Permit CITY OF TIGARD MECHANICAL PERMIT
`: 0 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00123
- F f G A.R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/07/2012
Parcel: 2S104CD10100
Jurisdiction: Tigard
Site address: 13620 SW TRACY PL
Project: MCKINNEY Subdivision: HILLSHIRE ESTATES NO.2 Lot: 100
Project Description: Gas fireplace installation with venting.
Contractor: GO SALES INC. Owner: MCKINNEY, FRANK D & LISA M
14210 SE STARK ST 13620 SW TRACY PL
PORTLAND, OR 97233 TIGARD, OR 97223
PHONE: 503 - 256 -3473 PHONE:
FAX: 503 - 254 -1011
FEES
Specifics: Description Date Amount
Gas Fireplace 03/07/2012 $33.39
Type of Use: SF Chimney /Liner /FlueNent 03/07/2012 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 03/07/2012 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 03/07/2012 $33.29
Stories:
Fuel
Fuel Types:
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: IP
i3
Call 503.639. , 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.
' Mar.06.2012 17:34 PAGE.. 1/ 2
Mechanical Permit Applicat n ` ,, � rt to O l'I((. t si ON 1.1
• City of Tigard i, , clan Rev
\�. A _ -
13125 SW Hall Blvd., Tigard,0C.' ?, c. Al'- ��/1 AMP // 3
Review
Phone: 503.718.2439 Fax: 503.' • .196 S pate/By: Other Permit:
0.
I 1 , 1 , 1 , inspection Lioe: 503.639.4175 P /V ,O N Date Reedy /By: hurler: is See Page a 1br
Internet: www.tigard- or.gov O� ` ,1\ C J �� Notified/Method: -� Supplemental Information
TYPE OF Wj1.
�� ®� COMMERCIAL FEE* •a�u>E - USECREC1 T
VV Mechanical permit fees* arc based on the value of the watt
0 New construction ® Add ition/alteration/replacement per .[dkae the value (wed to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. _ ,
CATEGORY OF CONSTRUCTION
. Value: $
R> TTAL QIFIPMEN__L__
F EA981tP,ES*
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For spodalInfo nmoloo we awing.
❑ Multi - family ❑ Master builder ❑ Other: Description Total 1
JOB SITE INFORMATION AND LOCATION • Heating/eool ng:
Air conditioning
Job site address: 13620 SW Tracy Pl (requites site plan showing placement) 46.75
City/State/ZIP: Tigard, OR 97223 Pomace 100,600 BTU Sductslvcn� 46.75
Furnace 100,600 t BTU (ducts/vents) _ 54.91
Suite/bldg. /apt. no.: I Project name: Heat pump
(requires Sile plan shoring 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 boaters (fuel -type, not electric),
in -wall, in- dueler, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent for arty of above ' 2332
Other: r 2332 1
Tax map/parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater j 23.32 J
Install gas fireplace and venting. Gas already at site. Gas fireplace, for 1 33.39 33.39
. Flue vent for water heater or gos
fireplace _ 23.32
Log lighter (i as) 23.32
Wood/pellet litove 33.39
Wood fireplafe/insert 23.32
- . El PROPERTY OWNER I I: TENANT Chimney/liner/flue/vent I 23.32 23.32
Other: 23.32
Name: Lisa McKinney Environmental exhaust and ventilation: •
Address: 13620 SW Tracy PI Range hood/rilher kitchen
equipment • 33.39•
City/State/ZIP: Tigard, OR 97223 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)784.92% Fax: ( ) toilet compartments, utility rooms) ._, 23.32 _ , .
0 APPLICANT 0 CONTACT PERSON Attidarawlszrace farts 23.32
•
Other: 23.32
Business name: -
--- Fuel piping: , .
Contact name: $14.15 for first four, $4.03 fir each additional
Address: Furnace, etc. •
City /State/ZIP: Gas heat pun ,
Wall/suspended/unit heater
Phone: ( ) Fax: : ( ) - Water heater •
E -mail: - Fireplace _
Range •
• ..
• . . CONTRACTOR • Barbecue
Business name: GO Sales tat Clothes dryer (gas) t I
Other.
Address: II210 SE Stark St MECHANICAL PERMIT FEES*
City/State/ZIP: Portland, OR 97233 • . Subtotal • - 56.71
Phone: (503) 256-3473 I Fax: (503)254-1011 - Minimum permit fee ($90.00) 90.00 Plan review (25% of permit fee)
CCB lie.: 194285 _ State surcharge (12% of permit fee) 10.80
J` �� TOTAL PERMIT FEE 100.80
Authorised Signature' 7
„! � J ( , This permit spplkatmores n mores If a permit is not obtained within 180
days Sher It has been accepted as complete.
Print name: Kristin Gentry I Date: 3 - 116 • Fee methodology sn by Tri•Coun(y Building Industry Service Board
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