Permit ? l • ,� CITY OF TIGARD MECHANICAL PERMIT
' * ' • COMMUNITY DEVELOPMENT Permit #: MEC2011 -00485
Date Issued: 11/01/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718 2439 Parcel: 2S115AA02900
Jurisdiction: Tigard
Site address: 10680 SW KENT ST
Project: KILDERS Subdivision: DOVER LANDING NO 2 Lot: 68
Project Description: Installing gas furnace and tankless water heater with gas piping
Contractor: HEAT RELIEF CO Owner: KILDERS, FRANK
13122 NE DAVID CIR # 800 BUCY, LISA
PORTLAND, OR 97230 10680 SW KENT ST
TIGARD, OR 97224
PHONE 503 - 261 -9915 PHONE:
FAX: 503 - 261 -9814
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 11/01/2011 $46.75
Type of Use: SF Water Heater 11/01/2011 $23 32
Class of Work: ALT Type of Const: Fuel Piping 11/01/2011 $14.15
Occupancy Grp: 12% State Surcharge - Mechanical 11/01/2011 $10.80
Stories: Minimum Fee Adjustment - Mechanical 11/01/2011 $5.78
Fuel
Fuel Types: Natural Gas
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 1987 or 1.800.332 2344.
Issued By: - Permittee Signature: �, t
r
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.
10/31/2011 MON 14: 29 FAX 503 261 9814 Heat Relief 2002/003
Mechanical Permit Application RECEIVE I FOR OFFICE USE ONLY
City o£ Tigard
II Datel Received By: 1 v ® Penult No,.
13125 SW Hall Blvd., Tigard, OR 97223 OCT 31 2'011 T plan Review � �- � � /� r ! P
' Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
Inspection Line: 503.639.4175 Date/
TI GA.tiD Date Read th S See men a l for
Internet: www,tigard- or.gov CITY OF TIGAR II Notifi * Supplementl Information
`_ BUILDING DIVISI�! L
i _
T ' tj�r r u 1fiN -. y fON T 's �: It t rer z 1 ri i- t ' a ;
u .; - * .. , i 7 9 W ( _ap��al, . `Y`;.1 1ry�:
... • �' �,. ' nt .t s. - --- m- - tu'6(t«. `s.i x' ....IJIl'a
ll Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition /alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
ft y n s _
Value: $
Fr a e'3 •¢ l. # '� ;t d ftn t r' a s " � LrP Wu � .' # , 7F . T . w . 7r
., � _ �.� k K �� ?`aatn t � � Y �.t re l� t 4 • - � c �..� .� t� if..��, , � per'''
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special Information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty I Ea Total
(, tt 4 ' " F fr 9 a E�ei D �lkilKI WI"
h k a >t 1 t Heating/cooling:
Mgt Heatin
a s a r ,,., � i Dom,
Air conditioning
Job site address: 10680 SW KENT ST (requires site plan showing placement) 46.75
City / State/ZIP: TIGARD OR 97224 Furnace 100,000 BTU (ducts /vents) 1 46.75 46.75
Furnace 100,000+ BTU (ducts/vents) 54 91
Suite /bldg. /apt. no.: I Project name: ,9 h k ( Heat pump
(requires sae plan showing placement} 61 06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
• hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 4675
•
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other. 23.32
Tax map/parcel no,: Other fuel appliances:
y ' ;
. ''lilt h . .• Ik, , 1 a 't itil x, � s F r Water heater 1 23.32 23.32
INSTALL GAS FURNACE AND WATER HEATER Gas fireplace 33 - 39
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
l : ' ,, i t3 aA Chimney /liner /flue/vent 23.32
� $lei ae 1 ,- '444 ,' *( c " ° �te !,,, i '.il `'°�,s z° i iK� AM.wV of Other: 23.32
Name: FRANK KILDERS Environmental exhaust and ventilation:
Address: 10680 SW KENT ST Range hood /other kitchen
equipment 33.39
City /State/ZIP: TIGARD OR 97224 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)515.3540 Fax: ( ) toilet compartments, utility rooms) 23.32
4� r faIRESSEREAREVAEMEENegga `M < Attic /crawlspacefans 23.32
Business name: HEAT RELIEF Other• 23.32
Fuel piping:
Contact name: KARINA GRANT V $14.15 for first four; $4.03 for each additional
Address: 13122 NE DAVID CH3 #800 (�( (P` v- \ \ \\ Furnace, etc.
C� q Gas heat pump
City/ State/Z1P: PORTLAND OR 97230 0 t \y Wall/suspended/unitheater
Phone: (503) 261.9915 I Fax: : (503) 261.9814 ■ ( �.`� V Water heater 1 Pi. 1S
�" c ` Fireplace
E HROFFICE @HEATRELIEFTODAY.COM
*r, r v a, 9,,i Range
� r , "( 711 ',e ' ti v 161,1a`Bsat t , re ,. � 1 ,„ , /� air Barbecue
Business name: HEAT RELIEF Clothes dryer (gas)
Other,
Address: 13122 NE DAVID CIR #800 ret r p / f pf- .
,< t
City /State /ZIP: PORTLAND OR 97230 Subtotal 70 07
• Phone: (503) 261.9915 Fax: (503) 261.9814 Minimum permit fee ($90.00) 90.00
/ r , Plan review (25% of permit fee) 0 00
CCB lie.: 122424 � � State surcharge (12% of permit fee) 10.80
_ 100.80
,L TOTAL PERMIT FEE
Authorized signature: ' �� ., , � . _� / w . - - -T `
This permit application expires ifa permit is not obtained within 180
Print name: KARINA GRANT Date: 10/31/2011 days after it has been accepted as complete.
t\ Building \Permits1MEC- Pernut App dec 09 /09/10 440 -4617T (I1 /02 /COM/WER)