Permit " . " ' ,i Y TIGARD MECHANICAL PERMIT
° -,. COMMUNITY DEVELOPMENT Permit #: MEC2009-00607
T t GARL7 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Date Issued: 11/13/2009
Parcel: 2S114AD01900
Jurisdiction: Tigard
Site address: 16622 SW 88TH PL
Subdivision: WAVERLY ESTATES Lot: 18
Project: Hawkins
Project Description: Add gas line for kitchen range.
Owner: FEES
HJELM, ROXANNE & Description Date Amount
HAWKINS, KONNI J, 16622 SW 88TH PL Fuel Piping 11/13/2009 $14.15
TIGARD, OR 97224 12% State Surcharge - Mechanical 11/13/2009 $10.80
PHONE: 503 - 268 -1524 Minimum Fee Adjustment - Mechanical 11/13/2009 $75.85
Contractor:
WESTERN HEATING & COOLING INC
50618 COLUMBIA RIVER HWY
SCAPPOOSE, OR 97056
PHONE: 503 - 647 -5808
FAX: 503- 543 -3693
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 Notifica • nter. 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 estions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued B / , Permittee Signature: ( ,.--A.......—_
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.
Nov 12 09 09:29a Western Heating 503- 543 -3693 p.1
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Mechanical Permit Application
1 . r . OF , , . , , - rf , t N : , 44 �(
J RE CEIVED Received / .2 / 1 4t City
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Permit No.: yffe /w/ti 7
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
C. �( [/CJ
,. Phone: 503.639.4171 Fax: 503.598.1 Other Permit:
''' 9°., rat Inspection Line: 503.639.4175 NU V 12 2009 D ate B y
TI KlU Date Readyi8y: hi ® See Page 2 for
Internet: wwww.tigard or.gov Notified,Metbod: Suppkmental Information
CITY OF TIGARD
TYPE dkillddltiU DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ 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: S
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
Z 1 - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description p I Qty. 1 Ea. I Total
JOB SITE INFORMATION AND LOCATION Ileating/eooling
Job site address: 16622 SW 88` PI Air conditioning
- -- - �. -- -_ - - -___ T-- - _ - _ . ^-- ---- _ - - __ -- --- - � ( megmres site plan showing placement) 46.75
City/State/ZIP: Tigard, OR 97224 -5443 I , Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91 I
Suite/bldgJapt. no.: Project name: Hawkins 1 Heat pump 61.06
Cross street/directions to job site: Duct work 23.32 J
Hydronic hot water system 23.32
Residential boiler (radiator or
hydror,ic) 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.: I Other fuel appliances
I DESCRIPTION OF WORK Water heater 23.32
Gas fireplace t 33.39
Add gas line for kitchen appliance Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) I 23.32 I
Wood/pellet stove 33.39
Wood fireplace/insert 1 23.32
C3 PROPERTY OWNER I ❑ TENANT " Chimney /liner /flue/vent 23.32
Other. . 23.32 1
Name: Konni Hawkins Environmental exhaust and ventilation
-- ---------------------
Address: 16622 SW 88`" PL Range hood/other kitchen •
equipment 33.39
•
City /State/ZIP: Tigard, OR 97224 -5443 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms..
Phone: (503)268 - 1524 Fax: ( ) _ toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawlspacc fans I 23.32
Business name: Western Heating & Cooling Inc Other: 23.32 j l
Fuel piping
Contact name: Darcy R Nelson 514.15 for first four; S4.03 for each additional
Address: 14314 SW Allen Blvd., Ste 220 Furnace, etc.
Gas heat pump
City/State /ZEP: Beaverton< OR 97005 Wall/suspended/unit heater
Phone: (503) 647 -5808 Fax: : (503) 543 -3693 Water heater
E -mail: djnelsonCwesternheating.corn Fireplace
Range 1 14.15
CONTRACTOR Barbecue
Business name: Western Heating & Cooling Inc Clothes dryer (gas)
-
Address: 50618 Columbai River hwy MECHANICAL PERMIT FEES*
City/State/ZIP: Scappoose, OR 97056 Subtotal 1 14.15
Minimum permit fee ($90.00) 1 90.00
Phone: (503) 647 -5808 I Fax: (503) 543 -3693
Plan review (25 %of permit fee) 1 0.00
CCB lic.: 76978 State surchargc (12% of perrnit fee) 10.80
TOTAL PERMIT FEE ' 100.80
Authorized signature: a/(7 / !! l /1e1.)1 This permit application expires if a permit is not obtained within 110
days after it has been accepted as complete.
Print name: Darcy R Nelson Date: 11 - 12 - 09 • lee methodology set by Tr-County Building Industry Service Board
t :■Dui: cing1Pcunirs1MEC- Pcnnit.'pp.doc 10•'01/09 440 - 41517:(1 I /OJCOM/WEB)