Permit CITY OF TIGARD MECHANICAL PERMIT
a COMMUNITY DEVELOPMENT Permit #: MEC2012 00131
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/13/2012
Parcel: 2S104BA15000
Jurisdiction: Tigard
Site address: 13609 SW NORTHVIEW DR
Project: Lee Subdivision: CASTLE HILL NO.3 Lot: 180
Project Description: Install gas piping for range.
Contractor: A -1 INSTALLATIONS NW LLC Owner: LEE, THANH &
15842 SW UPPER BOONES FERRY RD. HUANG, LIU
TIGARD, OR 97224 13609 SW NORTHVIEW DR
TIGARD, OR 97223
PHONE: 503 - 620 -5657 PHONE:
FAX: 503 - 620 -1696
•
FEES
Specifics: Description Date Amount
Fuel Piping 03/13/2012 $14.15
Type of Use: SF 12% State Surcharge - Mechanical 03/13/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/13/2012 $75.85
Occupancy Grp:
Stories:
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, o ' ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility •tification Ce er. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or d' -ct questions to OU ` • -fling 503.232.1987 or 1.800.332.2344.
Is - ed By: Permittee Signature:
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 A,pplicatiRECE! n FOR OFFICE ONLY
City of Tf art I � E IJS
�/ Reeetved permit xo.: 1
n 13125 SW Hall lvd. Tigard, OR 97223 MA '� Z0
Date/By: 0 /'� Q/� G��J�
Phone: 503.718.2439 Fax: 503.598,1960 Plan
at ew Other Permit:
TIGARD Cnspection Line: 8 or.00v 639.4175 YOR F Gn y y 0 See Page 2for
Internet: www.tigard. CI I f TI /1fi D Notified/Method: Supplemental Information
brit:
BUILDING DIVIS10►
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t Mechanical permit figs" 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
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® I- and 2- family dwelling II Commercial /industrial ❑ Accessory building For spedal Infonnrtlon are checklist
❑ Multi- family II Master builder ❑ Other: Description I Qty. I Ea. I Total
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- . _ Air nditioning
Job site address: 13609 SW NORTTRVIEW DR (requires site plan showing placement) 46.75
City /StateJL1P: TIGARD, OR 97123 Furnace 100.000 BTU (ducts/vents) 46.75
Furnace 100.000+ BTU (duets/vents) 54.91
Suite/bldg. /apt. no.: Project name: LEE Fleas pump
(requires site pian showing placement) 61.06
Cross strect/directions to job site; WALNUT Duct work 23.32
Hydronie hot water system 23.32
_..._. - Residential boiler (radiator or
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 about 23
_ - Other: 23.32
Tax map /parcel no.:
Other fuel appliances:
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m r o. . ' n Water heater 2332
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INSTALL GAS PIPING FOR A RANGE Gas fireplace /insert 33.39
Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood freplacc/insert 23.32
s; s;°,. ;Et )l! . ::,,,r�r.x�:O t t; e, - _ ' - it ,'t^` tilitt:u . Chimney/liner/flue/vent 23.32
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. -.._ . .----- .........::..3 _,.=:..: other: 23.32
Name: Environmental exhaust and ventilation: _
Address: Range hood/other kitchen
equipment 33.39
City /State/2.1P: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
( )
Phone: ( ) Fax: toilet compartments, utility rooms) 23.32
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; ? :.:., iN " - ... _ Attic/crawl
:•.. r ':,:' =' :;!: • 06" ;4111, .g. r.. .i i. t4,.� ..,...., : ..:;_- ,__-_: �t A.CV +I .ui :. - _ _ space fans 23.32
Business name: A -1 1NSTALLA`LONS NW Other: 23.3
Fuel piping:
Contact name: CURTIS MOORE 514.15 for first four; $4.03 for each additional
Address: 15842 SW UPPER BOONES FERRY RI) Furnace, etc.
Gas heat pump
City /State/ZIP: CAKE OSW EGO, OR 97035 Wall/suspended/unit heater •
Phone: (503) 620 -5657 I Fax: : (503) 620.1696 Water heater
Fireplace
E -mail: alinstailerOyahoo.com
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Business ntune: A -t INSTALLATIONS NW Clothes d :as
Address: 15842 SW UPPER BOONES FERRY 1, / Other: 5y �
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City /State/ZIP: LAKE OSWEGO, OR 97035 Subtotal 14.15
Minimum permit fee ($90.00) 90.00
Phone: (503) 620 - 5657 Fax: (503) 620 - 1696 Plan review (25% of permit fee)
CCB lie.: 186516 State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80
Ibis permit application expires if a permit is not obtained within 180
Authorized signature: g deyc ever it haft been accepted bt eomptett
Print name: ERIC SMITH Tate: 03/12/2012 I 6 Fee methodology set by Tri- County Building Industry Service Board
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