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Permit ,5■ 1 T v CITY OF TIGARD MECHANICAL PERMIT 4 COMMUNITY DEVELOPMENT Permit #: MEC2009 -00495 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/18/2009 TFiGARD Parcel: 2S103DB10300 Jurisdiction: Tigard Site address: 13220 SW GENESIS LP Subdivision: Lot: 0 Project: Cutonilli Project Description: Installation of gas line and venting for tankless water heater. Owner: FEES CUTONILLI, STEPHEN & DIANA Description Date Amount 13220 SW GENESIS LOOP Flue vent for Water Heater or Gas 09/18/2009 $10.00 TIGARD, OR 97223 Fireplace PHONE: 503 - 684 -7915 Fuel Piping 09/18/2009 $5.40 12% State Surcharge - Mechanical 09/18/2009 $8.70 Contractor: Minimum Fee Adjustment - Mechanical 09/18/2009 $57.10 GEO A MORLAN PLUMBING & APPL CO 2222 NW RALEIGH ST PORTLAND, OR 97210 PHONE: 503 - 274 -1444 FAX: 503 -624 -8251 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 Notificati. • - - • er. 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 q - tions to 0 C by calling 503.246.6699 or 1.800.332.2344. 1 L Issued :y: ` I ' `_ IP � t JL / Permittee Signatur D . — 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. ,.: , • t' ep 18 09 01:38p 5036248251 p. 3 W E D F O R FOR O F1 t t SIl O FS City of Tigard Received 9 �f r 13125 k Permit No.. ' ee 9 .09-1)6y-47 5 SW Hall Blvd., Tigard, OR 97223 /� of . 7 Phone: 503.639.4171 Fax: 5011101010108 2009 D Daat ee Other Permit: TIGARD Inspection Line: 503.639.4175 [T' Internet: www.tigard or.gov Date Ready /8y: PI See Page 2 for C1 OF TIGARD Notified/Method: En Supplemental Information SIGN Ttlit h COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ❑ New construction Addition /alteration/replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ Y" 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES* For special information use checklis ❑ Multi-family . Y ❑ Master builder ❑ Other: Description Qty. I Ea. I Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: / J4 / ..1 17/i/ .1-41 f / Air conditioning or heat pump / (requires site plan showing placement) 14.00 f City /State /ZIP: `iei j7��- f/ [ Furnace 100,000 BTU (ducts/vents) 14.00 Suite/bldg./ t. no.: ! /J Project Caine; Furnace 100,000+ BTU (ducts /vents) 17.90 o P Gas heat pump 14.00 Cross street/directions to job site: Duct work 10.00 Hydronic hot water system 14.00 _ Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct. suspended, etc. _ 14.00 _ Subdivision: Lot no.: Flue /vent for any of above 6.80 Other: I 10.00 Tax map /parcel no.: Other fuel appliances t ESCRH'T1ON OF WORK Water heater 10.00 - Gas fireplace 10.00 /-- // , /Y.1 • ill ' / ''/ // /4 I // Flue vent for water heater or gas • 7ay u��� � ,e fireplace 10.00 I Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace /insert 10.00 Chimney/liner/flue/vent 10.00 14 PROPERTY OWNER ❑ TENANT • • Other. 10.00 Name: Dim J ( /J l Environmental exhaust and ventilation Address: L /.64 //i) Y R ej /) z ��� Range ge hood/other kitchen equipment 10 00 City /State /ZIP: 7 ,,,,,, /�il �J Clothes dryer exhaust 10.00 Phone: 3 ) 7 /5 - ( �` Fax: ) t ing co p rtm (bal roo , C toilet compartments, utility rooms) _ 6.80 ❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00 Business name: &/.A AWL Other: 10.00 � �/ i' 1 .i Fuel piping Contact name: / j' 7� -E�� SS.40 for first four; 51.00 for each additional Address: A�J�� `�� Furnace, etc. _ � L f /l� ! Gas heat pump CitylState /ZIP: fJIJ 9��� Wall /suspended/unit heater Phone: rr 71./.7 Fax: � � Water heater @. / %d/ 6f� /t�/l � OY P /a / / /��ft��i l� Fireplace a E -mail: 6' C CTOR Barbecue Business name: ��� �� ,� //� / -1J/j ��/ ��� Clothes dryer (gas) l ( /�/ Other: i Address: , t y. • -‘ MECHANICAL PERMIT FEES* City /State /ZIP: A /h1t / ` - ^ / .777& _ ( �3) D271��/ !/ Fax'- Subtotal j[��/ Minimum permit fee ($72.50) 7",,,,T Phone / / 3 ) (� I Plan review (25% of permit fee) CCB Iic.: ,7�� State surcharge (12% of permit fec) ;ll TOTAL PERMIT FEE &/, ,/16) Authorized Signature: This permit application expires if a permit is not obtained within 180 days after it has been accepted as complete.