Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00183
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/11/2012
Parcel: 2S114AB14600
Jurisdiction: Tigard
Site address: 9370 SW JULIA PL
Project: Hval Subdivision: KNEELAND ESTATES NO.2 Lot: 101
Project Description: Relocate and run new gas line to existing furance, water heater and range.
Contractor: SKY HEATING & AIR CONDITIONING, INC Owner: HVAL, GENE
1637 SE NEHALEM ST 9370 SW JULIA PLACE
PORTLAND, OR 97202 TIGARD, OR 97224
PHONE: 503 - 235 -9083 PHONE: 503 - 995 -8123
FAX: 503 - 235 -0454
FEES
Specifics: Description Date Amount
Fuel Piping 04/11/2012 $14.15
Type of Use: SF 12% State Surcharge - Mechanical 04 /11/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/11/2012 $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, 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: .
•
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.
04/10/2012 09:46 5032350454 SKY HEATING AND AC PAGE 02/02
A \{ .4C P.
Mechanical Permit A p p l i c a t i o n , , � � " ' ' " ' " ( l
City of Tigard if � �� �� - - p. y /o `; ':'7 s�.,n;tNO � , 641
N i 13125 SW Hall Blvd.. Tigard. OR 972 \ / Q � _° Phone: 503.718/439 Fax: 503598.1 Q� NA Date Other Permit
.,. i i , Inspection Line: 503.639.4175 Q` ON ,-"c)' Ewe Rpa 3y ee Paipo rvr
Inter www.tigard-or.gov 6 �v NntifiednvicalaL ®3 pt tal 2 information
Mechanical permit fees* are based on the vahre of the work
❑ Now construction ® Addition /alteration /replacement perftmned. indicate the value (rounded to the neatest dollar) of all
❑ Demolition ❑ Other. mechanical materials, equipment. labor. overhead, and profit.
y � Valle: S
: '• C.A1 t ' OP CIA1 J4 119 ..
f
® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For speck! i'nfofmation sere checitiLn'
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty I Ea. j Tom
JOB 'TF. I * .1t ,: O�CAt RO' : • ; Hesdnigeaoliat: •
Air conditioning
Job site addr>:ss: 9370 SW JULIA PLACE (requites site plan showing ptacaws° 46.75
Furnace 100,000 WTIJ (ductrlvcn) 46.75
City/State/ZIP: TIIGARD. OR 97224 Furnace 1 00.On0+ BTU (ducts/rrent° 54.91
Suite/bldg./apt. no.: J project name: BVAL Heat pump
(requires site plan shooing placement) 61.06
Cross street/directions to job cite: Duct work 23.32
Hydronic hot water system 23.32
Residential holler (radiator or
t rdronic) 23.32
Unit heaters (fuel-type, not electric),
in - wall, induct, suspended, etc. 46.75
Subdivision: Lot Flue/vent fa any of above 23.32
no.:
Other, _ 23.32 -
'fax map/parcel no_: Other feel appliances: _
q i Water heater 23.32
RELOCATE AND RUN NEW GAS LINE TO EXISTING FURNACE, WATER Flu fie vent for nt for water 33.39
luter heater or gag
HEATER AND RANGE. fireplace 23,32
Log lighter (gas) 23.32
Waod/polct stove 33.39
Wood fireplace/iinsert 23.32
• • • ` II ilas [ .. : Chimney/liner/Rue/vent 23.32
� -- ° Other 2332
Name: JOHN & BARBARA LRVAL Environmental exhaust and ventilation:
Address: 9370 SW JULIA PLACE Range hood/other Idtchen -
cgaipmort 33.39
City/State/ZIP: TIGARD, OR 97224 Clothes dryer exhaust 33.39
Single-duct exhaust ,
Phone: (503)995 -8I23 Fax: ( )
toilet co ipaartnents, utility rooms) 23.32
is APPUCA10t. .. , Q . tier. 1PIO1s • `. • Attic/crawlspace fans 23.32
Business name: SKY HEATING & A/C, INC. (Wm: 23.32
Fuel piping:
Contact name: TAMI HAGEMAN S14.15 for first flair; 54.13 for each additional
Address: 1635 SE NEHALEM ST. Furnace. etc. l
Gas heat wimp
City /Stale/ZiP: PORTLAND, OR 97202 Wall/suspended/unit heater
Phone: (503) 235 -9083 Fax: : (503) 235-0454 Water heater 1
Fireplace
E -mail: TAMiG SKYBEATiNG.COM • ez i
•
Barbecue
Business name: SKY BEATiNG & A/C, INC. Clothes dryer (gas)
Other:
Address: 1635 SE NEHALEM ST. : .
City/State/Z_iP: PORTLAND, OR 97202 _ Subtotal 14.15
Phone: (503) 235 -9083 Fax: (503) 2350454 Minimum permit fee ($90.01) 90.00
a Plan review (25% of permit ftx)
CCB lie.: 50244 State aurehame (12% of permit foe) 10.80
1 TOTAL PERMIT FEE 1.00.80 ..,'--
Authorized signataue:
C J This permit appEaditm eapirm if a permit in not obtained 100111189
days arise It has been accepted as complete.
I Print name: TAMI RAGEMAN 1 Date: 4/10/12 - • Fee methodology set by Tri- County Building Industry Service Board
n; INuadinp itOWEEC- PormitAOp.doc 43/07/12 44D Tr (11/172/COM/WISB)
i