Permit ` r','` . CITY OF TIGARD MECHANICAL PERMIT
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71
Q COMMUNITY DEVELOPMENT Permit #: MEC2010 00178
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RD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 04/21/2010
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i ,,, i ,..i sU,,,, *= Parcel: 2S114BA02100
Jurisdiction: Tigard
Site address: 9860 SW SERENA WAY
Subdivision: PICKS LANDING NO. 2 Lot: 118
Project: Nelson
Project Description: Install tankless water heater, gas line and venting
Owner: FEES
NELSON, KRISTINE J Description Date Amount
9860 SW SERENA WAY Flue Vent for Water Heater or Gas 04/21/2010 $23.32
TIGARD, OR 97224 Fireplace
PHONE: 503 - 443 -4164 Fuel Piping 04/21/2010 $14.15
12% State Surcharge - Mechanical 04/21/2010 $10.80
Contractor: Minimum Fee Adjustment - Mechanical 04/21/2010 $52.53
THERMAL FLO INC
7236 SW DURHAM RD 100
PORTLAND, OR 97224
PHONE: 503 - 670 -8343
FAX: 503 - 598 -6746
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: ,��:, //' jig= Permittee Signature: )t/ f �/ - 77O
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 ApplicationRE
CEIVED FOR OFFIC:L LSE ONLY
I City of Tigard Received
0 /0 :fa', Ftrmit No.:HtT - s f p .,
II Phone: 503.639.4
I _ • . 13125 SW Hall Blvd._ Tigard. OR 9r-23
' 17 I Fax: 501.598.1960
C.; A R0 Inspection Line: • 503,639.4175 CITY OF TiGARD a Ready/y. )uris
Internet: www.tiganl-or.sov n • Da.te/By:.
APR 2 0 201u p,..R.„ ,
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NotificcVMethod: Other Pcobit.
T1 ( 6 K Pg for
M See ae 2
Supplementhl Infonniitinn .4
BUILDING DIVISIO .
.-.: 'l'tkiit 4.if.*Pitit:Z.C."
ID I '
--Xf Mechanical pemnt fees* are based on the value of the work
New congruction Addition/alteration/repiacement;
performed. Indicate the value (rounded to the nearest dollar) of ail
Eil Demolition 0 ()Met: mechanical materials. equipment, labor, overhead, and profit.
- -• • -
e4t$0 : : . ; : . ;, '. 1 : ' ' . .'::::..'' ' . :: ::',. ::: ;... 7 . ':. : .::: . . Value: $
. n'..:':
7i 1- and 2-family dwelling 0 Commercial/industrial 0 Ae4essory building
For special informazzon use checklist
0 Multi 0 Master builder 0 Otler:
Description Qty. Ea_ i Total
.!pp,:::,5riz,vikorimAll a :43401: ! ,; - 7•; :::' Heating/cooling
Job sitc address: ar
City/State/Z1P: 1-5 tCelbal " eL
/ aret. , oe q122.417 Air conditioning 46.75
-.titres site •lan showire! ,taeement
Furnace 100.000 BTU (duct/vents) 46.75
Furnace 100.000+ BTU (ducwvents) 54.91
Suite/bldg./apt. no.: Proiect narne: ,
Heat .urn. 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system
.. 23.32
Residential boiler (radiator or
h dmnie)
23.32
i--- Unit heaters (fuel-type, not electric),
in-wall, in suspended. etc. 46.75
— Flue/vent for anv of above 4 23.32 ! ..
Subdivision: Lot no.:
Other 1111111M1111.1.
Tax map/parcel 110.; Other fuel appliances
::i.:.'.'.!■';4:.'.t.:;i:'.. -p .,.-e' - . iebii:i OF Ann, r.sm" sse...,:...Z4 Water heater
■In‘:•',..:t , : ,, •tst - •:? . t.r.r. ,,,, ttty!niFF - .:77 . srpf.9. -:. t:.71::' , ::.•:;::t.;. - :‘ , ..7;' "•••••"...''''..•:.''--'',.. ,:
2332
Gas fire . lace
3339
j
LI 9/21,// Ta. i tiVie-Ob w&/,- nue vent for water heater or gas
fi lace
Los baker ( . as)
1 ilarec; ao Lille ro Pfit7t/ Wood/pellet stove 33.39
1
lietz Kea f j n *" 1 Wood fireplace/insen 23.32
I 23.32
4fl:::; 414firgr*4>:":tiVAttk:.::: T.E:::::,:: 'IiNiNtc.;:i; :::?:%.:*!:i''.::F..; other
23.32 •
Name: • ft e Lre4.e.-- ae9/1. Environmental exhaust and ventilation
—
Address:
City/State/ZIP: g,' ,(1 Sb cc16,,,k__. — Range hood/other kitchen
e • ui mcnt
er exhaust
Clothes dry 33.39
1 PhonekA5 44 — 4,./4_. Fax: ( ) I — Singic exhaust (bathrooms.
toilet compartments. utility rooms) 23_32
.''Zi - 0 :'.':' Attic/crawl ' ace fans 23.32
i I
I I Business name: d F c. „, . •
Other: 23.32
_ Fuei 'till .
I Contact name: .. Doe / 1
,
. 514.15 for first four: 54.03 for each additional
1 .
Address: 7/040 o Igizribautt / # ft/ WO Furnace etc. _ Gas heat . urn. IIIM
City/Slate/ZIP: 10‘,1 0 ' i 7%2¢ 1 Wall/sus ended/unit heater MI MEM
Fax: :iffeA) 0170•4,141-411 MI wzm
Phone: eilii )17 °
.. , Water heater
Fireplace
E-mail: g 0 1, hoine ,. e ,,,,,4„,
Ran .e Illill
Ciothae dryer (r. ) 11111111111111111
Business name: . 1
Other: I
Address: / r .ei 1
0 40
City/State/ZIP: Subtotal fralikli
I -
Phone: ( ) Fax: )
Minimum pettnit fee ($90.00) 4 4 t 00
(
Plan review (25% of permit fee)
Is t i /61:B lie.: 4 . 7 t7 _ State surcharge (1.2% of pertnit fee) 1. :: 1
sinatur '
I Authorizes/ g i a2/4„,t,etele./. TOTAL PERMIT FEE 00.; ,,fi IV
Tili permit application moires it a permit is not Obtain
s td within IRO
days after it has been accepted us complete.
F I fy Date: 4--- .-10 - Fee methodology set by In Buildinkt Industry Service Beard
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