Permit � a CITY OF TIGARD MECHANICAL PERMIT
,: o - COMMUNITY DEVELOPMENT Permit #: MEC2009 -00671
.., 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 12/17/2009
T'�G t� R D 9 Parcel: 1S133DB11800
Jurisdiction: TIG
Site address: 11371 SW SYCAMORE PL
Subdivision: Lot:
Project: SHAVEY
Project Description: Replace w/h with tankless gas fired w /h.
Owner: FEES
DIANA SHAVEY Description Date Amount
11371 SW SYCAMORE PL 12% State Surcharge - Mechanical 12/17/2009 $10.80
TIGARD, OR 97223
(manual)
PHONE: 503 -590 -7077 Additional Permit 12/17/2009 $90.00
Contractor:
WEST COAST CENTRAL PLUMBING LLC
12714 SE MAJESTIC LN
HAPPY VALLEY, OR 97086
PHONE: 503 - 298 -0435
FAX: 503- 855 -3264
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: _ " V.l.' lk . V tkAA Permittee Signature: ' Z i u 1' cm
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.
Dec 16 09 12:33p West Coast Central Plumbi (503)298 -0435 p.1
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TfG:� • inspection Line: 503.639.4375 C 't009 � y Other i 't' i N , •� CO c2�
• - Internet www.tigard-or.gov V Dale Reed
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❑ New construction Additional' ' •. I.15eemertt Mechanicai permit fees' are base. ()lithe value of the work
performed- Indicate the valve (rounded to the nearest dollar) of all
❑ Derrtolitictn ❑ Other: mechanical metal*, equipment, tabor, overhead, end Profil-
e
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Y g ❑ Comme rcia l/industrial ❑ Accessory building � �'° :;•%c r "" v vi!� ea :� li
❑ Multi family ❑ Master builder ❑ Other:
Far spec fol Wormation use checklist
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s Description ;Teach, COOMR
Job site address: j i ', S rtsm. � , • inn sItcwia leconera 4 6.75
CitylStatetZfP- ' 1 f/Aa, ri 16R_ , 61722?) Furnace 100.900
Suittlbldg lapt. no.: J ) Project name: Furnace 100,000+ BTU (ducts/veep)
Heal pump 61.96
Cross street/directions ter job sitc:(N ej S I J"311a VQ , Duct work
S Ct . kra ntr litA, 'h t f ) H dmnic not tier ( atrn
l� i Y 1 Residential boiler (radiator or
. hydrertt) 23.32
Unit heatcry 11*Gcl typ - not electric),
in -wall. io -duct, suspended, etc, 46.75
Subdivision: Lot no.:
Flue/vent for any of above 23.32
Other, 23.32
Tar map/parcel no.: !
$qj y Fl rr .`-::::1'. Other fuel appliances r�
:�fr�g':F':rP'.i%G_ `f�Y'1`-r.",' -G�. r JN' r.Oi F•� ,. w .%.4...:::!'..::' fJ: aY :':
� Water heeler , 1 23.32 YJ.3-
Gas ti lace 33.39
l 1 i i U . .it I '_tee 1 _ /'
I Flue vem for water heater m ges
nt �t( k It's � � & h - ' r• � u h /,�L� f, �— fireplace 23.32 •
! J Lo 1i�+6to ( 23.32
c •.pYLL 10 /A YYt. • ' - Wood /pellet stove 33.39
Wood fireplace:men 23.32
�' s : ` �: i (( 5�c " c'� `� ; ' _; a , , Chinn 1ineN9ue/vctt 23.32
'" Sal.u,r .4 Y . ii :! ' 1: , . - ',, ..:: . .. 't- %•
� _ �: , . • :�;. � � ' �s , . <, " ��:.� `Y ��;:': �, . i Other 2-3.32
Name: Firs reli a vie Itnvif onmental cahoot andvenlllanoo
Range hood /otter kitchen
gddrrss:
)13 71 ,Sycht -rt>s e P1. egoipmenl 33.39
City /State /.ZDP: � 1()Gf 1 - Cloth dryer exhaust 33.39
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7
PhonePhone.. � f ig.., t � � es 9ingladuclexhaust (batlrroortts.
( ) , Fax.: ( ) toilet compartments. utili rooms 23.32
. ;•'.: • r , i..A +': •l .. 'c' . ` ".. ' ;•:3 ' «^6 >• -- •:-
- ``••:-'; Attic /crawl .ace fans 23.3
BusineAx name: (1 5.1_ j�� JJ �
Other. 23.32
;� (� t,trxlr:l Fuel&ley
Contact name: K q SC ri % 5 ( Ii , ,rr z_ S14.15 for first four; 54 .03 for each additional
Address. 147/ /v ' o (A - Gas heat p ornp •
j Cily/Statc/ZIP: r
at ,a 4 p y
I Z 4 C; 7
41°° Watt /suspendedfunit heater 1
,¢
Fhnne: { 5 ).( q LJ 6 lf Jt rJ S� rax:: J ( l ) __s5 .(9261/ Water heater 1 l 1`1• 15
Fireplace
E- mail : - .. 14A (�rnc_A -1-_ hey Range
z: .: 'fi0 y 7 ;T E OON'r -> ;: r:TS.:' .`t : J aarbceuc
Clothes dryer (gas)
.
f �J 1f ) �1� t - if lik �! 1 a l Other:
Address: IG�-Ii"f `L�1 p ..
d '1�r5 L' i.; y . w<r .:-.'.d r+ia r`�•'- •;4at'S ,y . +'t: ?r - ' 1 ' . •
City/State/ZI P: II • f / g / >� r: �3 . `
r/, L► j� W Subtotal 31'�
Phone' ) v �>7!� Fax: Minimum permit fee (590.00) • n . OD
t ' ' / J! M ( ) • r Plan review (25 of permit fce) Al
f , State surcharge (12% or pertnit fce) it '70
TOTAL PERMIT FEE]
Authorized si nature: ( . ' -;) "I "Mb permit spot iomon owns, lr permit is del Oft - • within 180
days alter it tea been accepted at complete.
Print name: ,. - ' , it,„ _ Date: , dq - Pee rretwdotogy act by Tri- Calmly 0urlding manly Service 8eM•d
IABuirdint;•Permw,ve mitApp.doc imouoa 440 .°01 nl/n /coat Wr) 100' V O