Permit CITY OF TIGARD MECHANICAL PERMIT
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" ' COMMUNITY DEVELOPMENT Permit #: MEC2010 00581
1 3125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/16/2010
T1CrARf3, Parcel: 2S103CB01200
Jurisdiction: Tigard
Site address: 12325 SW JAMES ST
Project: Bachofner Subdivision: Lot: 0
Project Description: Install gas fireplace insert, venting and piping.
Contractor: ALL FUEL INSTALLATION & SERVICE LLC Owner: BACHOFNER, JEFF
PO BOX 69 12325 SW JAMES ST
TROUTDALE, OR 97060 TIGARD, OR 97223
PHONE: 503 -674 -2350 PHONE: 503 - 590 -7453
FAX: 503 - 674 -2693
FEES
Specifics: Description Date Amount
Gas Fireplace 11/16/2010 $33.39
Type of Use: SF Flue Vent for Water Heater or Gas 11/16/2010 $23.32
Class of Work: ALT Type of Const: Fireplace
Occupancy Grp: Fuel Piping 11/16/2010 $14.15
Stories: 12% State Surcharge - Mechanical 11/16/2010 $10.80
Minimum Fee Adjustment - Mechanical 11/16/2010 $19.14
Fuel
Fuel Types: Natural Gas
Gas Pressure:
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 wit 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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /
Issued By: Permittee Signature: D/✓ !/ —//� D / p L f e ' 7d A/
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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 App1' IVE ;DI
FOR OFFICE USE ONLY
d Received City of 1'i an 1 2 ,: i /02
/9>�C poie BO5 ?
�' g 1 Receive Permit lve.:
41 13I25 SW Hall Blvd., Tigard, OR 2 2010 plan Resew /
1 0 Phone: 593.639.4171 Fax: 503.598.1960 Other Permit:
�± � pg� Date/By:
TJ GAR D Ins Li ne: 503 CITY OF TIGARD Date Ready /By: Ju s 21 See page 2 for
Internet: www.tigard or.gov BUILDING DIVISION Notified/btethod: / Supplemental Information
T TYPE OF WORK COMMERCIAL FEE" SCHEDULE - USE CHECKLIST
Mechanical permit fees` are based on the value of the work
❑ New construction ® Addition /alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
El 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building RESIDENTLIL EQUIPMENT / SYSTEMS FEES*
I=1 Multi-family ❑Master builder For special information use checklist.
❑ Other: Description Qty. Ea_ Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 12325 SW James St Air conditioning
(requires site plan showing placement) 46.75
City/State /ZIP: Tigard, OR 97223 Fumace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldgJapt.no.: Project name: y sleet pump 61.06
Cross street/directions to job site: Ductwork 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydrouic) 23.32
--- Unit heaters (fuel -type, not electric),
m -wall, in -duct, suspended, etc. 46.75
Subdivision: Flue /vent for any of above 23.32
Lot no.:
Other: 23.32
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace I 33.39 33.39
Install gas insert, venting and piping Flue vent for water heater or gas
fireplace 1 23.32 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
1 Chimney /liner /flue /vent 2332
® PROPERTY ] RTY OWNER TENANT Other: 2132
Name: Jeff Bachofner . Environmental exhaust and ventilation
Address: same as above Range hoodiother kitchen
equipment 33.39
City /State/ZIP: Clothes dryer exhaust 33.39
Single-duct exhaust (bathrooms,
Phone: (503)590 -7453 Fax: ( 1 toilet compartments. utility rooms) 23.32
❑ APPLICANT ❑ CONTACT .PERSON Atticcrawlspace fans 23.32
Other: 1 23.32
Business name: See Below
Fuel piping
Contact name: 514.15 for first four; 54.03 for each additional
Address:
Furnace, etc.
Gas heat pump
City /StateiZ[P: Walllsuspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace I 14.15
. E -mail: allfuel @comcasLnet Range
CONTRACTOR Barbecue
Business name: All Fuel Installation and Service, LLC. Clothes dryer (gas)
Other:
Address: YO Box 69 • _MECHANICAL PERMIT FEES*
7 StatcfZlP: Troutdale, OR 97060 Subtotal 70.66
e: (503) 674-2350 Fax: {503} 674 -2693 Minimum permit fee ($90.00) 90.00
Plan review (25% of permit fee)
CCB sic.: 169503 Slate surcharge (t2 %of permit foe) 10.80
L / TOTAL PERMIT FEE 100.80
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete
Print name: Eric Camp l Date: 21/11/10 J ` Fee methodology set by Tri County Building Industry Service Board
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