nn.: Prgjcdn:tme: Cm beat Pump 14.00
Crom 9treatldimcdems to job site: Duct work 10.00
H tonic hot water s smn 14.00
PaidenUal boiler (radiator or
b dt'omic 14.00
Unit hca0ers (ttiel-typc, not clccttie),
in-wall, in-dock w coded- ere. 14.00
Flm&=t fat of above 6.80
Subdivision: Lot no.:
00►er_ 10.E
Tax maplpart:el no.: Other Poet G "Sam"
• . DESCI1l rmw OF vOm Wstr l,eapx LO.00
Gash lace: 10.00
P, c> 0.`J 1 n S v' } Flue vent fm water heater at gas
6 face 10.00
li l 0.00
wood/ stove 10.01
Wood IaceJmF rt So OD
❑ PROM W O'WN6R ❑ TIARA' C'hiatn na/tluetvemt 10.00 G
IhUcr: 10.00
Name: KL~ G Jc Enviroomeotal exhaust lead real ftlas
Ad*=. Ran bo othar kitchen 10100
City/StaulliP: ' Clothes d exhaust 10.00
Singk-du:t mhxust (bathrooms,
Phone' (5~~~)
0 ( )
_mm toilet com a utili rooms 6.80
❑ AlP4LICAtvT•' Q. comrAcr PERsoiq Attiekrawit fans 10.00
llnsiocss rta:ne: Dthec 10.00
X- MC! + C.i.2 Feel vlow
Cvatact name: V_ ~ ~ti1 SSA for first four x1.90 for each additional
Address: 7 6 p ' 1 I1lmaca, cm
Gas ham Pump
City/StatrILIP: r S v C- a°_e Ci 7I t waWsu deftnithcew
Phone: (Sc~) i_ q 13 Faz : (SCSI ! ((i - °1 Water beater
E-mail: / L4 cZ ~G(' 1o O • C-, R lace } rya U
l 5 i~-1 GLv1 Rant
CONTRACTOR BWtL4=
Rusinem name: Y_ p sec
Addrmv: d p X t t MCHANICAL PIULM [OZ W
Citylstotc0p: Q 5{- V d~' ~"1' I ! Sa[ytofal y
portrlit feo t2,$p)
Phone: (St-3) 7~ '---I - C} } -7 3 Fax: ( S (/z~) S~(o ^ Q , CIS— lni*etrm
Plan review (25% of permit ft)
CCB I(c.:
1 LQ State surchhup (129% of pamitt ffft))
O
T ALPERMTpri..Ba
Aw4horized signewre: ~ Pe 1 spokstion ecpirn Ba pera;t 4 not w:tbin ]8o
a.so alas to tux Eesv orapted .sev.,pleod
Print rattle: [ Dam; _ Fee m aiwdofngr rrt try Tri Carroty ►tv ldinx Industry 5ervix Board
t:t9rildlnalaenRinV~fL~C•1M.n'ewpp.~ee 01~19v07 ar(~.S67T1'r1tAClC(1A4+aR'Dl 00. ~O