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Permit CITY OF TIGARD MECHANICAL PERMIT n t COMMUNITY DEVELOPMENT Permit #: MEC2010 -00129 T [ G ARE) 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/30/2010 Parcel: 1S135CD09500 Jurisdiction: Tigard Site address: 9923 SW PIHAS CT Subdivision: JACOB COURT Lot: 3 Project: Abrams Project Description: Replace gas fireplace. Owner: FEES ABRAMS, JENNIFER L Description Date Amount 9923 SW PIHAS CT TIGARD, OR 97223 Furnaces < 100K BTU 03/30/2010 $46.75 12% State Surcharge - Mechanical 03/30/2010 $10.80 PHONE: Minimum Fee Adjustment - Mechanical 03/30/2010 $43.25 Contractor: GASPRO INC 7603 SE LOUNSBERRY LN PORTLAND, OR 972056 PHONE: 503 - 775 -7020 FAX: 503 - 775 -7019 - 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: /lt $ f\ Q n (lA Permittee Signature: Call 503.639.4175 by 7:00 a.m. for an inspectio. :Y. . ss 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. nRECEIVED , , F t ,, L�75 t Mechanical Permit Applicatio A ` .I P „ : rg � , u ,, I 1WO r l l 1SI 0, I ' I City of Tigard Received Date/By: VD Permit No.: Q'(\ Q 6 b . ock • I N ° 131 25 SW Hall Blvd., Tigard, OR 97223 MAR D ®L �� K I. _ . Plan Review Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit: ;i ; 6; Inspection Line: 503.639.4175 Page 2 for _ -. Internet: www.tigard- or.gov CITY ®FTIG/�RD Not Ready/By: d/Met Notified/Method: Su pplemental Information BUILDING DIVISION pin TYPE OF `WORK . COMMERCIAL FEE* ' — USE CHECKLIST. ❑ New construction ddition/alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY ;OF'CONSTRUCTION . . Value: $ • RESIDENTIAL EQUIPMENT / SYSTEMS FEES* . - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ` For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description 1 Qty. Ea. 1 Total • JOB SITE .INFORMATION .AND LOCATION Heating/cooling �/ / ' Air conditioning Job site address: 3 5 4� i 4/ 5 C (requires site plan showing placement) 46.75 City /State /ZIP: 7 d� / � l/ t) k / / 172)- Fumace 100,000 BTU (ducts /vents) 46.75 l' r / Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldg. /apt. no.: Project name: Heat pump 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 46.75 Subdivision: Lot no.: Flue /vent for any of above 23.32 Other: 23.32 Tax map /parcel no.: Other fuel appliances 'DESCRIPTION OF. WORK Water heater 23.32 Aio /� Gas fireplace / 33.39 C f} C (9 ✓•/ s , G. ,? GQL k 1 (• t- _ Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33 "39 _ Wood fireplace /insert 23.32 Chimney /liner /flue /vent 23.32 PROPERTY. OWNER I 0 TENANT Other: 23.32 Name: 3 e no, ;ek. '9b4el," s Environmental exhaust and ventilation Range hood/other kitchen Address: 5-4-)71 Lr equipment 33.39 City /State /ZIP: Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: (5 r�) 7 D 5 2 i Fax: ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT . ❑ CONTACT PERSON ` Attic /crawlspace fans 23.32 Other: 23.32 _ Business name: Fuel piping Contact name: S14.15 for first four; $4.03 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) Fax:: ( ) Water heater Fireplace E - mail: Range • CONTRACTOR " Barbecue Business name: /43X0 � Clothes dryer (gas) L - Other: Address: ?t 0? 5-6.- 2 y /� , ' .MECHANICAL PERMIT FEES* ' City /State /ZIP: (O /{ Subtotal Am ��,� Minimum permit fee ($90.00) Phone: ( 7_2 I 7f 7 (ray) 75 'yy Plan review (25% of permit fee) CCB lic.: / 7 t/ / j / State surcharge (12% of permit fee) TOTAL PERMIT FEE Authorized si azure/ This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. — Print name: fai,4/ A i t //,P S Date: y30 / /CO /� • Fee methodology set by Tri- County Building Industry Service Board I:\ Building \Permits\MEC- PermitApp.doc 10/01/09 440-4611T(11 /02//COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial & Multi- Family Fee Schedule: Total Valuation:. Permit;Fee: $0.00 to $500.00 Minimum fee $69.06 $500.01 to $5,000.00 $69.06 for the first $500.00 and • $3.07 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and $2.81 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and $2.54 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and $2.49 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $2,608.71 for the first $100,000.00 and $2.92 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. I:\Building\Permits\MEC- PermitApp.doc 10/01/09 2