Permit CITY OF TIGARD MECHANICAL PERMIT
`' 2 COMMUNITY DEVELOPMENT Permit #: MEC2010 00345
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/16/2010
Parcel: 2S 114AB 10900
Jurisdiction: Tigard
Site address: 16142 SW 93RD AVE
Subdivision: KNEELAND ESTATES NO. 2 Lot: 138
Project: Lafontaine
Project Description: Install tankless water heater
Owner: FEES
LAFONTAINE, TROY Description Date Amount
16142 SW 93RD AVE Water Heater 07/16/2010 $23.32
TIGARD, OR 97224 12% State Surcharge - Mechanical 07/16/2010 $10.80
PHONE: W3 Minimum Fee Adjustment - Mechanical 07/16/2010 $66.68
Contractor:
ROBBEN & SONS HEATING INC
2214 SE 8TH AVE
PORTLAND, OR 97214
PHONE: 503 - 233 -5841
FAX: 503 - 238 -8849
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: Permittee Signature: c/'° —7
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.
Jul, 15, 2010 9:46AM Robben & Sons Heating Inc. No.8647 P. 1
Mechanical Permit Application P 1..( )1: ()1 rlt l: I sr. t,\'l.\
City of Tigard RE Received ;,.,
Permit No
13125 SW hall Blvd., Tigard, OR 4 C EIVED 223 ma y ` 44 , //T ' 1 13 _11
Flan Review Phone: 503.639.4171 Fax: 503.598.1960 Dote/By; Other Permit:
/
i 1/ f , \ // / ., Inspection Line: 503.639.4175 ,, IU UL 1 5 r+ , pate
Internet: www.tigard- or.gov I Notified/Method:
S See Page 2 for
Supplemental laformatiop
CITY •F _ e
;may ` fI 0, '''% #��.
. i . . � l � k �k �: . � • . , 'h�,+.r.�k," 't . ; , �` ��i" s�DUL)Gr
New construction (w ddition /alteration/replacetnettt Mechanical permit f e e s * based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: y , �� mechanical materials, equipment, labor, overhead, and profit.
.. ..:,01.:;:':, ::, ` .,'. '''. .AZ GQ 'Y'` ' ' i) f pli4 ' �f � �s t ' I` ; i ii . ' i ` 4 ` i'l L Y ' r Value $
' .. a -.- i
1 - and 2 dwelling ❑ Commercial/industrial ` ., �r r , Y3T> • y g 0 Accessory building
❑ Multi - family ❑Master builder For special information use checklist.
❑ Other.
Description j Qty. 1 Ea. 1 Total
J B I3TTIEi.; /JR 7 ; ',t '- O - �:,�u .. e i Ilealin cool ,
Jab site address: Air conditioning ,
� r 111..A.-.1 .1...._ i ,� (requires site plan showing Placement) 46.15
s , �*, • Furnace 100,000 STU (duotslveota) 46,75
`�' r Furnace 100000+BTU (4ucts/venta) 54.91
Suite/bldg. /apt. no.: Project name: Beat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydrant lot_ 23.32
Unit heaters (fuel -type. not electric),
in-wall, induct, suspended, etc. 46.75
Subdivision: Flue/vent for any of above 23.32
Lot no.:
Other. 1 23.32
Tax map /parcel no.: Other fuel a . . Ilances
?�. '' .,r y `0? 0?1: L' ,.,. - =. ,L x - 1731. - 19g4" � . Water healer \ 2332
Gas fircplace 33.39
♦ om & *AI & ,_ qu _mut 116 " # Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
' Wood fireplace/insert 23.32
r 1,i 'PRO>; t ER ` ' � , , ' ; c4,� q .. e '' ' " fit '` v C`► s� Chimnay/Iiner /Fue/vent 23,32 • l Z. so 1 a , , , ,, . .. ,'.., Other:
EMILTIO 23.32
1Will Environmental exhaust and ventilation
Range hood/othcr kitchen
-
Address: , �' �, equipment / 3339
City/State/Z1' . •, ma a re a" Clothes dryer exhaust 3339
Phone: W , t i comp rtments , utility ro oms) 23.32
s,
toilet cotnpartlrtentslity ro
z, i s" ;; ,;3/40 lCi l` {.y, 4 � ' : <y ht ; - .. ib atC0 m 1, ,y',ri'r ri.1, Attic/crawlspace fans • 2332
Other:
Business name: 23.32
�` �.� l�tl \4�_f LOT Fuel piping -
Contact name. e ` + ` r-- $ 14.15 for firot four; $4,03 far each additional
Address: ."- Furnace, etc. _
• � Gas heat�mp
� _� .� �i�trwka- 410 + *I Wall/suspended/unitheater
Phone: , + .e � +, a. r
��: ill i r ry � t � Water heater
Phone . _Fireplace
.at //1 � Er e' ■-h.. -k�.S1xw Rams
„+� ,, s : > ; ,. , o,1tt e ` . :ill �4a z :1 B arbecue
a1Mi : .r te pli2 < `iy . Clothesdrver -
'w �� Other.
Address: �= �w � 3 : 17: '.
- `r tom. i1 4 a — Subtotal
Phone.' , r A -,4 :11..... r_ en. fa Minimum permit fa (590.00) `Te�
�^ , ' *go
Plan review (25% of permit fee)
CCB tic.: State surcharge (12% of permit fee) ib, Viii ✓
t<
TOTAL PERMIT FEE IY p
Authorized signature: '' • ' di This permit application expires if a permit is not obtained wl*hin r81
days after it has been accepted as complete.
Print n • ,,o .,.. D at .'� • Fee!` • +. .�� , & methodology set by Tri- County Building Industry Service Board
MBeildineWeemleAMEC •PermitAtmece 10/01/09 ..,, ...—.- ..-- . -...