Permit CITY OF TIGARD MECHANICAL PERMIT
.114
n . COMMUNITY DEVELOPMENT Permit#: MEC2013 00482•
T[GARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/19/2013
Parcel: 2S114AB03000
- Jurisdiction: Tigard
Site address: 16415 SW 93RD AVE
Project: Manghelli Subdivision: KNEELAND ESTATES Lot: 17
Project Description: Install gas piping for range.
Contractor: A 1 INSTALLATIONS NW LLC Owner: MANGHELLI, DONALD L AND
15842 SW UPPER BOONES FERRY RD BARBARA A
TIGARD, OR 97224 16415 SW 93RD AVE
TIGARD,OR 97224
PHONE: 503-620-5657 PHONE:
FAX: 503-620-1696
FEES
Specifics: Description Date Amount
Fuel Piping 08/19/2013 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 08/19/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/19/2013 $75.85
Occupancy Grp:
Stories:
Fuel .
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: l Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
08/19/2013 10:58 5036201696 //��EJ d jj� Al INSTALLATIONS NW PAGE 01/01
ch
Meanical Perm ��
it,Af]DIiC8tiolt��'A ED FOR OFFICE USE ONLY
City of Tigard Received
13125 SW Hall Blvd.,Tigard,OR 97223 AUG 19 7 013 Date./3y: Ur Permit Ng/y�� /�3�O .��
Phone: 503.7182439 Fax: 503.598.1960 c" Plan Ravi
Inspection Line: 503.639.4175
Date/By: Other Permit:
T1C;A1:D p CITY OFTIGARD Date
Internet: Line:
gard 3941 see Page 2 for
BUILDING DIVISION Notified/Method: Supplemental Information
ti .F2..-,'i�,. 'rr)_Iu�.iSSiei;::• :ifzr��iT, '<,t_._y''�, 7,7i ,ATM+,-._� .,ny ..:.�e�•. - �y}.,'eRrdr�:`�,,, ,-JL$, - -
...., 4;.?rp A-.luj.d ,r':.al: C:it �{T. i R 5=�t�,1�(.9d'n -
"'"-'-'-°.1 '' v `','' `P......,--9, 7.' iruzl per l e -ui:n �¢.ua-.e+'''. ..
�❑New construction Mechanical permit fees'are based on the value of the work
®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials .ui.men labor,overhead.and .rofit.
_:....,-:•:.tie'== =a';*�_!13- _ �:x ,x value:S
.z,.:.;:.,•i; ,;54.,: rrc_,-..,n'T.It'� .,rte x5,.a: ; yi.- - "
-and 2-family �,..,,...k-_. ._... � a'�L�- -,;'•'�a':i ,j'�'., ��fE117 � .r::..,
® amily dwelling ❑Commercialindustrial '�` - `ialf "o _e c
❑Accessory building For special information tr3s checklist
❑Multi-family ❑Master builder ❑Other: Description
Descr i tion
Qty. Ea. Total
:-., _ . ,.'3V-!:,g_s li r�. � roIr M1 _ i 7 _-J ur .
.73-,+ Ieati r "'Win"
Job site address:16415 SW 93'iD AVE lair eonditionin:
Furnace 100 000 8113 ducts/vents 46.75
City/State/ZIP:TIGARD,OR 97224 Furnace 100,000+BTU ducts/vents) 54.91
Suite/bldg./apt•no.:- I.Project name:MANGRELLI Rem' 23.32
Duct work 23.32
Cross street/directions to job site:SW MILLEN H dronic hot waters 23.32
Residential boiler(radiator or
-
h dronic 23,32
Unit heaters(fuel-type,not electric),
in-wall,in-du. su .ended,etc. 46.75
-
Flue/vent for an of above 23.32
Subdivision: I Lot no.: Other: 23.32
, Other fuel a..fiances:
Tax map/parcel no.:
,;::::..;r ."._.''- =... �_tY,' "�•.
Water heater
;:.� - r - ap- :��Ll/ l: ; pM s`ID N? Gas fir •lace/insert 33.39
, - 31 •-s'+ -�_iwi•,--.. nT--.-.c. •
flue vein fo water heater or gas
INSTALL GAS PIPING FOR A RANGE
fire•lace 23.32
. Enr1 23,32
-
Wood/.Het stove 33.39
Wood fi -•lace/insert 23.32
Chimney/liner/flue/vent 23.32
Other: 23.32_:a c:40..:4 Q• " rr .�!At - - .% . : t)ir"`....:.,_.` , m ""' - z `• Environmental exhaust and ventilation:
Name: - Range hood/other kitchen
Address: -•ui,ment 33.39
Clothes d r exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet corn.: ents utili rooms 23.32
Phone:
.r:::.::r _.•.a•.'. ) _ _ "•c=, Fax:
( )
Attic/crawl .ace fans 23.32
' .......u,,,,.' :tom.� =F-i��: .„. aE � a an(�`=-. _ ti •. Other: 2332_- ..�►1 _ - i Ir 50 • - ,},..; e:,. .i .„
Business name:A-1 INSTALLATIONS NW LLC Fuel i.i$•
' S14.15 for first four;54,03 for each additional
Contact name:PAUL ROCHELLE REMMIIIIIIMI _
Address:15842 SW UPPER BOONES FERRY RA
wall/sus.ended/unit heater
City/State/ZIP:LAKE OSWEGO,OR 97035 Water heater
Phone:(503)620-5657 r I_ Fax::(503)620-1696 Fir •lace
OrallilillIMI
E-mail:alinstallations@gmaiIcom 1 14.15 14.15
, = Barbecue
:,:n2,1:M ar:.: 71 �_ w p - ( _ ��-;^�
to 41 '{r:-�� �l"4R�-..
Business name;A-1 INSTALLATIONS NW LLC Other:
"iii:_•. Yq".. .-._...... ,...
Address:25842 SW UPPER BOONES FERRY RD
r °�::__t.l „�;. 4 ' . �l _R biota ;=•;.:': .:
Subtotal 14.13
. City/State/ZIP:LAKE OSWEGO,OR 97035 Minimum permit fee($90.00 90.00
Plan review(25%of permit fee)Fax:(503)620-1696 )
State surcharge(12%of permit fee) ,10.80
CCB tic.:186516 9s9/g _ TOTAL PERMIT FEE 100.80
This permit application expires if a permit t9 not obtained within 180
days after it has been accepted as complete.
Authorized signature: • Fee methodology set by Tri-County Building Industry Service Board
Print name: r- •,Q// /'-C L[c//& Date: r--//. %�
L\9uiWu.y'Perm t,'MLC PPermliApp_Q4OI I3.doc rTG ") 440-4617x(11/ovCO/WM/wr;B)