Permit ;agn MECHANICAL PERMIT
, :z CITY OF TIGARD ii
` - COMMUNITY DEVELOPMENT Permit #: MEC2010 00233
;' Date Issued: 05/20/2010
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T IG p 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S111 CA11800
Jurisdiction: Tigard
Site address: 9765 SW OAKS LN
Subdivision: SATTLER PARK Lot: 3
Project: Klein
Project Description: Installation of gas log lighter and gas piping for log lighter, bar -b -que and firepit.
Owner: FEES
KLEIN, DAVID A & CINDY Description Date Amount
9765 SW OAKS LN
TIGARD, OR 97224 Log Lighter (Gas) 05/20/2010 $23.32
Fuel Piping 05/20/2010 $14.15
PHONE: 503 - 997 -8455 12% State Surcharge - Mechanical 05/20/2010 $10.80
Minimum Fee Adjustment - Mechanical 05/20/2010 $52.53
Contractor:
ALL FUEL INSTALLATION & SERVICE LLC
PO BOX 69
TROUTDALE, OR 97060
PHONE: 503 - 674 -2350
FAX: 503 - 674 -2693
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 Notifi - '.n Center. . ose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or direc .uestions to OUNC b' . ng 503.246.6699 or 1.800.332.2344.
Issu d By: f 0.4 / Permittee Sign: ure: �� / , AO / r -
Call 503.639.4175 by 7:00 a.m. for an inspection that busin -: 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 Apnlicatio CEWED " s ,,, 4^ u' t ' ° I- ? ? ! l ' F ON L \. ' s > �� `
l' t IrV` C1}� of Tigard Received
r [f + ' ° 1312ySN1 Hall Blvd., Tigard. OR 97223 Plan Renew / 'O I Permil Nn.: fC
�o�lO DUa
y. ' I ^ fir,, Phone: 503.639.4171 Fax: 503.598.1960 MAY 18 2010 Da t�By Other Pem,it:
11 Lii"6 Inspection Line: 503.639.4175 Date Ready /By: le ^ ® See Page 2 for
r n imsm ir,�.r wi Internet: www tigard or.gov CITY OF TIGARD Notificd/Method: - 06. . Supplemental Information
RIIILDING DIVISIO' ___
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CIIECKLIST
❑ New construction ® Addition/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*
El 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For .special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description
Qty. Ea. 1Tota1
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning
Job site address: 9765 SW Oaks Lane
(requites site plan showing placement) 46.75
City /State /ZIP: Tigard, OR 97224 Furnace 100,000 BTU (docrs/vents) 46.75
Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldg./apt. no.: Project name: Heat pump 61.06
Cross streelidireetions to job site: Duct work 23.32 T _
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
Gas fireplace 33.39
Install gas line to fireplace and lire -pit Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 1 23.32 23.32
Wood/pellet stove 33.39
Wood fireplace /insert 23.32
10 PROPERTY OWNER Chimney/liner /flue/vent 23.32
❑ TENANT Other: _ 23.32
Name: David Klein l nvimnmental exhaust and ventilation
Address: Same as Above Range hood/other kitchen
equipment 33.39
City/ State/ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)997 -8455 Fax: ( ) toilet compartments, utility rooms) 23.32
►;t APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans - 23.32
Other: 23.32
Business name: See Below Fuel pilling
Contact name: $14.15 for first four; $4.03 for each additional
Address: Fumace, etc.
Gas heat pump
City/State/ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace 1 1 14.15
E -mail: ecamp_aIIfuel @verizon.net Range
CONTRACTOR Barbecue 1
Business name: All Fuel Installation and Service, LLC Clothes dryer (gas)
Other: F; et . Q } 1
Address: PO Box 69 MECHANICAL PERMIT FEES*
City / State(LIP: Troutdale, OR 97060 Subtotal 37.47
Minimum permit fee ($90.00) 90.00
Phone: (503) 674 -2350 Fax: (503) 674 - 2693
�/ Plan review (25%ofpermit fee)
f '
CCB lie.: 169503 Y Ip (( ` State surcharge (12% of permit fee) I0.8
TOTAL PERMIT FEE 100.80
Authorized si tare '�, This permit application erpires if a permit is not obtained within 180
>' l / days after it has been accepted as complete.
Print name: Eric Camp Date: 5/18/10 • Fee methodology set by Tri- County Building Industry Service Board
1:'. Building,Permes1/4MEC-PennaApp.dec 10/01/09 40 t 7T (11/O1COMM'EB)
L £69ZbL9£09 uopllelsul land IIV 8 9: H. 06 e L /eW