Permit CITY OF TIGARD MECHANICAL PERMIT
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DEVELOPMENT Permit# MEC2011 -00469
TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Date Issued 10/26/2011
Parcel 25111 BA04000
Jurisdiction Tigard
Site address 14100 SW 98TH AVE
Project Brack Subdivision MCDONALD ACRES Lot 15
Project Description Install gas line, venting and new gas fireplace
Contractor ALL FUEL INSTALLATION & SERVICE LLC Owner BRACK, RICHARD J & DORENE
PO BOX 69 14100 SW 98TH AVE
TROUTDALE, OR 97060 TIGARD, OR 97224
PHONE 503- 674 -2350 PHONE 503 - 639 -5863
FAX 503 - 674 -2693
FEES
Specifics Description Date Amount
Gas Fireplace 10/26/2011 $33 39
Type of Use SF Flue Vent for Water Heater or Gas 10/26/2011 $23 32
Class of Work ALT Type of Const Fireplace
Occupancy Grp Fuel Piping 10/26/2011 $14 15
Stories 12% State Surcharge - Mechanical 10/26/2011 $10 80
Minimum Fee Adjustment - Mechanical 10/26/2011 $19 14
Fuel
Fuel Types Natural Gas
Gas Pressure
Total $10080
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 questio OUNC by calling 503 232 1987 or 1 800 332 2344
•
Issued By ) �/'e'4"„447-'!'l O r Permittee Signature �� r�L O'u-
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 Applicat C `VED iY ltOFFICL UsE ONL1
a �'' Received
Illi City W Tigard 1 2011 Date/By, !0 9i n 4 ' Permit No we , 2„ 4"4
^ 13125 SW Hail Blvd . Tigard, OR 97223 OCT 2 Plan Rehew i "
■ ` Phone' 503 718.2439 Fax 503 598 1960 D Re Gibes PUMA'
,T WARD Inspection Line 503 639 4175 CITY OF TIGAF1D Date Ready/Sy loos H See Page 2 for
Internet www.trgard- or.gov 11 DING D NiSION NonFed/Method' Supplemental tales matron
l9 >likil cipg3'ttpli,1df,,'� ' ill ,. q N "' 9 ) ; 'I� , t% lII rt��74{1� i
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r „ , construction ® Add
�.u4 � ��k' ,,�5dl / , 94? a �. .• «..Jl „u i « f „!., ,.,;,.1�
` "' "- � Mechanical permit fees` are based an t h . f e value of the work
❑ New tmotlo ition/alteration / replaccmcnt I performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
,r IRr.�tt , *„ i.nua .r^T« "aXa01i4s^� ,;a'up a, TFjledufllY'�'il Value $ a
w= d'�'wa'1(i s❑ . ii,. § r' +� ' . e - �. ra �,elii$Sil, s i.. itNwantliiri 4,104. r `� -"'t,” '..2., �''vi 'ti _ " 6 1 E 1
(o ) �;,p 9/.4 . �� �{�:• Y J �l nin6 , ti 6,� �
tik a
® I- and 2- family dwelling ❑ Commereialhndustrial ❑ Accessory building For special information use checklist.
❑ Multi - family ;y y ❑ Master builder
y �( ' ,I II Other, Description Qty, 1 Ea Total
il bl i ' :d4�pfw�Nr�.', l i !fiP- crop (it }{ ^ I� yip HeannpJcaoling-
�� /p n� Air conditioning
{A Job site address 14100 SW 98th Li (requires site plan showmp, placement) 46 75
U I Pomace 100 000 BTU (ducts/vests) 46 75 1
City /State/ZIP. Tigard, OR 97224 Furnace 100,000+ BTU (ducts/vents) 54.91 _
Suitc/bldg /apt. no : Project name Heat pump
(requires site plan showing placement) 61 06
Cross street/directions to job sue: Duct work 23 32
Hydronle hot water system 23.32
Residential boiler (radiator or
hydronic) 23 32 _
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc i 46 75
Flue/vent for any of above 23 32 1
Subdivision, Lot no.:
Other 23 32
Tax map /parcel no. i Other fuel appliances:
�Xl s' iT „ !a,•'�'Pe ' �g,Y , ,�?n'ev 'M t;t IIX6 1 ntrp�nrr�i�,h4jLg °y , " '!'Pfk131�L'y,rv1R,y�ir� hV$ifi" hill, `. IG Water heater 2332 lI
. Pt. gl�i'!! f' �n) tillr�„ 7:' USt�fdiV'( 1N• Io,=V �N{• X' h!f Ml4mia %n,Y'�nn•.R,OP.Y?!li7u•:1 ^.f hY+li44 „!�, iNiilGk', ^al;il,�io�nlin�:,�i
Gas fireplace 1 33 39 33 391
Install gas Iiaq venting and new gas stove Flue vent for water heater or gas
fireplace 1 1 23 32 23.32
Log hghtet (gas) 23 32
Wood/pellet stove _ 3339 ,
Wood fireplace/insert , 23 32
t (. .� y, � Chimne /Imv /floc /vent I 23,32
l ilip li '"is sisi° i' a :- - � , �a` (l'e; , 1 ,, ,,i'' �14If'."}".'� tar 4 Sim isitaled{i,i1f la., 'ire l i /sS�alatUd000iSsifsesfi i Other I '73 32 I .._
Name: Dick Brack Environmental exhaust and ventilation: _
Address. Same as above Range hood /other Icitchen
equipment 33 39
City /State/ZIP: Clothes dryer exhaust 123 39
Single -duct exhaust (bathrooms, I
Phone: (503)639 -5863 Fax" ( ) toilet compartments utility looms) 23 32 -
tir nl�m{ v+ gaps, fr s+ . ° wflr, + 4,n yi s -5 4 a6,•hn i ;'x , ' , Np . • p "" , , ' ;' I ei , ' pi Amc /crawls ace fans 23.32
'> 'l.d I + ti ikaidk"r„,$ h ,,PAI Itil'ill !3il rAll( xil+li:e''H"x�6 .4, o A�. * "31 � p ,• wt tin' Smrs p
Other, 23 32
Business name' See Below
Fuel piping:
Contact name $14.15 for first four, $4.03 for each additional
Address: Furnace, etc
Gas heat pump
City /State /ZIP Wall /suspended /unit heater -
Phone' ( ) Fax: ( ) Water heater
Fireplace 1 1415
E -mail: allfuel@comcast-net �' � , � Range 1
i i j�rvl ' •, ,e l '4i1 "fh.nh r „If, � .
S r, � , $? , ' (kT YiS k iati2tYd,l lithir . tas N' a Barbecue
Business none- All Fuel Installation and Service, LLC, Clothes dryer (gas)
Other
evyV Address. PO Bet 69 l )1?IuV iii: � ! > ,`t4111 'N* n ` dot£ �k�i l:i "�;i:'lJ
U City /State /ZIP: Troutdale, OR 97060 Subtotal 70 86
Minimum permit fee ($90 00) 90,00
Phone: (503) 674 -2350 Fax' (503) 674-2693 Plan , eview (25% of permit fee)
CCB lie . 169503 State surcharge (12% of permit fee) 10.80
7 TOTAL PERMIT FEE I 100 80 I
This permit apphca@on expires if a permit s5 not obtained within ISO
Authorized Signature' days after it has been neeepted as complete.
I Print name: Eric Camp Date 10/20/11 • Fee methodology set by Id- County Building Industry Service Board
l,auddmg Peme•,App.doc 09/0eno 440.46177 (11/0/COMN/tn)