Permit 14 .- - CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00331
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/14!2010
Parcel: 2S103CB01200
Jurisdiction: Tigard
Site address: 12325 SW JAMES ST
Subdivision: Lot: 0
Project:
Project Description: Gas piping for range
Owner: FEES
BACHOFNER, JEFFREY Description Date Amount
12325 SW JAMES ST
TIGARD, OR 97223 Fuel Piping 07/14/2010 $14.15
12% State Surcharge - Mechanical 07/14/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 07/14/2010 $75.85
Contractor:
CENTRAL AIR LLC
PO BOX 433
CLACKAMAS, OR 97015
PHONE: 503 - 656 -1908
FAX: 503 - 650 -3898
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: �c / Permittee Signature: OA/ f9 G / C 77a //
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.
07/12/2010 15:07 50365098. - CENTRAL AIR INC PAGE 01/02
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City of Tigard JUL 1 3 Z 010 Rec / /D ��Z P
13125 SW Hall Blvd., Tigard, OR 97223 Plan Rem Offer Permit:
503.639.41 Fax 503.598.1960, ",� Date /Hy: ®geoiPn4e
- Date Ready/By: TiC:At t3 e ionLine: 503.639.4175 .• otified/method: Suppiementalhorormation
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? c.:4 hanccal ermit fees are based on the value w �' ^ 4
� ts . � 1�7 � 1 ' ��t .^'R F� '7���'.� ' r r v,r � � ... {':,.i5..:8... -,� aaS tf .lt
�... r� of the work
❑ New construction A • ddition/alteration/replaCemcnt performed. Indicate the value (rounded to the nearest dollar) of all
O mechanical materials, equipment labor, overhead and rofit
❑ Demolition Value $
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s/ 1- and 2- family dwelling ❑ Commercial/industrial 0 Accessory building For s' ecza( Wormation use checklist.
❑ Multi family ❑ Master builder 0 Other Description I Qty. Ea, Total
-4 ° r L'-c° it Resit coohn
Fc;,.,d. ,r .t1{10 ik +l v , U t n.^' t ., 4- 1'.3 -}„I . • ' .S .7 1 ,,,,i . r TR CI , „. ,� .. Pe r !. .
R . s i R e d ' conditioning L M°51 ' 4(i.73 •
7-C•' C' r , u #tea site ,Ian showin _ r lacement
Job site address 7-
46.75
.::- --, ,' • Furnace 100000 BTU (ducts EMI
City /State/ZIP: _ di L Furnace 100 000 BTU ducts/vents 54,91
Suite/bldg./apt. no.: 1
Project name: Heat ,um, 61.06 MI
Duct work
Cross street/directions to job site: - - H (Ironic hot water s stem 23 23.32
Residential boiler (radiator or 23.32
h dronic
Unit heaters (fuel -type, not electric). 46.75
in -wall, in -duct sus , ended, etc.
Flue/vent for an of above _ 23.32
Lot no -: Other. 23.32
Subdivision:
Tax map/parcel no yy s 1 os gr ++ Other ter fuel a au ea 3.32
r +r°db ,ri( Jl F �a¢ �c�101 L .art '. i k , �e 33.39
r; x n Gas 1✓ire.iace
�'�`v s ` " ir�l"9�r,.4W':. r /. y}ir.&..I- - uLSY. `
Flue vent for water heater or ens
�`1 C� « • ` ' fireplace
Lo: li• .ter _as INIELIMMIll
A19- J ? ' Wood/pelict stove 33.39
Wood fireplace/insert 110 23.32
* 472. S , S " C- ,.. Chinn /liner /flue /vent NM
..,..R' , 'tv. a.§4. �1 , I 11 ,: . -"(.,, !' r
� 'c. Other: 23,32
s 1 , f S h,r«t' ,i',,A , raa,:dni"�
Environmental exhaust and ventilation
Neale .0 II _ T. t h aNz! a --4 , A Mange hood/other kitchen
ilk Address: a ui t
1 �. Clothes dryer exhaust 33.39
C' /State/ZIP: Single -duct exhaust (bathrooms,
� toilet com utili rooms
.
Phone ) 1 ar ma Attic /crawlspace tans 23.32
s R� Y tit + �' ��' kr7 a 47 i • .
�+ sr - ! y 1, l . aG �..,.. ..i , }.h;j . 1,4k-x". other, 23.32
Business na e A r Fuel�lptn t
�'� $14.15 for first four; $4.03 for each additional
Contact name: k i_ '.. 0 L. Furnace. etc.
Address: r Gas heat Dump ��
0 4- ".' Wall/suspended/unit boater Ciry /State/Z1J': �1 dig Waterheat¢r ��
Fa x:: (sl3:�1 �`• .. T 3 .
Phone: ( r Fire , lace
t !L (-C.4 Ran -
vim
E-mail: r - -
+4.7r'S ? y ` z- ,1' r �1h.iv ,„�. ; -1y l �. r :1�. , f '' Bar becue
«, a s , : of _w ! ' of 1 .__ _ _•f , i dryer 89
y .r ! �caj _: '- Cloth dry MIN
Business name: _ �
� M Other: +r r v. y . n 1J f 1 F i + ! .�,., L r _ y. . 3
d S u..atmFd c 's
� h r ear
'r
Address: " Q ` q 3 -3 Subtotal .
City /State /Z P: C, . A g C
-. " � Minimum permit f ee ($90.00) <- 0 -
Plan review (25% of permit fee)
Phone: ( I {p r - f1
State surcharge (12% of permit Cee) $ • a
CCB lie.: a TOTAL PERMIT FEE trJ(J.�t�
This permit application eipirm if a permit is not obtafnea within 180
l days alter it has been accepted a complete.
Authorized Siglature: j J j.+o,..� - ' d/ + Date: • Fee methodology set by Tri-County Building Industry Service Hoard
Print name: : !f r
1:0.Bu;IdinglParmibV ,IBC- PermitAvP. 10 /01/09
.140 171 (I 1102 /COM/wEa) •