Permit 114 CITY OF TIGARD MECHANICAL PERMIT
- COMMUNITY DEVELOPMENT Permit #: MEC2011 -00244
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/01/2011
Parcel: 2S 114 BB08700
Jurisdiction: Tigard
Site address: 16288 SW 104TH AVE
Project: Morris Subdivision: SWANSONS GLEN Lot: 28
Project Description: Gas piping for range.
Contractor: JOHN D PLUMBING Owner: MORRIS, MICHAEL N /GAIL A
7472 SW FIR STREET 16288 SW 104TH AVE
TIGARD, OR 97223 TIGARD, OR 97223
PHONE: 503 - 620 -7600 PHONE:
FAX: 503 - 598 -9355
FEES
Specifics: Description Date Amount
Fuel Piping 06/01/2011 $14.15
Type of Use: SF 12% State Surcharge - Mechanical 06/01/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 06/01/2011 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952- 001 -0010 through OAR 952- 001 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232. 0Z_332.234
Issued By: Permittee Signature:
Call 50 .63'.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
MAY -31 -2011 11:51A FROM: JOHN D. PLUMING (503)598 -9355 TO : 5035921960 P.3
Mechanical Permit ApplicatiPECEIVE `
City of Tigard
kr n 1312$ SW 11x1! B1wd, Tigmd■ OR 97223 M AY 31 201, i R D d— r- J M �; ►� 4 ..�..__
Phone: 503.718.2439 Pax. 503.59E1%0 Odom Davie
Detalir 503.639,4175
l
di asePeessfer
imner www.tiand-or.gov CITY OF TIGARD
BUILDING DIVISI0�3 N Mir a'
TYPE OF WORK COMMERCIAL FUP SCHEDULE — USE CHECKLIST
D New cotlshtiction 12 Addition/alteration/replacement MedtaniaF pan* Pons° are baud on the value of the work
ID Demolition 0 Other: f Materials, neui lobe oov b dell
CATEGORY OF CONSTRUCTION Value: $
RWODEN17AL RQU1Pa Nt /SYSTLMS YEt8'
f i- and 2- thmily dwelling 0 Commercial/industrial ❑ Accessory building FamedalaWvaasitwasrdeeYRt
❑ Multi - family 0 Master builder ❑ Other Description ) Qty. T EL I Total
JOB srm INFORMATION AND LOCATION HeadalYeoslna;
Air conditioning
Jab site address:
( 0 Z 8 . Zsok) (04_ j . imeutressilerms downs atietawtel 46.73 ,
city /Stats /ZIP: n a 2 D 1 0 2 `l ZZ Partake 100.000 WV (m s s) 46.75
Pomace 100,000s 8711(x) 54.91
SuitetbldgJapt no.: 1 Prgicct rouse: H 0 QQ (6 Hest pimp
(nwNmaaso ens *owls ntscarroon 61.06
Cross atreef/diseotions to job site: _ Duet work 23.32
f() 2.44 Pr la (; T`O 104- A-0-e-. ale hut water system 2332
Rotidentist boiler (mdietaor
hymen) 23.32
Uah heaters (flrl -type, not elaeulej,
in-wall, isaduet, suspended, etc. 46.75
Subdivision: f Lot no.: Flue/van Tor env of arrow 23.32
Other: 23.32
Tax maprparccl no.: Other thel appWttees:
UESCIUYIION OP WORK Water heater 23.32
I tie y{1_ C-roi P1 P!~ - O>L'.. RA-1,1 GE F fix water heater or 33.39
Meade 2332
Loa l ehter (awl 23.32
Wood/pellet stove 33.39
Wood (ttenble /inert 2132
E3 PROPERTY OWNER I O TENANT Chimmelinerfikelvent 23.32
er 23.32
Name: Mo2Q1ep M tertf -n ( -
-E . s -t - 01
( Environmental adman end .eatllatlaa;
Address: 1 2_-.M w 1 O 4. 744g- - Range haodlolher khdiat
bluMmolt
Ci ty /Stater 11 lad , 0 2• a 1 ZZ 4 Clothes dire exhale 3 3 3 3.339
( ) Tax: ( ) Singte-duct exhaust (bathrooms.
tenet compietnicatkutllity mores) 2332
❑ APPLICANT D CONTACT PERSON Attidenwlspaae tins 23.32
Business name: 23 32
Contact names Pad pipit: '
_ $14.15 far fla hr; SW farads aM sal
Address: Fumece, etc.
— Gas Met punt
City/State/
WaNsuspeededAmjt heats
Phone: ( ) I Fax: : ( ) Water liter
E - mail: Fireplac
CONTRACTOR Barbecue ` + ' /s ' [
Business temtte: 70f P tk) D P4-UM at k) G - 'cloth= drys CPO
Address: '747 2 �= t2 r` s oa r
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