Permit ry CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00175
Date Issued: 04/20/2010
T f GA R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 1 S 133DB03400
Jurisdiction: Tigard
Site address: 11569 SW SHEFFIELD CIR
Subdivision: Lot: 0
Project: Ericksen
Project Description: Install gas line for BBQ, range and fireplace
Owner: FEES
ERICKSEN, STEVEN A Description Date Amount
11569 SW SHEFFIELD CIR Fuel Piping 04/20/2010 $14.15
TIGARD, OR 97223 12% State Surcharge - Mechanical 04/20/2010 $10.80
PHONE: 503 - 579 -6371 Minimum Fee Adjustment - Mechanical 04/20/2010 $75.85
Contractor:
HAVEN SPAS AND POOLS
10560 SE HWY 212
CLACKAMAS, OR 97015
PHONE: 503 - 655 -9440
FAX: 503- 655 -9514
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 OU by calling 503.246.6699 or 1.800.332.2344.
Issued By: 40 `�� / - Permittee Signature: O� 7� j 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.
04/19/2010 10:33 FAX E001/O01
Mechanical Permit APAIicati°RECEIVED FOR OFFICE USE ONLY
City of Tigard Received
Date/By: Permit No.: / Lee, 9.00 -01.)/15
14 .. ,--• 13125 SW Hall Blvd., Tigard, OR 97223 APR 1. 9 Plan Review
• ! Phone: 503.639.4171 Fax: 503.598.1960 2010 Date/By: Other Permit:
Inspection Line: • 503.639A175 •
"FIGARO Date Ready/By: hurls: E5 See Page 2 for
Internet: www.tigard-or.gov CITY OF 'TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
. . ... , .
■ •-•,:- ,': .--Pl!,,r • •-.h.t i , rstrIgq"A :: ,...tt1=7§Irriti . : 7 - ;:';' . ''' ' '. '''' '...' ''
It 4'1 W 1 Ri “4 ' r,l , : i i 4 4 : .:1!: ;:l ;li■if;iiivi.W i:!;:.',... ''.4iff1 ':',44"
0 New construction ddition/alteration/replac,ement
Mechanical permit fees* are based on the value of the work
.7. •
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 1:3 Other: mechanical materials, equipment, labor, overhead, and profit,
tiw Value: $
1 , l' : : ,, ,..,,,_, 5 “1 , 1 4' '", 4P+[Pr^:fl'; , '',..;:, :!:.;!::: .- .3,..: . :, . -.. ...i ■ ., ..7'... , „, . , , .,.: A ., , ,, ... '''4■; . , c, ` , 4 0 , ,., .• • ■ ' .; 'A:1 , . i V_,..f ir..
2ri and 2-family dwelling E Commercial/industrial 1:3 Accessory building
;: ' ':,',1; i...2 4,• :::
For special information use checklist.
0 Multi-family 0 Master builder 11 Other:
Description I Qty. I Ea. Total
7.• , ..03 , i,gt#':**WAON, - ** . .40,7.irW:: •-• Heating/cooling
Job site address: 11 6 ( %)..) Sv‘EccELD Owe__ Air conditioning
(requires site plan showing placement) 46.75
City/State/ZIP: 11 el? oR cliaarb Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Project name: 5i ER ‘cys_Or)
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
Flue/vent for any of above 23.32
Subdivision: I Lot no.:
Other: 23.32 _
Tax map/parcel no I e 13.60e> 1 3-6LA (3T) Other fuel appliances
.,.:• TI:Ti4 i:764 water heater 23.32
'.:ei-Dgir.:41:i.f5c. ..... .._;:on ::',--:,--:.-:.--:, , ' , „;:--- , :'..:1,.!;'17.-F.Taisie, .' ::.
Gas fireplace 33.39
-c.k Go, line. •IP Flue vent for water heater or gas
Zlert) j Pan an cl n- i blau, fireplace
Log lighter (gas) 23.32
23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
:12"01iitit*ftWiiightiti' ' . i'-'.--' - Y ' • .0• ',." , ' ::..'::::',."-;,'_ 23.32
Name: Skeiie. Range hood/other kitchen e..RIcYn Environmental exhaust and ventilation
Address: i 1 56 ci t 1.0 sy,,efffei 6 ejczcis.,, equipment 33.39
City/State/ZIP:116(112n OR c1-7.9aQ-- Clothes dryer exhaust
Single-duct exhaust (bathrooms, 33.39
Phone: 603 5oct....4 I Fax: ( ) toilet compartments, utility rooms) _ 23.32
- _Attic/crawlspace fans 23.32
Other.
Business name: v.ka l e- j x6 rind coLs
23.32
Fuel piping
Contact name: ,e-fa,i±in rp S14.15 for first four; $4.03 for each additional
Address: 1 0 N 5E ‘4 „D \ a. Fumace, etc.
Gas heat pump
City/State/ZIP: Q yafflOC_ Ofa 5 , Wall/suspended/unit heater
Phone: ( 5/35 10 CI411C) I Fax: : (953 1055 (15.114 Water heater
Fireplace 1
E-mail: ‘..e „ „... niet.
Range
Wi
' •. 7 ,' " : . , .;-,', T i o*
itiot'.;:;: A i 1 ,. - !■' ",'.:!...,, ,7;';:t ' *: B i
Business name: kA cLu e s) ..)„, cifyi pais Clothes dryer (gas)
Other:
Address: 1 0 ... .. t Jou ef9A D ___ • ::::::.-.
City/State/71P: OACIC V
-1 or ct/ DI 5 Subtotal
Minimum permit fee (S90.00) CIO swam*
Phone: (5122 L C1440 Fax: (SZ 1055 q )4
Plan review (25% of permit fee)
CCB lic.: 11 52(9.0 State surcharge (12% of permit fee) /0 i koi
..
•
TOTAL PERMIT FEE /p 6 . R 0 ,,.../
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: , 1St. i llatialMirfr Date: ITAZIP:1011. • Fee methodology set by Tri-County Building Industry Service Board
IABuilding\Permi1AMEC-PermitApp doc 10/01/1 441 .617T (I 1/02/COM/WEB)