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Permit u- CITY OF TIGARD MECHANICAL PERMIT x COMMUNITY DEVELOPMENT Permit #: MEC2009 -00458 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 09/01/2009 TIGARD Parcel: 1S134CD00700 Jurisdiction: Tigard Site address: 11825 SW KATHERINE ST Subdivision: Lot: 0 Project: Killion Project Description: Install gas line for range. Owner: FEES KILLION, RANDY Description Date Amount 11825 SW KATHERINE ST TIGARD, OR 97223 Fuel Piping 09/01/2009 $5.40 12% State Surcharge - Mechanical 09/01/2009 $8.70 PHONE: 503 - 524 -4996 Minimum Fee Adjustment - Mechanical 09/01/2009 $67.10 Contractor: FAST WATER HEATER COMPANY 12601 132ND AVE NE KIRKLAND, WA 98034 PHONE: 425 - 636 -7054 FAX: 425 - 636 -7055 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: Permittee Signature: dfi/ 7°f'G /e7-0 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. ],From: 08/28/2009 10:24 11784 P.002/003 nici CFM fl Mechanical Permit App n .. •� ,, - , o,: orrice_ usi:: (wt.1 Cl Received r permit No, lig a 13 125 of Tigard SW Hall Blvd., Tigard, OR 97223 AUG 2 2009 Date/By: 7 / (d ; i`16GaZ009 00 ® Plan Review / Phone: 503.639.4171 Fax: 503.598.1960 -! Other Permit Ti n it D Ins Line: 503 �I Iii OF �G ` +� Da ReadyBy ' H See Page 2 for Internet: www.tigard-or.gov BU ILDING DIVISION Notified/Method: //� Supplemental Information _ , rye R;:- 3Z"��', r�8'k'G 'v�.e Jx ,.:�� �N+,�.kw:/ ;S #�z `. �as� -- :m ?., - � a; e.7 -<. 5:.a.�Ax�t"4,�. ..h����..- .���- .��.`�«u =: -. �Y.' �F. s r- �" Zx' �. x�a�F< s.=;;... �.,. �.' �., v. .. «.w��,,.���.�`:��U.,w.: -•:,. �rv�'sGX�' ,. -� .. .. �..i*��; :�� +u== iYi2A� .vs. �r.� "�£ +tC+vsw d -.•w.zu+�x " ,- .�,..ear� -... -, � :� 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. . '3' fi w- 4561 1 , -. ( !ri , [R/ , '�� . : �; �� • *-, tt_ < f Value: $ $550.00 ,, d , „ ,,, @. „ ...�.T.rz :.w. a p.CA ,u :+o-o vme x . ;.., ,c "p`r.".c'>L b ' ,,,,, s,t,. ri' ��„ ` r z ' i, m X. a �,virr::a vra ac s rxy ra-,-. awa,. .,,,-,+ - w - i , " ® 1 -and 2 family dwelling ID mmerei ❑ ,wr a!� 4z S;;a�BSltit IA . = 1511 , Commercial/industrial Access building `" "�'` " "�'�'°" " " ^`"''�"'�=�"'" '"�' '� �' "`''�°�' ❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist. a w a xe r. Description I Qty. Ea. Total . ,- ,„..�xS . , � a © T ; # i?I �i . g. l. : . ; ,. : Heatm / coolin Job site address: 11825 SW KA # S T / < ,t� // S - Air conditioning or heat pump (requires site plan showing placement) 14.00 City/ State/ZIP: 97223 Furnace 100,000 BTU (ducts /vents) 14.00 Furnace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: KILLILN Gas heat pump 14.00 Cross street/directions to job site: SW 121 AVE 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: 10.00 Tax map /parcel no.: Other fuel appliances e y s^" � dra ~1 0 W 1 z 14161 w ater heater 10.00 INSTALL GAS LINE TO RANGE Gas fireplace 10.00 Flue vent for water heater or gas fireplace 10.00 Log lighter (gas) 10.00 • Wood/pellet stove 10.00 , Wood fireplace/insert 10.00 -". b- z t- 4 .,r-. rv Tg -7. �-... - "< .�. Chimney/liner /flue/vent 10.00 • :•, , �;:__.....;T other 10.00 Name: RANDY` k i L i. / 0/v Environmental exhaust and ventilation Range hood/other kitchen Address: 11825 SW KATHRINE ST equipment 10.00 City/ State/ZIP: 97223 Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (503)524 -4996 Fax: ( ) toilet compartments, utility moms) 6.80 a #azT 11G'!CtuCg;e ., ,,a Attic /crawlspace 10.00 Oth Business name: FAST WATER HEATER Cr. 10.00 Fuel piping Contact name: CAROL RANDALL $5.40 for first four; $1.00 for each additional Address: 12601 132 AVE NE Furnace, etc. Gas heat pump City/ State/ZIP: KIRKLAND, WA 98034 Wall/suspended/unit beater Phone: (425) 636 -7054 Fax: : (425) 636 -7055 Water heater Fireplace E -mail: CAROLR @FASTWATERHEATER.COM Range I 5.40 5.40 v s y .� r � . ' -... ., ,v:: ,.. : �s:,,=, � Y" .." . k x 4 � Barbecue Business name: FAST WATER HEATER Clothes dryer (gas) Other: Address: 12601 132 AVE NE ` - ' , ^ =' � , t ^"-� City /State/ZIP: KIRKLAND, WA 98034 Subtotal , Phone: (425) 636 - 7054 I Fax: (425) 636 - 7055 Minimum permit fee ($72.50) 72.50 / Plan review (25% of permit fee) CCB lic.: 168049 • State surcharge (12% of permit fee) • 8.70 _ , ,'j TOTAL PERMIT FEE 81.20 L.'''. Authorized signature: /; • [ '��j��� , f f / This permit application expires if a permit is not obtained within 180 days after It has been accepted as complete. Print name: CAROL M W RANDALL Date: 08/28/095 " Fee methodology set by 1ti -County Building Industry Service Board I:\ Buil ding \Permits\MEC- PermitApp.doc 01/19/07 440-4617T (11 /02/COM/WRB) r Pc f I9 0 . 01 F ›{ T /S Ter Y�5 -- 36_ -7of'S � � 0 r)