Permit Hof °z CITY OF TIGARD MECHANICAL PERMIT
' :3 ,:: COMMUNITY DEVELOPMENT Permit#: MEC2015 00838
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439
Date Issued: 12/17/2015
Parcel: 1S125DA04200
Jurisdiction: Tigard
Site address: 9410 SW 69TH AVE
Project: Schlect Subdivision: KINGS VIEW Lot: 27
Project Description: Installation of gas line for new range.
Contractor: J &M CONTRACTOR SERVICES INC Owner: SCHLECT, BRIAN M& KELLY M
15604 NE REID RD 9410 SW 69TH AVE
AMBOY,WA 98601 TIGARD, OR 97223
PHONE: 360-263-5600 PHONE: 971-400-3169
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 12/17/2015 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 12/17/2015 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 12/17/2015 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuanc- e L ork is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
y Notification C-'ter. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to O 1,' ., calling 503.232.1987 or 1.800.332.2344.
Issued By: ,v/ Permittee,Signature: 1A./ ,
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Call 503.639.4175 by 7:00 a.m.for the next available ins• tion date.
This permit card shall be kept in a conspicuous place on the jolisite until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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Mechanical Permit Applicati li ' C I %E FOR OFFICE ITSI ONLY
City of Tigard Received
®� � Permit No.J/
13125 SW Hall Blvd.,Tigard,OR 972231 /�� ��
C ;n,- Plan Review
' Phone: 503.718.2439 Fax: 503.598.196 r 1 i ; •1 Date/By: Other Permit:
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: Juris:
Internet: www.ti ard-0r. ov A@� �' y_ Supplemental
See Page 2 for
g g CITV d Uf IIG A di°t Notified/Method: Supplemental Wormation
RUILIHNIC 9JV B�)1`
WORK
TYPE OF WORK a
4 B COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
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Mechanical permit fees*are based on the value of the work
0 New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition 0 Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
® 1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other: Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION - Heating/cooling:
Air conditioning 46.75
Job site address:9410 SW 69th Ave Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Portland OR 97223 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:
Duct work 23.32
Cross street/directions to job site:SW Taylors Ferry Road 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
Flue/vent for any of above 23.32
Subdivision:Kings View Lot no.:Pt 27 Other: 23.32
Other fuel appliances:
Tax map/parcel no.:655/H/1 R0230315 Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert 33.39
Flue vent for water heater or gas
Gas line to range on main floor above crawl space with existing gas water heater fireplace 23.32
and furnace Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
® N
PROPERTY OWNER 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name:Brian&Kelly Schlect Range hood/other kitchen
equipment 33.39
Address:9410 SW 691°Ave Clothes dryer exhaust 33.39
City/State/ZIP:Portland OR 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(971)400-3169 Fax:( ) Attic/crawlspace fans _ 23.32
® APPLICANT 0 CONTACT PERSON Other: 23.32
Business name: Fuel piping:
$14.15 for first four;$4.03 for each additional
Contact name:Kelly Schlect Furnace,etc.
Address:9410 SW 69th Ave Gas heat pump
Wall/suspended/unit heater
City/State/ZIP:Portland,OR 97223 Water heater
Phone:(971)400-3169 Fax::( ) Fireplace
Range 1 14.15 14.15
E-mail:kellyschlect@gmail.com Barbecue
CONTRACTOR Clothes dryer(gas)
Business name:J&M Contractor Services Other:
MECHANICAL PERMIT FEES*
Address:15604 NE Reid Road
Subtotal 44.15
City/State/ZIP:Amboy,WA 98601 Minimum permit fee($90.00) 90
Plan review(25%of permit fee) -390'
Phone:(360)263-5600 Fax:( ) State surcharge(12%of permit fee) /V„{'O+7*"
CCB lie.:188595 lt(4iI1r\ TOTAL PERMIT FEE A093"1.
Authorized signature: Ik , This permit application expires if a permit is not obtained within 180
Q days after it has been accepted as complete.
�J,u✓v" ' * Fee methodology set by Tri-County Building Industry Service Board
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