Permit ipi CITY OF TIGARD MECHANICAL PERMIT
o COMMUNITY DEVELOPMENT Permit #: MEC2009 -00673
';11'G AR D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/18/2009
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Parcel: 2S104BA09600
Jurisdiction: Tigard
Site address: 14029 SW LIDEN DR
Subdivision: CASTLE HILL NO. 2 Lot: 131
Project: Searl
Project Description: Run gas line to range.
Owner: FEES
SEARL, KENNETH R & LANI G Description Date Amount
14029 SW LIDEN DR
TIGARD, OR 97223 Fuel Piping 12/18/2009 $14.15
12% State Surcharge - Mechanical 12/18/2009 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 12/18/2009 $75.85
Contractor:
THE PLUMBERS INC.
90 NW 150TH AVE
BEAVERTON, OR 97006
PHONE: 503 - 519 -6644
FAX: 503 - 469 -4540
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: CQ i KU , ) , ) X ) 0 Permittee Signature:
r
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.
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.218/2009 11:09 FAX 503469454 Q002
Mechanical Permit Applieatio.ECEIVED , . „{ , li � ,, , , . ,,\,,
City Of Tigard `y i Permit No.: : ne1 ..- i - • -7
13125 SW Hall Blvd., Tigard, OR 97223 DEC 18 2009 Uu
Dale/By: Plan Review l
Phone: 503.639.4171 }lax: 503.598.1960 Other Permit
Inspection Line 503.639.4175
rii i; , ain CITY OF TIGARD H Raaa see Papa for
Intemet: gard Natified/Metbnd: Ssppkmeual Information
BUILDING DIVISION
TYPE OF WORK COM RC1AL; FEE PRE ;E
❑ New construction 151Addition /alteration/replaeeinent Mechanical pmt fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment. Tabor, overhead, and profit_
CATEGORY • Olt CONSTRUCTION
_ .. Value $
1 - and 2 - family dwelling ❑ Commercial/industrial ❑Accessary building
For spactal trijornra8on use checklist
0 Multi- thmily El Master builder ❑ Other: Description F Qty. J Ea. I Total
30B gniz -1 EOlgt1M fON ` LOCATION Heating/coodng
1 �r C� r I ` _ Air conditioning
Job site address
``� W �V tick" \ 'r (requires site plan showing placement) 46.75
City /State/VIP: T_ do 9 1.z Furnace 100,000 HTU ,Jductshmnta) _ - 46.75
Suite/bldg./apt. no.: j Project name: Furnace 100,000+ BTU (doamJveata) 54.91
Heat pump 61.06 _
Cross street/directions to job site: Duct work 23.32
Hydrmtic hot water systern 23.32
Residential boiler (radiator or
hydtoitic) 23.32 ,
Unit hoatote (foal -type, not etecWc),
in -wall, in -duct, suspended, etc. 46.75
Suluilvisian: f Lot Pluelvent for any of above 23.32
- I Other: 23.32
Tax map/panel no.: Other fuel appliance _ _
AF CII '1014 ov,w�K; , Water heater 2332 .
. 1 Gan fireplace 33.39
T axr■ runs p 1 i(1"\01 � I/Yl 90 re. Lc) c O..Tr 1 nh • Flue vent for water heater or gas
*0 a • fireplace 23.32
�U s 1 ` J 1 Log lighter (gas) 23.32 _ _
Wood/pellet stove 33.39
Wood fuapiece/insert 23.32
F.! (MIER Q „ Tl
Chimney/liner/flue/vent Chimney/l' 23.32
Other; _ 23.32
Name: Lan i S QA Environmental exhaust and ventilation
Range Address: \IA° ZR °, C„Ia.Q J �''4 nine kitchen 33.39
City /State/ZIP: 7k a raj, t 0 Jz. C1.1 _3 Clothes dryer exhaust 3339
Phone: (503) 50 - 221 -12. Fax: ( ) toilet com ( utility rooms) 23.32
l: AFPur.lor' Q CONl.t1 CJJ avow; • Atticlorawisp fkns 23.32
Business Name: -"� hD. (' 1_�l,Yr 1,,3 ^s hG , Other: 23.32
. Pod Qipl
Contact name: 7 (lm S S14.15 for fire! fuurL$4.03 for each additional
Furnace, etc.
Address: Cta Ian ISO .
Gas neatpump
City/State/ZIP: / 4 l 1 •y- { q 100 (.p Wall/suspended/unitheater .
Phone: (5d3) S 1 ci - lQ 4e( I Pax :: ( ) , Water heater
Fireplace _
Ena11: - i .
GUI 1 O Barbecue
Business nam T S 2 C Clothes dryer (gas) J
ONur
Address: C t0 ) S6 -1-4'.‘ LLB- , Mz ”
City/StateiL1P: 4 r • OR C41O 62,0 _ Subtotal
i Minimum permit fee (590.00) CO, 6 Q
Phone: (5j'c SIC( CeCe (4, Fax: ( ) _ Plan review (25% of permit fee)
• CCB lic.: I �� State surcharge (12% of permit fee)
TOTAL PI!.BIbtIT FEE (1X) . go
Authorized signature' Thb permit s pplk tioa expires If a permit net obtained within 180
,1 days alter it bee been accepted u complete.
Print name: I Date: 1 * Fee methodology set by T ri- County Building industry Sarvioa Board
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