Permit CITY OF TIGARD MECHANICAL PERMIT
I a COMMUNITY DEVELOPMENT Permit #: MEC2010 00475
•
T I G A R D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/30/2010
Parcel: 2S115AA04200
Jurisdiction: Tigard
Site address: 10531 SW KENT ST
Subdivision: Lot: 0
Project: Leggett
Project Description: Gas line for range.
Owner: FEES
LEGGETT, ADAM R & TIMOREE A Description Date Amount
10531 SW KENT ST Fuel Piping 09/30/2010 $14.15
TIGARD, OR 97224 12% State Surcharge - Mechanical 09/30/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 09/30/2010 $75.85
Contractor:
ROTH HEATING & COOLING
PO BOX 1265
CANBY, OR 97013
PHONE: 503 - 266 -1249
FAX: 503 - 266 -3478
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:C
P er mittee Signature: ce
Ca 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.
SEP-28-2010 TUE 08:50 AM ROTH HEATING FAX NO. 5032663478 P. 02
Mechanical Permit Application Fort oFFIcE ust: 0 IN i..1'
City of Tigard Received
125 SW Hull Blvd., 'rgard, OR 97223 i Date/By: P 1411211 AIMM.....-A !PM
' 111 q 13 Plan Review
F . Phonc: 50'3.639.4171 Fax: 503.598.1960 c
A Date/By: Other Permit:
Inspection Line: 503.639.4175 I.)
TIGARD Pate Rendy/By: Awls: 121 Soo Page 2 for
Internet: www.tigard At fel Notified/Method: 7 o Supplemental Information
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Th. i Mikiltz1044:44ii**6:4:04**,tigg40.th
x\i‘S Mechanical permit fees* are based on the value of the work
0 New construction El Addition/alteratiotst1410. - performed. indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: k}XX mechanical materials. equipment, labor, overhead. and profit
Value: $
4400000k4 ..„ . ,. , ., .. ., . . . .. s. . .., .
.:!.'4g '..i,kgRiE *
,.1:)14 .2.iEi1$1tEMS :,FEE.Sif.V:*.
IX] 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For .wecial Mformarion use eheeldia,
0 Multi-family D Muster builder 0 Other:
Description I Qty, I Ea. natal
40 . HeatinWcooling
Air conditioning
Job site address: ) 053i F-A,0 Y.Ail A- S'r • (requires site plan showing placement) 46.75
City/State/ZIP: y
i a al 0( 6 1 -12-"al-1 Furnace 100,000 BTU (ducm/vents) _ 46.75
Furnace 100,000+ BTU (ducts/yams) 54.91
Suite/bldg./apt. no.: Project name: I ar ii—
Heaton's') 61,06
Cross street/directions to job site: Duct work 23.32 .
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 46.75 ... ,
Flue/vent for any of above 23.32
Subdivision: Lot no.: ...
Other: 23.32
Tax map/parcel no.: Other fuel appliances Water healer 23.32
4; '`::.....!!'s - ''
Gas fireplace 33.39
Ci.S Li n e fo rar Flue vent for water heater or gas
fireplace 23.32
,- L011 lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert _ 23.32
m
ra ..:em•ein
' ' ii
rinp.''''"v " - -
ts' nu I.i'e.13 4
:
1 .;! .: : 1 i '
r::',:' . 31
.::::ipii:'' ChimneYilineriflueivent 23.32
; •;',:' ':::•::: .. ....,.!.:-.■■ ' ON? ::... '......,.! :....T.r:.7. oth 23.32
_
_ Name: Ar 0 vn L et) leir Environmental exhaust and ventilation
'
Range hood/other kitchen
Address: Sorne, CQU ipment 33.39
City/State/ZIP: Clothes dryer exhaust 33.39 _
Single-duct exhaust (bathrooms,
Phone: (6S Cla42 — 3.2... Fax: ( ) toilet compartments. utility rooms) 23.32
7,..., ,.:,..."6, ,,,,,- ::: r,,.,; Attic/erawlspacc tans 23.32
1!v!1,41! ' ..............................;,,t:
Business name: e 1101,,, eX) n St. AS-MOGUL/1,0 Other: 23.32 9 i I rie, Fuel piping .
Contact name: - rm $14.15 for first four $4.03 for each additional
UMICC, CtC,
Address: 1 51 5 ,s 1.10 s excnce. Q .
Gas heat pump —
City/State/ZIP: - 1 - 1.9 c , t , r d , O. 9 2_2si Wall/suspended/unit heater ,
Phone: (5:11 4 01 — 47 ( 1 Fax: ; ( ) Water heater
Fireplace
E-mail: Range _ I 14.15
::,: T 4
..:...iliAi-..;iol 4 r i4 .. 4-.,, D erhecite
?e.:!..•::..',.....',.&.!!,0!:!! . ...,.. .... ; ... .... ; ...- .. ..%11. 't: .3: ..,,o , . ■ .I.,.'ej••■•;:le 'I ' 1 . , C^, V.:0c 1•1',1 . •
Clothes dryer (gas)
Business name: Roi--11 1-e ct,f7 el 9 C,DOLLn I Other.
Address: pp eit x I 2to 6 ..i.,i..;i
City/State/ZIP: e 1, , 012_ '71 31 2 Subtotal II-1 , i 5
Minimum permit fee (590.00) 10 . (10
Phonc: (r,j33) 2_4 th , 12 cjei Fax: (5 2 lk (e) , 5447 g Plan review (25% of permit foe)
.
CCB lie.: iiit 0 g 4./ State surcharge (12% of permit fee) (0. )(1)
TOTAL PERMIT FEE 1/12() Sip
l r. e, This permit application expires It permit is not obtained within 1511
Authorized signature: '1(j i ta_--16o-e,I1 te, days after it has been accepted os complete.
Print name: A c
A VA-P,111 1 i/ Date: p , O • Fee methodology uel by Tri-County Building Industry Service Board
1:1BuildingWerrnitiVvIEC•PerrrhApp,doa 10/01/o9 in 7T (I I XC/COMANEN