Permit CITY OF TIGARD MECHANICAL PERMIT
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11 COMMUNITY DEVELOPMENT Permit #: MEC2009-00348
T t t�, A F O 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 07/16/2009
Parcel: 1 S134DC06100
Jurisdiction: Tigard
Site address: 11900 SW 113TH PL
Subdivision: MUTTLEYS ADDITION Lot: 14
Project: CONZELMANN
Project Description: Install gas line and venting for tankless w /h.
Owner: FEES
CONZELMANN, ARNOLD M III Description Date Amount
11900 SW 113TH
TIGARD, OR 97223 FlueNent For Any of Above 07/16/2009 $6.80
Fuel Piping 07/16/2009 $5.40
PHONE: 12% State Surcharge - Mechanical 07/16/2009 $8.70
Minimum Fee Adjustment - Mechanical 07/16/2009 $60.30
Contractor:
GEO A MORLAN PLUMBING & APPL CO
2222 NW RALEIGH ST
PORTLAND, OR 97210
PHONE: 503 - 274 -1444
FAX: 503- 624 -8251
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressue:
Total $81.20
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: ' A 0 i( 1 1 4 Permittee Signature: Q Q / ,
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.
Jul 15 09 10:11a 5036240251 p. 2
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Mechanical Permit Application RE 10,z,),,,(.„ I F_ O\►.\.
•
lig City of Tigard JUL 15 200' D e/B 4 PenultNo.: n f . Cd r, , g
13125 SW HaII Blvd., Tigard, OR 97223 Plan Review
¢ Phone: 503.639.4171 Fax: 503.598.1960 Other Permit
( Date/By:
T I GA R
CITY OF D Inspection Line: 503.639 I AR i idate Ready/By: FIN 63 See Page 2 for
Internet: www.tigard - or.gov BUILDING DIVISI0 Wified/Method Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction [5 Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
D Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: S
RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
® t - and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family 0 Master builder
❑ Ot her: Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 900 6 ( r f ti
3 p P • Air conditioning or heat pump
(requires sitejilan showing placement) 14.00
City/State/ZIP: T j g li P ci , 012- CJ 7 2 Z.3 Furnace 100,000 BTU ( ducts/vents) 14.00
Furnace 100.000+ BTU (ducts/vents) 17.90
Suite/bldgJapt. no.: Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic), 14.00
Unit heaters (fuel -type, not electric),
in -wail, in -duct, suspended, etc. 14.00
Flue/vent for any of above 6.80
Subdivision: Lot no.:
er: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
a Gas fireplace 10.00
17 4 S 7 Q /7 ! �'t Q ,'� // g am' e Q �/ ,+J Flue vent for water heater or gas
Ve If `r A C 2't t Mie,7' *emu 7e7. fireplace 10.00
Log g l ligh ghter (gas) 10.00
Wood/pellet stove 10.00
- Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ TENANT
Chimney/liner/flue/vent 10.00
Other. 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON ' Attic/crawlspace fans 10.00
Business name:
Other: 10.00
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/ State/ZIP: Wall /suspended/unit heater
Phone: ( ) Fax : : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR Barbecue
Business name: G L o b e -9 e 0 - r /Q y �i�., ,6 pz� y Clothes dryer (Ras)
/!� !� �! Other:
Address: /22 z /pa; iQ "A MECHANICAL PERMIT FEES*
City/ State/ZIP: PQ /clr? 6 9 7Z/ Subtotal
rte ^„ 3 2 71/ - / tit/ � 6Z4 -
Minimum permit fee (572.50) 7 z • 5
Phone: x`77 VV Fax: (
82s -----) Plan review (25% of permit fee)
CCB lic.: 2 73 C- State surcharge (12% of permit fee) 70
'
l',. TOTAL PERMIT FEE W i. 2 a
�,2. I'C This permit application expires If a permit is not obtained within 180
Authorized si afore: j' days after it has been accepted as complete.