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Permit n CITY OF TIGARD MECHANICAL PERMIT ' • COMMUNITY DEVELOPMENT Permit #: MEC2012 00669 - t GARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/18/2012 Parcel: 2S111AD11500 Jurisdiction: Tigard Site address: 8860 SW REILING ST Project: Baker Subdivision: SCHECKLA PARK ESTATES Lot: 44 Project Description: (1) gas insert installation and (1) gas line extension Contractor: NW GAS LINES Owner: BAKER, CATHERINE L 16731 NE WASCO ST 8860 SW REILING ST PORTLAND, OR 97230 TIGARD, OR 97224 PHONE: 503 - 256 -2436 PHONE: 206- 375 -2880 FAX: 503 - 256 -2245 FEES Specifics: Description Date Amount Fuel Piping 12/18/2012 $14.15 Type of Use: SF 12% State Surcharge - Mechanical 12/18/2012 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/18/2012 $52.53 Occupancy Grp: Wood Fireplace /Insert 12/18/2012 $23.32 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: bill j Q pp( / e A ' !Dki Call 503.639.4175 by 7:00 a.m. for the next available inspection date. 7 a 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. Dec 1712 11:33a Tony Young RE CEVED 503 -256 -2245 p.2 Mechanical Permit Application DEC 17 201 City of Tigard �/± � j e t / g I c)-. iriC.- Pcrmit i, —Del4 • 13125 SW Hall Blvd., Tigard, OR 97223 C, r T� ;, , Review Oder Permit: is: Phone: 503 718.2439 Fax 503.598.1960 C'1 L,�utG DWI` rgy. T 1 : \ n Inspection Line: 503.639.4175 u�V V1 Date Ready/By: Supplemental �information a v Internet: www.tigard- or.gov Notifed/Method: . , 0 I TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST Mechanical permit fees' are based on the value of the work ❑ New construction Addition /allerationlreplacenent ' performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: . mechanical materials, equipment, labor, overhead, and profit, Value: S CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT /SYSTEMS FEES* 1- and 2- family dwelling ❑ Commerciab'industrial C Accessory building For special buformetion use checkli.&. ❑ Multi- family ❑ Master builder C Other: Description I Qty- I Ea. j Total JOB SITE INFORMATION AND LOCA 'MN Heating/cooling: Air conditioning Job site addr s: r v (�iJ �' (requires site plan sttowiop placement) 46.75 Furnace 100,000 BTU (duets/vents) 46.75 City/State/ZIP: ,'p / �v Qr Furnace 100,000+ BTU (duds vents) 54.91 Suite/bldg. /apt. no.: Project name: Heat pump (requires site plan showing placement) 61.06 Cross streelldirections to job site: 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: [Lot no.: Flue /vent for any of above 23.32 Other i 23.32 Tax map/pancel no.: Other fuel appliances: _ DESCRIPTION OF WORK Water heater 23.32 _ Gas fireplacelinsert ' 33.39 dr ' i e I // / /. E`- - Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 , Wood fireplace/insert 23.32 TENANT Chimney/liner /flue/vent 23.32 PROPERTY OWNER El TENANT 23.J7 /' � Name: / ryi Q 1J `i Environmental exhaust and ventilation: Address: C / `, // f� ] l I� _ Range hood/other kitchen IG fJ 4_5-4) , /f /, equipment _ City/State/ZIP: d yii j� 4 j/ y' a a 33.39 9 Clothes dryer exhaust 33.39 Single-duct exhaust (bathrooms, Phone: ( ) 375 --„ 810 Fax: ( ) toilet compartments, utility rooms) 23.32 APPLICANT g ©NTACT PERSON Atticfcrawlspace fans 23.32 x /d n /c rpf7sis D,31 fi1W PERSON , _ Fu 23.32 Business name: }y / Fuel piping: Contact name: / i / � 1 �,4 y,‘,64„, 41 514.15 for first four, $1.03 for each additional Address: Furnace, etc. ��' 7 3� �[�1 —(C1 , S �. — Gas heat pump City/State /ZIP: i( / �,,, f) 9' � j23 ^� _ , Wal1 uspcnded/unit beater _ r1 Phone: 1 �(, 5 ` 0fiK CC Fax:: (73 ) . S r "- p J` � Water heater E -mail• / • t / /4C hi] �JX ( /4_57 i 11 e Range • tv� V// CONTRACTOR Barbecue Busine name � � S S Clothes dryer (gas) O dryer Address: /b 73, N dI) E J/ Si- y 97.231 MECHANICAL PERMIT FEES* City /State/ZIP: Subtotal Minimum permit fee ($90.00) . e7tl I Pil ✓ Mile: �) a SL - % �( Fax: (513) 4 f 7? s Plan review (25% of permit fee) Lj 8 CCB lic.: /5"y L g State surcharge (12% of permit fee) II G1 ! TOTAL PERMIT FEE /00 8 CI �� this permit application expires ifs permit is not obtaioed within 130 Authorized si ;mature: � / days after it has been accepted as complete. Print name: / ureic 1./01 t/ Data: /...1// 7/� • Fee methodology sex by TriCounty Building Industry Service Board l- tuilding\Per, itsMEC- PmmnApr. doe 03x7/12 44A46t7r(l /fO /COM/WEB)