Permit 1
CITY OF TIGARD MECHANICAL PERMIT
II COMMUNITY DEVELOPMENT Permit #: MEC2009 -00620
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/19/2009
Parcel: 1 S134AD03700
Jurisdiction: Tigard
Site address: 10940 SW 108TH AVE
Subdivision: BLACK BULL PARK Lot: 9
Project: Hope
Project Description: Install gas fireplace and associated gas piping.
Owner: FEES
SLOAN, JOHN E JR & Description Date Amount
DUKE, PATRICIA, 10940 SW 108TH AVE Gas Fireplace 11/19/2009 $33.39
TIGARD, OR 97223 Fuel Piping 11/19/2009 $14.15
PHONE: 12% State Surcharge - Mechanical 11/19/2009 $10.80
Minimum Fee Adjustment - Mechanical 11/19/2009 $42.46
Contractor.
T & K MECHANICAL
PO BOX 116
FOREST GROVE, OR 97116
PHONE: 503 -844 -9173
FAX: 503 -846 -0195
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. Q
Issued By: J /\Q Permittee Signature: - \ n Q / .�
� 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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np.c c� hest WV is 4.o
Cross slt/dbeatiotes m jdb sift Dud wodc _ 10.00
. *drank hotteystem 14.00
Raideedal baler (radiant or
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in•arall. al•dadC sued. ere. , 1400
Subdivision: I eo<,no.; flash= fa aotY of shove 6.30
--..- Other 10.00
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Wood tirerdneensert 1100
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timer , 10.00
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