Permit CITY OF TIGARD MECHANICAL PERMIT
S COMMUNITY DEVELOPMENT Permit#: MEC2013-00497
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/27/2013
Parcel: 2S 111 CC 12400
Jurisdiction: Tigard
Site address: 10385 HIGHLAND DR
Project: TREICK Subdivision: SUMMERFIELD NO.4 Lot: 175
Project Description: Gas line for dryer.
Contractor: HEAT RELIEF CO Owner: TREICK,TOM EUGENE
13122 NE DAVID CIR#800 10385 SW HIGHLAND DR
PORTLAND,OR 97230 TIGARD,OR 97224
PHONE: 503-261-9915 PHONE:
FAX: 503-261-9814
FEES
Specifics: Description Date Amount
Clothes Dryer Exhaust 08/27/2013 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 08/27/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/27/2013 $56.61
Occupancy Grp:
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:
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.
08/26/2013 MON 11: 40 FAX 5032619814 He Relief Co 12 002/003
•
Mechanical Permit A t t lie';u,1' FOR OFFICE USE ONLY
City of Tigard S ® Received•
4 13125 SW Hall Blvd,Tigard,OR 97223 Plan ale/By: • �7 v 7
1 C Phone: 503.718.2439 Fax: 503.598.1 Data/B view OnerPermit:
Inspection Lint: 503.639.4175 G 2 6 Z 013 1Jate/)d1r Date Ready/By: lode lid See Page 2 for
TIGARD Internet: www,llgatd-or.gov CITY OF TIGARD Notified/Method: pci Supplemental Intbrmatlon
_ ... . ..,:.: ...... .. .. cinY0y,l:;:{y'l1:Vl`i••I}Iar',i:i,l:(:•1:ii511,... '..•.!%,....!......:-x.:.:..:,::..:. .....
• I fth
❑New construction /.• dditiodalteration/r laeement Mechanical permit fees are based on the value o c work
ep performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition [0 Other. mechanical materials,equipment)labor overhead,and profit.
...... .... ,.. .. ... .I; ................................ ........ .. . . ,.....Value:
. , ;c;111:∎ic!"C):;",";;17 :,:"^`I fJ,.II:I I;G),I, ftlyi,Llll JL..,,OC •
. .....,` u.-_
.....dL.J"...1.;...:51rJdii'.�.'?
X-and 2-famil dwelling ❑Commercial/industrial Uindustrial ]Accessory building For Wwnatfon use radk/k :
._.
❑Multi-family ,[]Master builder - ❑Other: - Description I Qty. I E . f Total
Ito,1:,S Vrnc .I,' ,P1 •,a1111e,t v.:i: .10);,,:Cjl!IOIt' - .
i' + i al pRt
. .. ..._......._._ � ........ Ar� IJ conditioning
Job site address: I 0 3 j 14 v,land il„, (remdrea site plan snowfall placement) , 46.75
City/State/ZIP: T 0.V-•i (Q C1•a1� F� 1W,000BiU(duota/valw) 46.75
Fwnace 100,000i-BTU(dueunv•nar) 54.91
Sulte/bldgJapt.no.: 0 I Project name: Heat pump
(requires aite plan snowing plaeamont) 61.06
Cross street/directions to job site: Duct work 23.32
Hydranlo hot water system 23.32
._ Residential boiler(radiator or
hydronic) 23.32
Unit beaters(fuel-type,not electric)),
in-wall,Induct,suspended,etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 23.32
•
Other: 23.32
Tax map/parcel no.: Other Nei
appliances;
ii;l;l:�(i:al:li!LII I :I I; '.ii)I :\; .. Water heater 23.32
$ ere N b.' & -..
Gas fireplace 33.39
� r - kes t. • .t. $ Flue vent for water heater or gas
fireplace 23.32
Log lighter(Ras) 23.32 .
wood/pellet stove 33.39
Wood fueplaceinsert 23.32
:: .. ....... hmtney/linu/fluevent 23.32
iii::1RSIi,JJ J(\i l,!.•r'•!,:I:1:( !� ,11:,,,,,A,1,1
—L. :. Other. 23.32
Name:�p1M ��Q`L,T�, ` � Environmental exhaust and ventilation:
Address; 10 be C.,a S W rT-1 10.r 1 ILL_ , Range hood/other kitchen Oa. equipment 33.39
City/State/ZP:lic&oor � Clothes dryer exhaust 33.39
Single duct exhaust(bathrooms,
Phone:($(oC,St S a 3( , Fax:( ) toilet compartments utility rooms) 23.32 -
-1 :9:.: i,li;:VIII :;;i ;:icitali'At 'i'!fi;11cl;I Attlo/orawlspacefbns 23,32
( 1.
Business name: GI 1 a..1.
Other: 23.32
Nuel plpingt
Contact name: L a 12.t >(G $14.15 for first fours 51.03 for each additional
Address; I ,L23- Ai e, bAy i b 0_4 reeks., ' ) ^&mnee,eta. l pump Gas City/State/ZIP:' ft 4 Jt�d C I. `1'ke) 0 Wall/sutstxnded/uait beater — .
Phone:(G.r$)a(o( C CC ($- I Fax::(605 caw i 412i Water heater
((��r �ll "�` ~Fireplace
E-mail; hf01"C1 cad V •WC !l'. k• a • r + ..t. Range
i?!:I );;'•;I 1111E Barbecue •
Rat Clothes dryer(gas) i
t
Business name:
Address ` Other
2
City/Stata/ZIP:'Ry layua 04 cil-„DZO Subtotal q'V.cxi
41%14 ' Minimum permit fee($90.00) 4-0 O d '
Phone:(G��.wl O\C s I Fax:(SoN a(9` Plan review(259'0 of permit fee)
CCBlie.: 1aD.-Li ait State surcharge(12%ofponnit foe) 10 ' )
TOTAL PERMIT FEE toot $0_
Authorized signature 'fhb permit application aspires if a permit is not obtained wlthta 180
days after It his been accepted as complete.
■
I Print name: L. relr a L I Dater 13 I ' • Fee methodology set by Tri•C,ounty Budding Industry Service Board
1A.BofldingWermitAMEC armiLApp.dec 09109/10 4404617T(I1/o/comwas) ,