Permit ',;: -, , CITY OF TIGARD MECHANICAL PERMIT
.`: COMMUNITY DEVELOPMENT Permit #: MEC2010 -00065
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 02/12/2010
TIGARD 9 Parcel: 2S103AB01100
Jurisdiction: Tigard
Site address: 11100 SW WALNUT ST
Subdivision: Lot: 0
Project: Kahn
Project Description: Install gas line and vent for tankless water heater
Owner: FEES
KAHN, STEPHEN Description Date Amount
11100 SW WALNUT ST Water Heater 02/12/2010 $23.32
TIGARD, OR 97223 Flue Vent for Water Heater or Gas 02/12/2010 $23.32
PHONE: 503 - 598 -0658 Fireplace
Fuel Piping 02/12/2010 $14.15
Contractor: 12% State Surcharge - Mechanical 02/12/2010 $10.80
ALL FUEL INSTALLATION & SERVICE LLC Minimum Fee Adjustment - Mechanical 02/12/2010 $29.21
PO BOX 69
TROUTDALE, OR 97060
PHONE: 503 - 674 -2350
FAX: 503 - 674 -2693
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 1.800.332.2344.
Issued By: Permittee Signature: e ,9-- P
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.
•
Mechanical Permit Application ECEIVED • mo r -tA - u { , : -- .: � ,- p
, 2 F,OR OFFICEl S E O \L�l 4 t. 4 , t
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re Received
M City of Tigard Permit `,c-.
• g FEB 1 2 2010 Date;ey: v 2/ 44 , �y �oio 00065
V; a Blvd., Tigard. OR 97223
131 _5 SW H
Plan Review
(�', A . 1 h • Phone: 503.639.4171 Fax: 503.598.19 Other Permit:
� i • � Inspection Lint:: 503.639.4175
C ITY OF TIGARD Date;By:
1T1 GARD. °ate Beatty /3y: luris: Sec Pine 2 for
S1 Internet: www.tigard -or.gov BUILDING DIVISION Notified/ ?Ached: i( Su pplemental Information
TYPE OF WORK COMMERCIAL FEE' SCHEDULE - USE CHECKLIST
® Additionialteration /replacement Mechanical permit Fees` are based cn the value of the work
❑ New construction performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, tabor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL. EQUIPMENT / SYSTEMS FEES*
® 1- and 2- family dwelling ❑ CommerciaUindustrial ❑ Accessory building
❑ Multi - family ❑ Master builder ❑ Other; For special information use checklist.
-- --_ ---- Description 1 Qty. I Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 11100 SW Walnut St Air conditioning
(requires site plan showing placement) 46.75
Cit•iState/ZIP: Tigard, OR 97223 Fumace 100,000 BTU (duets/vents) 46.75
Suite/bldg. /apt. no.: Project name: Fumace 100,000+ BTU (ducts veins) 54.91
Heat pump __ __ 61.06
Cross streetfdirections to job site: Duct work I J 23.32 1
Hydrunic hot water system 1 23.32
1 Residential boiler (radiator or
hydronle) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for anv of above j 23.32
1 Other: I 23.32
Tax map /parcel no.: 1 Other fuel appliances _
DESCRIPTION OF WORK Water heater 1 23.32 I 23.32 .
Gas fireplace 33.39
Install gas line and vent for tankless hot water heater Flue vent for water heater or gas
fireplace 1 23.32 23.32
Loe lighter (gas) 23.32
Woodlpellet stove 33.39
Wood fireplace/insert 23.32
® PROPERTY OWNER 1 ❑ TENANT Chimney /liner /flue /vent 23.32
1 • Other. J 23.32
Name: Stephen Kahn Environmental exhaust and ventilation
Address: Same as ABove Range hood /other kitchen
equipment 33.39 _
City /State/ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)598 -0658 Fax: ( ) toilet compartments, utility rooms) 23.32
Z APPLICANT ❑ CONTACT PERSON 1 Attic/crawlspace farts 23.32
23.32
Business name: See Below
Fuel piping
Contact name: Eric Camp 514.15 for first four; 54.03 for each additional
Address: Fumace, etc.
- - Gas heat pump
City /Slatc/ZIP: Wall /suspended/unit heater 1
Phone Water heater 1 1 14.15
( 1 Fax:: ( )
Fireplace 1
E -mail: ecamp allfuel@verizon.net Range
CONTRACTOR Barbecue 1
Business name: All Fuel Installation and Service Clothes dryer (gas)
Other:
Address: PO Box 69 MECHANICAL PERMIT FEES*
City /State /ZIP: Troutdale, OR 97060 Subtotal j StaR'r
Phone: (503) 674 - 2350
Phone:
tic.: 169503 Minimum permit fee ( 690.00) go ,
Fax: (503) 674 -2693 Plan review (25% of permit fee)
C State surcharge (12% of permit fee) '?/)
/ TOTAL _PERMIT FEE 68
Authorized signature: L / � /
This permit application expires if a permit u not obtained wi m 1110 !I �
`!!!! l� days after it has been accepted as complete. ) 00 r 1
Print name: Eric Camp I Date: 2/12/10 ' Fee methodolegv set by Tri- County Building Industry Service Board
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