Permit ill CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: MEC2011 -00241
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/01/2011
Parcel: 2S112CCO2200
Jurisdiction: Tigard
Site address: 8035 SW CHURCHILL CT
Project: LEAHY Subdivision: BOND PARK NO.3 Lot: 50
Project Description: Extend gas line for kitchen range, fireplace and install log lighter.
Contractor: ROBBEN & SONS HEATING INC Owner: LEAHY, IKE & MARY
2214 SE 8TH AVE 8035 SW CHURCHILL CT
PORTLAND, OR 97214 TIGARD, OR 97224
PHONE: 503 - 233 -5841 PHONE:
FAX: 503 - 238 -8849
FEES .
Specifics: Description Date Amount
Log Lighter (Gas) 06/01/2011 $23.32
Type of Use: SF Fuel Piping 06/01/2011 $14.15
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/01/2011 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 06/01/2011 $52.53
Stories:
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 will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, o work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utilit otification Ce te-4. Those rules are set forth in OAR 952- 001 -0010 through OAR 952 -I l -0090. You may obtain a copy of the rules
or irect questions to OUN'C b alli g 51 .232.1987 or 1.800.332.2344.
' 41111114,
Is ued By: 41, Permittee Signature: AIL ���'�
Call 503.639.4175 by 7:00 a.m. for the next available in •ection date.
This permit card shall be kept in a conspicuous place on the job site stil completio of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application,
KECEIVED F OR OFFICE USE ONLY
City of Tigard Received ji_ 1 '
Date/By: W /I din Permit No.!' ee ..., i e ,..-60 6 2 /
I
- ' 13125 SW Hall Blvd.. Tigard, OR 97223
.- - Phone: 503.718.2439 Fax: 503.598.190U N 1 2011 Plan Review
Date/By: Other Permit
Inspection Line: 503.639.4175
TIGARD Date Ready/By: lurk. El See Page 2 for
Internet: www.tig.ard CITY OF TIGARD Notified/Method: Supplemental Information
BUll DING DIVISION
i,Vi ivoiig4,-,L pC09MERct4IEEt SCHEDIJEE':'psE!,CHKKE.4517,
Mechanical permit fees* are based on the value of the work
111 New construction (ZI Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition D Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $
. ','-- - • -
CATEGORY ' M : ''C 9 N 1 ITTI I PI:eT'`'i±-'A'4 - --,'-''', --' '-',:-'', '''', ' ; iiigii161 FEES*
....... „. ,_ .., - .. , ., .... „, .
Ei I- and 2 dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi-family 0 Master builder D Other: Description Qty. Ea. Total
Heating/cooling:
Air conditioning
Job site address: 8035 SW CHURCH HILL CT (requires site plan showing placement) 46.75
Furnace 100,000 BTU (ducts/vents) 46.75
City/State/ZIP: TIGARD OREGON 97224
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Project name: LEAHY Heat pump
(requites site plan showing placement) 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:
'D E SC R IPTI ON OF AWORK '? - 1' -,-,-:-' l''' - -,,,-- -0 Water heater 23.32
' Gas fireplace 33.39
GAS LINE EXTENTION TO FIRE PLACE AND KITCHEN
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) I 23.32 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
El' PROPERTY'OWNEit 'T;'!' '-,L,VO'''':ilal4E'N'ANT,;:t$F:ei, ''',';'''i" Chimney/liner/flue/vent 23.32
,..
-'-'' ' '- Other: KITCHEN RANGE 23.32
Name: IKE AND MARY LEAHY
Environmental exhaust and ventilation:
Address: 8035 SW CHURCH HILL CT Range hood/other kitchen
equipment 33.39
City/State/ZIP: TIGARD OREGON 97224 Clothes dryer exhaust _ 33.39
Single-duct exhaust (bathrooms.
Phone: (503)708 Fax: ( ) toilet compartments, utility rooms) 23.32
APPLICANT r ': t,',.', ,' .!:';; r t , j ;,,, i , kei 4 iiiiii ,, ,4-:::; Attic/crawlspace fans 23 32
',,*: '"" ':. 1 `' v:
Business name: ROBBEN AND SONS HEATING Other: 23.32
Fuel piping:
Contact name: RANDLE NELASON $14.15 for first four; $4.03 for each additional
Address: 2214 SE 8'" AVE Furnace, etc.
Gas heat pump
City/State/ZIP: PORTLAND OREGON 97214 Wall/suspended/unit heater
Phone: (503) 233-5841 Fax: : (503) 238-8849 Water heater
Fireplace I 14.15
E randle@robbenandsons.com
Range 1
CorsitfUefoiii. - ,,, ' Barbecue
Business name: ROBBEN AND SONS HEATING Clothes dryer (gas)
Other:
Address: 2214 SE 8" AVE ?..''',,.: ' ''''.;, '.- fliMECITA ' ' .: ..,-,;'--
City/State/ZIP: PORTLAND OREGON 97224 Subtotal
Minimum permit fee ($90.00) 90.00
Phone: (503) 233 Fax: (503) 238
Plan review (25% of permit fee)
CCB lie.: 1884 State surcharge (12% of permit fee) 10.80
. 72
4 4 TOTAL PERMIT FEE 100.80
Authorized n., . i,
/1 applicaio
tn expires if a permit is not obtained within 180
,, , ( , This permit days after it has been accepted as complete.
Print name: RANDLE NELSO Date: 6/1/2011 * Fee methodology set by Tri-County Building Industry Service Board
1:\Building \ Permits \ NIEC-PertnitApp.doc 09/09/10 440-4617T (11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi - Family Fee Schedule:
Total Valuation:, Permit�Fee; n *a ,
$0.00 to $500.00 Minimum fee $69.06
$500.01 to $5,000.00 $69.06 for the first $500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to $10,000.00 $207.21 for the first $5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,000.01 to $50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to $100,000.00 $1,363.71 for the first $50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof, to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first $100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I: \Building\ Permits \MEC- PermitApp.doc 09/09/10 2