Permit ,Ir:''.!n CITY OF TIGARD MECHANICAL PERMIT
,� COMMUNITY DEVELOPMENT Permit #: MEC2010 -00215
i .,, D Issued: ate ssue 05/11/2010
11dARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S111DA09200
Jurisdiction: Tigard
Site address: 8915 SW GRAVENSTEIN LN
Subdivision: Lot: 0
Project: Morelo
Project Description: Install gas piping for barbecue
Owner: FEES
MORELO, KAREN Description Date Amount
8915 SW GRAVENSTEIN LN Fuel Piping 05/11/2010 $14.15
TIGARD, OR 97224
12% State Surcharge - Mechanical 05/11/2010 $10.80
PHONE: 425- 306 -0488 Minimum Fee Adjustment - Mechanical 05/11/2010 $75.85
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.
Issued By: Permittee Signature: DN/0Lj ee9-7-7e2,,,/
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.
May 07 10 10:57a Aline wynne 503-846-0195 p.2 /1
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Mechanical Permit Applica 7. „,,,
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City of Tigard - $
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CITY OF TIGARD
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Value: S
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Suitzibidt.:.,ar,L. oo. 1 r ro 'name: R y e.... la_ i ; reat paw, 1 — - -1— -----
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.as; sttccr!rctiorts :0 ic_!,-,1sizr,r, ! Deo worL
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1 ldeatial bolter ,` or ; i
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i Uti 4 fliel-i. ae rit.a dot:loc.
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in.rvall, ill-La:at_ susptetie. c etc.
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! Other: I
i 23 32 i I
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: Tar frlapiparcoi ao.... i Other fuci A pOance_ i
FiES,C0.1 t'T(ON OF WORE I Willer her r ! 23.32 I i
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1 Gas' fireplact t t 3139
-_■_1(N_9,..,_—_-Q-3---...-.-13--a—C) 1 Flue vent for water heater or gas I I
_tiollace 23.32
Log tighter (gas) 1 I 23.32
1 1
Wood/pellet stove 1 I 3339 ,
Wood fireplace/insert 23.32 I
' Chitnneyilinertflue/vent 23.32
E PROPERTY OWNER „ — 7I 0 TENANT
Other: 23.32
Name: •■.) t't Environmental exhaust and ventilation
C) -r Q i -,,
i Range hood/other kitchen I
Address: I s ., , , ,) (,)\,.._ ow Q.. l ' .i..\ equipment 33,39
City/State/ZIP: 1 i. •y...., tr•eI 0 •J' e- ° 73, al. Li Clothes dryer exhaust 33.34
Single-duct exhaust (bathrooms, I
Phone: ( "ciei:b ) tk A s - . -,- 8 L.1% Fax: ( ) toilet compartments, utility rooms) i 23.32
0 APPLICANT 1 fl CONTACT PERSON . Anid'IsPace fans 1 2332
Other: B 2:6 , ■ I 23.32
Business name: 1 . IL, , q . Q . CI,, C [..,‘ 1
Fuel piping
Contact name: y vv S14.15 for first four: S4.03 for each additional
Furnace, etc.
1
Address: •4 F 0X IIU , GO Ilea pump
CityfStaterZIP: 7" ev Q ()) rcv Q.., nr,e._ 9711 ti Walt/suspended/unit heat I - _
, Water heater
Phone: ( cCrs) ' :41 f i 1 ').) ', Fax: ! ( SZ,) c lc r'
i i_D Fireplace • •
E -mail: Range
CONTRACTOR Barbecue 1 19.
___.., , Clothes dryer (gas)
Business name: Or) D ( i,_ c), r\; c....0,_
Other ,
Address: C () P) CA \ \ D j MECHANICAL, PERMIT FEES*
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Ci ty/Srate/Z1 P: V CV 2. 0\ - c CR/ L C)7 91 i i ( I) 1 mi Subtotal
nimum permit fee (S90.00)
Fax: ( c 'S-e..1.u. _ 0 i r 5.
. I Plao rcvicw (25% of PCIThit (CO
CCB lic.: \ DAUS— 1 State surcharge (12% of permit fee) 1 'O.'S"' - I
"fOTAL PERMIT FEE i AO „V' V
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1-1,[,,,,,,,,,it ..., t-cmiret ir s permit t% !Int nt,i. ruithtm t513
Authorizer' sipature: d27. g fur it h..i.i: been actrpted 21 01.mrlie !I..
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ame: P(1 . l< (4)(inrs. t I Da: ''' td - 10 ,
1 loc I CIO ! 410-461Tr 0 10