Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit# MEC2011 -00474
Date Issued 10/26/2011
TIGARD, 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Parcel 25101 BC0050D
Jurisdiction Tigard
Site address 12300 SW KNOLL DR
Project Stolt Subdivision KNOLL ACRES Lot 10
Project Description Replace duct work, dryer vent and bathroom exhaust fan
Contractor COST PLUS HEATING & AIR Owner STOLT, FRED
7132 N FESSENDEN ST 12300 SW KNOLL DR
PORTLAND, OR 97203 TIGARD, OR 97223
PHONE 503 - 781 -9090 PHONE 503- 312 -0657
FAX 503 - 286 -6552
FEES
_Specifics• Description Date Amount
Duct Work 10/26/2011 $23 32
Type of Use SF Clothes Dryer Exhaust 10/20/2011 $33 39
Class of Work ALT Type of Const Single Duct Exhaust (Bathrooms, Toilet, 10/26/2011 $23 32
Occupancy Grp Utility Rooms)
Stories 12% State Surcharge - Mechanical 10/26/2011 $10 80
Minimum Fee Adjustment - Mechanical 10/26/2011 $9 97
Fuel
Fuel Types
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, o work —i- uspended for more the 180 days ATTENTION Oregon law requires you to follow the rules adopted by the Oregon
Utility • ification Center ose - - set forth in OAR 952- 001 -0010 through OAR 952- 001 -0090 You may obtain a copy of the rules
or du: t questions to OUNC by : ing 50 232 1987 or 1 800 332 2344
i
Issued By / / /1 ' Permittee Signature
Mir
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 Applicft}on � \ /ED ,4),,..,7,,, 07 USE ONLY
1 Id O� Received /O - l iltn �_�!/
City of Tigard R Pemit No 'lG��tL'/C Z
n 13125 SW Hall Blvd, Tigard, OR 972231r T 26 2011 Plan Review
C ' - Phone 503 718 2439 Fax 503 598 1960' D ate / By Other Permit
TIGARD Inspection Line 5036394175 TIr Date Ready /By tans ®See Page 2 for
Inremet www tigard -or gov CITY OF I IGARD Notified/Method Supplemental Information
BUILDING DIVISION
"" ' • , . TYPE W ORK z - COMMERCIAL FEE" SCHEDULE, USE CHE .; CKLIST ,
., Mechanical permit fees' are based on the value of the work
❑ New construction '® /replacement performed Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials, equipment, labor, overhead, and profit
w Value $
- „CATEGORY Or CONSTRUCTION
r '.,RESIDENTIAL EQUIPMENT I SYSTEMSFEESR* `. ',y;
® I- and 2 -family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist
❑ Multi-family ❑ Master builder ❑ Other Description Qty I Ea Total
. i JOB SITE INFORMATION AND_ LOCATION +' ' - Heating/cooling:
- - y - Air conditioning
Job site address ( Z O C) S S.& K J no LL \ f ( requires site plan showing placement) 46 75
Furnace 100,000 BTU ( ducts/vents) 46 75
City /State /ZIP \ t r1 A r ilt. r Furnace 100,000-- BTU (ducts/vents) 54 91
Suite/bldg /apt no Project name I leat pump
(requires site plan showing placement) 61 06
Cross street/directions to job site Duct work I 23 32 2-3.3j
Hydromc hot water system 23 32 _
Residential boiler (radiator or
s - hydronic) 23 32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc 46 75
Subdivision Lot no. Flue /vent for any of above 23 32
Other 23 32
Tax map /parcel no Other fuel appliances:
DESCRIPTION'OF "WORK - ^ ,_ Water heater 2332
j-¢_e lc, taa Do C wor t. 7 11x7 Z Gas fireplace 3339
( f'Y �-� ✓�w1 / FA e' Flue vent for water heater or gas
fireplace 23 32
Log lighter (gas) 23 32 _
Wood/pellet stove _ 33 39
Wood fireplace/insert 23 32
, Ca PROPERTY= OWNER' , s ID TENANT - ' u - Chimney/liner/flue/vent 23 32 -
Other 23 32
Name e I2.e;_-a_ S +o L_t
Environmental exhaust and ventilation:
Address Range hood/other kitchen
equipment 33 39
City/State/ZIP Clothes dryer exhaust i 33 39 Y j-bH
Phone (S ) j(2.— 065" Fax ( ) Sme (bathrooms, ( 1 1-1 Yodel compartments, utility rooms) 23 32
' YEA :APPLICANT - '' ❑'CONTACT - PERSON - Attic/crawlspace fans 2332
Other 23 32
Business name Cza$F ei' need-L(45 Fuel piping:
Contact name s4 Bfl' C 4 vx a v_f MN.) $1415 for first four; $4.03 for each additional
l Furnace, etc
Address . 1 1'52. fa cc SS e _vrC L.. Gas heat pump
City /State /ZIP (61,- - or g 72.0 3 Wall /suspended/unit heater
Phone (Sb 7S( - 9090 Fax ( 'd5) en, 6 5 ^}'Z Water heater
Fireplace
E-mail SJcvc Co 5 PA 5' () .Aoc. r c 0"-,- -' Range
CONTRACTOR : _ _ ,_ ,. . Barbecue
Business name Clothes dryer (gas)
Other
Address - a _ /MECHANICAL PERMIT FEES`, -' '
City /State /ZIP Subtotal
Phone ( ) Fax ( ) Minimum permit fee ($90 00) - •
/ / Plan review (25% of permit fee) r
CCB he • t-f 7 i 73 5 //Rl/ 3 State surcharge (12% ofpermu fee) /0,
TOTAL PERMIT FEE /W. 80
Authorized signature ^ This permit application expires if a permit is not obtained within 180
(� .{ -/ G�•r /JC•t /�� �� days after it has been accepted as complete.
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