Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00431
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 08/26/2010
Parcel: 2S102DC01300
Jurisdiction: Tigard
Site address: 8920 SW EDGEWOOD ST
Subdivision: Lot: 0
Project: Garibaldi
Project Description: Gas insert with venting.
Owner: FEES
GARIBALDI, ALBERT R & PATRICIA S Description Date Amount
8920 SW EDGEWOOD ST Gas Fireplace 08/26/2010 $33.39
TIGARD, OR 97223 Flue Vent for Water Heater or Gas 08/26/2010 $23.32
PHONE: Fireplace
12% State Surcharge - Mechanical 08/26/2010 $10.80
Contractor: Minimum Fee Adjustment - Mechanical 08/26/2010 $33.29
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 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 1.80Q332.2344.
•
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Issued B Permittee Signature:
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.
Mechanical Permit Application FOR OFFICE 1 :SF.ON1,Y .
City of Tigard Received -
,� u 13125 SW Hall Blvd., Tigard, OR 9' 2 ��V9 Date/By: / . •
Phone: 503.639.4171 Fax: 503.5it
Date/By: Review Other Permit:
.r i i;A h D Inspection Line: 503.639.4175 ,; �� Date Ready /By El See Page I for
Internet: www.tigardocgov
Cl) 2 b L Notified/Method: Supplemental Information
TYPE OF WOR C�F O �� COMMERCIAL FEE" SCHEDULE — USE CHECIQ AST
El New construction ® i Additionlaltet cert�nt Mechanical permit fees* are based on the value of the work
❑ Demolition ❑ Other: VA) performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: $
1- 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
® y g ❑ Commercial/industrial ❑ Accessory building
ID Multi- family ❑ Master builder ❑ Other: For speciai information use checklist.
Description 1 Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/eooling
Job site address: 8920 SW Edgewood St Air conditioning
(requires site plan showing placement) 46.75
City/State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts/vents) ' '. 46.75
Furnace 100,0004- BTU (duos/vents) 54.91
Suite/bldg./apt. no.: Project name: C , L � id r
r r Heat pump 61.06
Cross street/directions to job site: ` Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
l ydronic) 23.32
Unit heaters (fuel -type, not electric),
in - wall, in - duet. suspended, etc. 46.75
Subdivision: Flue/vent for any of above 2332
Lot no.:
Other: 2332
Tax rnap/parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 1 33.39 33.39 '
Install gas insert and venting, gas line is existing Flue vent for water heater or gas
fireplace 1 23.32 2332
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
IS PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 2332
Name: Al Gattitaldi� i 23.32
Environmental exhaust and ventilation
Address: Same as Above Range hood/other kitchen
equipment 33.39
City /StatelZEP: Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: (503)620 -9828 Fax: ( ) toilet compartments, utility moms) 23.32
® APPLICANT ❑ CONTACT PERSON Atnicicrawispace fans 2332
Business name: See Below
Other 23.32
Fuel piping
Contact name: 514.15 for first four; 54.03 for each additional
Address:
Furnace, etc.
Gas heat pump
City/StatefzlP: Wall/suspended/unit heater
Phone: ( ) I Fax: : ( ) . Water heater
Fireplace
E -mail: allfud @eomcast.net Range
CONTRACTOR Barbecue
Business name: All Fuel Installation and Service, LLC. Clothes dryer (gas)
Other 4
Address: PO Box 69 MECHANICAL PERMIT FEES*
City /State/ZIP: Troutdale, OR 97060 Subtotal 56.71
Phone: (503) 674 -2350 I Fax: (503) 674 -2693 Minimum permit fee ($90.00) 90.00
Plan review (25% of permit fee)
CCB lic.: 169503 State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80
Authorized signature:
Ibis permit d • p after ` ifs 1 obtained within 180 has
Print name: Eric Camp Date: 8/25/10 • Fee methodology set by Tri-County Building industry Service Board
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