Permit iii I CITY OF TIGARD MECHANICAL PERMIT
• , " COMMUNITY DEVELOPMENT • Permit #: MEC2012 00167
Date Issued: 04/03/2012
I 1GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 04/03/2012
Jurisdiction: Tigard
Site address: 12290 SW QUAIL CREEK LN
Project: WYATT Subdivision: QUAIL HOLLOW - EAST Lot: 55
. Project Description: Install range hood and make up air fan for kitchen remodel.
Contractor: HEAT RELIEF CO Owner: WYATT, COREY R
13122 NE DAVID CIR # 800 12290 SW QUAIL CREEK LN
PORTLAND, OR 97230 TIGARD, OR 97223
PHONE: 503 - 261 -9915 PHONE:
FAX: 503 - 261 -9814
FEES
Specifics: Description Date Amount
Range Hood /Other Kitchen 04/03/2012 $33.39
Type of Use: SF Other, ExhaustNentilation 04/03/2012 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 04/03/2012 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 04/03/2012 $33.29
Stories:
Fuel
Fuel Types:
Gas Pressure:
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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: it / 2 7.0/1 0 4 . / j 7d,
6
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.
04/02/2012 MON 12:42 FAX 503 261 9814 Heat Relief 2002/002
R E CE IVED
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Mechanical Permit ApplicatijR 3 2012 Folt OFFICE (SE ONLY
IN City of Tigard
Received zi a 13125 SW Hell Blvd., Tigard, OR OF TIGARD Daten3y: / - . >•0 1 _ r _ �r
Phone: 503.718.2439 Fax: 503, Plan Review
Ins ection L ine: 503.639.4!75 .DING DIVISION Date/By: O t h er P
TIGARD
P C L�� /�03
r.gov
Notified/method: Date Ready/By: ®See Page 2 for
Internet: www,tigard- o t;
Supptemeolal Information
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Mechanical permit fees" are based the value of the work
❑ New construction e Addition/alteration/replacement
El Demolition performed. Indicate the value (rounded d to the nearest dollar) of all
❑ Other: mechanical materials, equipment, labor, overhead, and profit.
�. i �X F .�`� .
„ '4 ' ; % 1 1 �ta�,, sik; i� M PI' aa u a; tf44'li 6 s ` a ' P4 , I`R 'e+ � ` Value: S
►5 1 and 2-family dwelling s :. o,t L fiu ' 4 . �` L ai L a v g � 2, ; 14? ' z� 1 ,
I Y g ❑ Commercial/industrial ❑Accessory building For sech .t } 2�.
❑ Multi family ❑Master builder vedal fa ormation use checklist
❑ Other: Description
�,� � tiYG�'��'�tt " � ^ "ff-� y rr�3�,�- r.��� , 2 � -.�• a r I M OOII Qty. I E9. � Total
'•-i b '�u S l'd/�S�f�? '35`x; f,' A v t ' y��+1� � t' { �'J \ h [In ® ) '.4 =t . � ; r � l5Wi * Headng/c nQ�:
1 r'. �',1 GJi:�i c tz r S• '^a -'P .- .id,
Job site address: 12290 SW QUAIL CREEK LANE Air conditioning
(requires site plan showing placement) 46.75
City /State/ZIP: TIGARD OR 97223 Furnace 100,000 BTU (ducts/vents) 46.75
Suite/bldg. /apt. no.: I Project name: T &M Heat pump 00+ BTU (ducts/vents) 54.91
pump
Cross street/directions to job site: (requires site plan showing placement) 61.06
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. 46.75
Subdivision: 1 Lot no.: Flue/vent for any of above 23.32
T T Tax map /parcel no.: Other: 23.32
rS) :h1 ? c c i y p nt Other fuel appliances:
i x 17,7ftl lt+ l jfi'� M it>i�•{. r. F t i t' C P r }P`.�' T I i { y tMt c��i: �.4 �� i
�.� 5, r_ su z .,sIL+ �t`4ua° �,. l�. a ' =;5 Water heater 23.32
INSTALL 11000 FOR RANGE AND MAKE UP AIR FAN Gas fireplace/insert 3139
Flue vent for water heater or gas
■
fireplace 23.32
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Log lighter (gas) 23.32
Wood/pellet stove 33.39
m j -- �. Wood fireplace/insert 23.32
�' t o Y�_ g-n +P�`i ��G q `t' 1z �s�`'t�"'r` !'fir, , NE „ a',3 ,- 1 j Chimney
' /l incr /flue/vent 23.32 _
w't
Other 23.32
i Name: CORY WYATT
Environmental exhaust and ventilation:
- Address: SAME AS ABOVE Range hood/other kitchen
City /State/ZIP: equipment 1 33.39 33.39
I Clothes dryer exhaust 33.39
Phone: ( ) Fax: ( ) Single duct exhaust (bathroom,
at�' Gw toilet compartments, utility rooms) 23.32
I f } ihi " IGIb �8 i :i ilu ( ?J i = i� INV,IO f 'o s d
s. :u, L.,,... - i<.c sli.3 - :,�•+I =i -,It: u Ifffri ti t!31G L,� ,i,' J , 1tt,.iulkui i9} AttielcrawispaCe 23.32
Business name: HEAT RELIEF Other. !MAKE UP AIRFAN
1 23.32 23.32
Contact name: KARINA GRANT Fuel piping:
I $14.15 for first four; $4.03 for each additional
Address: 13122 NE DAVID CIR €1800 Furnace, etc.
City /State/ZLP: PORTIAND OR 97230
Gas heat pump
I Wall/suspended/unit heater
I Phone: (503) 261 -9915 I Fax: : (503) 261 -9814 Water heater
I t I E -mail: HROFFICE@HEATRELIEFTODAY.COM Fireplace
;,; C:r'1,�'�f::�` 1` y �l , CY' i Si , "� J; ;>r:rc�. �4:Kt r",r,.., �y Range
'li 'riEaw•i: TAB :iS;d;F t i a��VJ�ifL r � %'4u�'I� / t 1,I 'lS:i✓ ,`)�. i Eik y ,r ' 'ia.7'fi. :7 , , I � 1 7 ., .. r ` ,
.aka ,11..cS..- 1.:,.�1v , i�. .t,iv' 4 ,t.iki� .,wr_`...t., .:t rf; .-
1 = .' ; Barbecue
Business name: HEAT RELIEF Clothes dryer (gas)
Address: 13122 NE DAVID CIR 11800 Other ?
•ii / �','1V� r�� l,II BPI�,I�Pi'N)�cK�3si q�
City/State/ZIP: PORTLAND OR 97230 Subtotal 56.71
Phone: (503) 261.9915 f Fax: (503) 261,9814 Minimum permit fee ($90.00) 90.00 •
CCB tic,: 122424 / Platt review (25% of permit fee) 0.00
State surcharge (12% of permit fee) 10.80
Authorized signature:
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j_._c_....... PERMIT FEE 100.80
Print name: MARK DEFRANCISCO h • s permit application expires if a permit is net obtained within 180
--- ---- ._...._..._..._.........._. --- C.I_------- .- : - _-------- ate:-. 04102/ - - - -.- 1__- days after ithea. keen. accented _aaremntam____._--- --.- ----- - --