Permit `,, CITY OF TIGARD MECHANICAL PERMIT
7 1 .! =, COMMUNITY DEVELOPMENT Permit #: MEC2009 00581
RT,I 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/02/2009
y Parcel: 2S111BD03800
Jurisdiction: Tigard
Site address: 9846 SW PEPPERTREE LN
Subdivision: • Lot: 0
Project: Goodhead
Project Description: Landscaping Outdoor Firepit/Outdoor Kitchen
Owner: FEES
GOODHEAD, DAVID D AND Description Date Amount
RUNDQUIST, JAN M, 9846 SW PEPPERTREE Fuel Piping 11/02/2009 $14.15
LN 12% State Surcharge - Mechanical 11/02/2009 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 11/02/2009 $75.85
Contractor:
DESIGN RESOURCE GROUP
PO BOX 4004
TUALATIN, OR 97062
PHONE: 503 - 421 -9829
FAX: 503 - 691 -1766
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
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: i / t 0 Permittee Signature: 1'l_ l _ (Ju--
■
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.
`' e f a t iC E +'l 51 ,47- ` ` "1 .. �,r ,j'�,� �y� ��� -
M echanical Permit Application ,. •, : iYl 622 ikt,+e hr,44twwau,hm..,a.•vrr9,itikx( d.e' fi/ 'al�i. �ix.::ti ii•'.
41,,,,}tii , vii Received Permit No.: (��S p
i ,. : C of Tigard CEIVED -
L: if i+s De'eive
• 131.25 SW Hall Blvd., Tigard, OR 97223 Plan Review
:urn. '�' Su ' � Phone: 503.639.417] Fax: 503.598.1960 Date /By: Other Permit:
1, �"`' .r^,+r±Y>dd inspection Line: 503.639.4175 O C T Da te Ready /9 o 3 0 2009 Juris. I ® See Page 2 for
tT;fGrARiD
(rt;+.,,tv�titWVr;a� Internet: www.tigard- ot.gov Notified/Method: 1 I Supplemental Information
OF
TYPE OF WO CITY TIG�S ON
COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction Addition `alteration /replacement I Mechanical permit fees* are based on the value of he work
j performed. Indicate the value (rounded to the nearest dollar) of alt
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: S
RESIDENTIAL EQUIPMENTI SYSTEMS FEES*
and 2- family dwelling ❑ Cornmerciatiindustrial ❑ Accessory building
For special i,fornarion use checklist,
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. Ea. 1 Total
JOB SITE INFORMATION AND LOCATION ! Heating/cooling
Air conditioning
Job site address:
ci ,„ l J F r — t f e i { - e (requires site plan showingplacementl 46.75
City /State/ZIP: ' _ oe _ Furnace 100,000 BTU (duels/vents) 46.75 1
j Furnace 100,000+ BTU (ducts vents) 54.91
Suite/bldg./apt. no.: en
Project Hoe: ('. Heat pump 61.06
Cross street/directions to job site: "'L Duct work 23.32
Hydronic hot water system 2332 t
122 9) oa 1,?Ef 1,t( eu� T ,— f eevkt -e-e. Residential boiler (radiator or
1 j 1 \ hydronic) 23.32
Unit heaters (tire) -type, not electric),
in -wall. m -duct. suspended, etc. 46.75 T
Subdivision: Flue /vent for any of above 23.32
Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 2332
Gas fireplace 33.39
. r " - Flue vent for water heater or gas
�-^e fireplace 23.32
'C-.1 P C T Log lighter (gas) 23.32
t% exs _ `�1 1 Wood/pellet stove 33.39
Wood fireplace/insert 23.32 1
❑ PROPERTY OWNER Chimney/liner/flue/vent 23.32
❑ TENANT Other: 1 23.32
Name: Environmental exbaust and ventilation
Address: Range hood /other kitchen
equipment 33.39
City /State/ZIP: Clothes dryer exhaust 33.39
- -- Single -duct exhaust (bathrooms.
Phone: ( ) Fax: ( ) toilet compartments, utility rooms)_ _ 23.32
APPLICANT ❑ CONTACT PERSON Attic.crawlspace fans 23.32
r5 � Ps 23.32
Business name: � ta r� t(� Fuel uel piping
Contact name: 6
a 514.15 for first four; S4.03 for each additional
Furnace, etc-
A s: O . Q,X 2 f Gas heat pump
City.rStatePZ1P: `�'t, o..1. u-t C- 1 CI. - Q W'aIl suspended'urtit heater
Phone: ( , Gr Fax:: (( " 7 )3 ) ( c r 7 t �6 Water heater _
r Fireplace T
E -mail: ToCIci p � SsOJsnr-e SoeurcEK, • c —'7 • Range
CONTRACTOR `` Barbecue 1 f
mess name:
Clothes dryer (
Other:
Address: MECHANICAL PERMIT FEES*
City /State/ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) �} i
Plan review (25% of permit fee)
i
,/CB tic. L 1. 7c� State surcharge (12% of permit fee)
w TOTAL PERMIT FEE C2 J C�
Authorized signature: ' �_ - This permit application expires if a permit is not obtain within 18[1
days after it has been accepted as complete. I (.
Print name• I Date: * Fee methodology set by Tri -County Building Industry Service Beard
,. 6--- ate: k p .ro3ear 1.30 ' 04
t. Utuadtng ■PermitsWEC- PermitApp.doc 10/01 09 440 -4 b 1 7T (1 If0
Z'd 99L 1.1.69£09 dnoie e0Jnose u5iSeO d89:£O 60 0£ too