Permit CITY OF TIGARD MECHANICAL PERMIT
0 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00551
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/02/2010
Parcel: 1 S125DC01100
Jurisdiction: Tigard
Site address: 7225 SW VENTURA DR
Subdivision: WASHINGTON SQUARE ESTATES NO. 1 Lot 1
Project: Storer
Project Description: Vent fan for crawlspace.
Owner: FEES
STORER, ROBERT A & Description Date Amount
TOCCI - STORER, BEVERLY A, 7225 SW
VENTURA DR Attic/Crawlspace Fans 11/02/2010 $23.32
12% State Surcharge - Mechanical 11/02/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 11/02/2010 $66.68
Contractor:
CASCADE RADON INC
3449 SE SHERMAN ST
PORTLAND, OR 97214
PHONE: 503 -421 -4813
FAX: 503 - 233 -1586
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 1.800.33 - 234..
/
Issued By: Permittee Signature: — r
ow" Call 503.6 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.
11/01/2010 15:09 FAX RI001
Me ahanicai Permit Aipl ' '
Itiltr)IIII l t :i1�1.1
11,___ City of Tigard L i Q ED
13125 SW Hall Blvd., Tigard, OR 97223 t ��/
II Phone: 5 Pax 503,5 0 pia '+
t, A t: t? Inspection Line: 503.639.4173 � Y ZI] 0 Date/By: Other Permit:
Interact: www.tigard- or.gov
age may: % See Page 2 fbr
CITY OF TIGARD N otified/Metho d: - Supplemental Information
TYPE O DIVISION
COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
E1 New construction Addition/a!(eration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar of all
(] Demolition Other:
mechanical materials ui men Tabor overhea and roflt.
CATEGORY OF CONSTRUCTION Value: S
i t 1 - and 2 - famlly dwelling ❑ Commercial/industrial G] Accessory building RBSWEN SYSTEMS FEES*
' CI Multi - Family ❑ Master builder 1] Oa For special irlfonnatlon trae checklis
.10B St7 B INFORMATION AND LOCATION e nripticn I Qty I Ea. 1 Total
Job situ address: A H ollne
D (,•1 r Air co wnditi nditionirtg
Cuy/SLAtC/ZIp: X77 , / (ma dreg s1tc plan ebowin�laeemen0 46,75
/ 7 S&(/1 Gt d ic Q' 022 S Furnace 100,000 BTU (ducts/vents) 46.75
Suite/bidg. /apt. no.: Project name: 2 _ Furnace 100,000+ BTU itteas/vents) 34.91
Cross streetldirec Heat pump I 61.06
Lions to job site: Duct work
23.32
�Hydronic hot water system 23.32
Residential bolter (radiator or
hydronio) 23.32
Unit heaters (Mel -type, not electric), —
in -wall, in -duct, suspended, etc, 46.75
Subdivision: I Lot no.: Flue/vent for any of abo ve 23.32 I(
Tax map /parcel no•: Other: 1 23.32 1
Other feel appliances
D ESCRIPTION OF WORK Water heater 23.32
/ / u / 4)1; r S , pf Oas fireplace 33.39
Flue vent for water heater or gas
0 0 - - ii .«tt> See' d - e._.....:,, �, fireplace 23.32
Log lighter (gas) 23.32
n w 1 W pellet stove
33.39
• II .
• al t1 ) WQpdfireplace/insert 2.3.32
' ROPERTY OWNER • Ch
• , imneypiner /ryue/vcat 23.32
Nome: d b 5 �-e re ..r 411V Other. _ 23.32
.Address: , Environmental ezbaust and ventilation
7 a '� S 5 l _ v, . k r AT r • Range hood/other kitchen
�± ea ulument 33.39
City/State/ZIP: l S , CD f •-1 - 7 a,�, 3 Clothes dryer exhaust 33.39
Fhone: ( ' Pte; ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
IErAPPLICANT '16NTACT PERSON - AniG wls ce 1 , 23)2 _ i
•
Business natue "�
S cate &'o/7 1/nL Other 23.32
Contact name: F_ uel olp "m
.4rin�- �t.GC%
+t�r 534.15 for nru than S4 03 rb r tac6 addttioapl
Address: ,3 4/1 S sSf'l erPYlew'] $ Pt s ita em
City/State/ZIP: / / d .1/ Gas heat pump
Wa heater
Phone: (S/J3) V/ , !l Fax:: ( �c , Water heater
E -rew �3 c t.— �3 i rcplace ,
RaaRe r
CONTRACTOR Barbecue
Business name: / Clothes dryer (µas)
Address: C� . I' ; • Other. `
City /State/ZIP: l� � 1i, d az .2/ ^
MECIIANICAL PERMIT FEES*
Snhtatal
Phooc: (o ) , / ; / Fax: ( ,/s) d d 3 / Minimum permit fee (590.00) fg 0 0
CCB tic.: / / �' :r 1 1 1, I• Plan review (2596 of permit fee)
- State suroharee (12% of termit Re) / 0. -571 — TOTAL PERMIT FEE / O ST
Authorized Sfgnature: This penult application expires ila permit is eat obtained within 150 '
Print Warne: days alter It brie been accepted as complete
r J J . ' .. X _ Date: // N • Fee methodology sot by Ri-County But K ing industry service Hoard
tmetkinoaminumcPamilApp ,a 10.V) 09
440.46 (11/ONCOMIw®)