Permit N
' CITY OF TIGARD MECHANICAL PERMIT I I
r
► '1 :: COMMUNITY DEVELOPMENT Permit #: MEC2009-00354
Date Issued: 07/17/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S125DC08800
Jurisdiction: Tigard
Site address: 7172 SW ASH CREEK CT
Subdivision: ASH CREEK ESTATES Lot: 21
Project: Patton
Project Description: Gas piping for outdoor BBQ and fireplace.
Owner: FEES
PATTON, ANDREW & Description Date Amount
PATTON, MELINDA, 7172 SW ASH CREEK CT
TIGARD, OR 97224 Fuel Piping 07/17/2009 $5.40
12% State Surcharge - Mechanical 07/17/2009 $8.70
PHONE. Minimum Fee Adjustment - Mechanical 07/17/2009 $67.10
Contractor:
MIKE PATTERSON PLUMBING
15028 S MITCHELL LN
OREGON CITY, OR 97045
PHONE: 503 - 632 -7374
FAX: 503 - 632 -5647
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 /e , Permittee Signature: Q/V // k. /e/9--77,9A/
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.
Mechanical Permit Application Fort "oN F to list ONEV.- • "
u fit.,
11 Ci ty of Tigard RECE I , d N Permit No.:�6C,zdo 0aSs"
" 13125 SW Hall Blvd., Tigard, OR 97223
Plan Revie
. i
Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
1 2009 D atelRy:
T i G A R [) Inspection Line: 503.639.4175 JUL Date Ready/By: his. 0 Sec Page 2 for
Internet: www.tigard- or_gov Notified/Method: 779 Supplemental Information
CITY OF TIGARD
TYPE OF wcFlUll DING DIVISION COMMERCIAL FEEA SCHEDULE - USE CHECKLIST
Mechanical permit fees' are based on the value of the work
❑ New construction OkAddition/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: S
�P4 qj RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist_
❑ Multi- family ❑ Master builder LI Other: Description Qty. Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
tlob site address: 1 C�• Air conditioning or heat pump
Z C C L (requires sae plan showing plaannent) 14.00
•
City /State/ZIP: -- t - ' IR tat 0 IZ g 7 22 3 Furnace 100,000 BTU (ductsIvenrs) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite /bldg. /apt. no.: Project name: c:7,g_.>'t Gas heat • urn r 14.00
Cross street/directions to job site: Ductwork 10.00
H dronie hot water system 14.00 1
Residential boiler (radiator or
hydronic) 14.00
Unit healers (fuel -type, not electric),
in -wall, in -duct, suspended. etc. 14.00
t Flue/vent for any of above , 6.80
Subdivision: Lot no.:
Other: I , 10.00
Tax map /parcel no.: Other fuel a ' • fiances
(jJ� DESCRIPTION OF WORK /� Water heater _ 10.00
i1�; as 17[12/ kLq k OLA Loo G6' q� Gas fireplace Flue vent for 10.00
1� water heater or gas
fir • .lace 10.00
"� � 1 1'{ Log lighter (gas) 10.00 •
Wood/pellet stove 10.00
Wood fireplace/insert 10.00 .
Chimney/liner /flue /vent _ 1 10.00
PROPERTY OWNER ❑ TENANT Other: 1 1 10.00
Name: / )/, /97 ZDtet.: 4 401‘i. /M64 Environmental exhaust and ventilation
Range hood/other kitchen
Address: S 4 -� L 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
- Other. 10.00 ,
Business name:
Fuel '' i in:
Contact name: -^ $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City/State/ZIP: Walllsus.ended/unit heater
Water heater
Phone: ( ) Fax: ' ( ) Fireplace
E -mail: Range I .
/ � p'l B CONTRACTOR Barbecue I .
1 L 1 KS a 11 1 I , Clothes dryer (gas)
Business name y S{1 R R UYYI v,1 I I�iu Other:
Address: 1 y' 10Zg WI t --(),(( L� D • MECHANICAL PERMIT FEES*
City/State/ZIP: ain J'II G J 0� o tjC Subtotal
J Minimum permit fee ($72.50)
Phone: ( j3) tc73 27'2 ---/ 3-7 6--{ I Fax: ( ) (0 2- S --Q 1 Plan review (25% of permit fee)
V1 CCB lie.: 4 - 1 La • .1/10 State surcharge (12% of permit fee)
TOTAL PERMIT FEE ?/
L ' Ql�j ` This permit application expires if a permit is not obtained within I80 i f
Authorized signature: ( J C� C/1 days after it has been accepted as complete. �
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