Permit (178) CITY OF TIGARD MECHANICAL PERMIT
.11111
1.1 COMMUNITY DEVELOPMENT Permit#: MEC2018-00738
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/13/2018
T r ,�I<.t7 g Parcel: 1S133DA03700
Jurisdiction: Tigard
Site address: 12545 SW GLACIER LILY CIR
Project: KRAAKEVIK Subdivision: AMART SUMMER LAKE Lot: 59
Project Description: Adding heat runs to laundry room and bathroom.
Contractor: BUDGET HEATING Owner: KRAAKEVIK, JEFF&SUSAN
13885 SE 177TH CT 12545 SW GLACIER LILY CIR
DAMASCUS, OR 97089 TIGARD,OR 97223
PHONE: 503-233-3133 PHONE:
FAX: 503-558-9050
FEES
Specifics: Description Date Amount
Duct Work 09/13/2018 $46.64
Type of Use: SF 12%State Surcharge-Mechanical 09/13/2018 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/13/2018 $43.36
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: �� J/ i �ree Signature:
LM&
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.
FOR OFF , . ,
]iCAtiOtt Received l Il����� p �l/
Nieces teal Permit App p 3 ;;018 pate/By: I.� �, rUC)
74
City of Tigard S C i 1 e, �_. a pttt�� ►
Plait Review la H See Page 2 for
*� 13125 SW Hall Blvd.,Tigard,OR 97223 paterBp:
503.598.1960 pate RcadyiBy: Supplemental information
Phone: 503.718.439 Fax: floe Re dyiBy:d:
Inspection Line: 503.639.4175 USE CCKI iST
i I G A r'— Internet: www.tigatd-or_gov * SC RULE
COMMERCIAL EEE
Mechanical permit fres*are based on the value of the work of alt
T : E OF WORK perfctrted.Indicate ilte value(roundott to the nearest dollar)
t-- IL; Addition/alterationtreplacement mechanical materials,:+ui•tnent,labor,overhead,and rofit.
( 0 New construction
I E:1 Other:I 0 Demolition
CATEGORY OF CONSTRUCTIONgESIDE,y7►AL EQUIPMENT!SYSTEMS FEES*
Far special information use
checklist.
Total
Accessory building Qty
0 Commercialiindustriat 0 Description
P, t-and 2-family dwelling0 Other: ��
❑Multi-family 0 Master builder Iieattrr coolin
ORNIATION AND LOCATION Air conditionin ma 46.75
JOB SITE Furnace 100,000 BTU(ductalvents)
c , 6. 5
Job site address: ,tnlliIll Furnace 100,000+BTU(ducts?cents) 61.06
GJr #b Heat.um• i. 23.32
C,ityiState171PtOkr Duca work
Project name: 2'32
5 Cross tdeet/di cti IOW
ResidHydraential
hot waters stem
Residential boiler(radiator or
street/directions to job site: h drank)
Unit heaters(fuel-type,not electric), 46.75
in-wall,in-duct.sus - ded.etc.
Other:
for an of above INN
23.32
Other:
Min
Lot no.: Gther fuel a_'iia?rc ::m®
Subdivision: ����
3339
Tax map/parcel no.: lierffillill11111111111'
DESCRIPTION OF WORK Flue vent for water heater or gas 7lacc 3 37
fire. It:h
1J r01 �°' Lai•hter( as) 1111111111121111111111
Wood/. net stove
33.39
Wood •.130e/insert
f
Chimn• '/liner/flue/vent 23.32
Other:
0 PROPERTY OWNER 0 TENANT oomental exhaust and ventilation:
Range hood/other kitchen 33.34
Name: e.ui.ment
Address:
Clothes d er exhaust 33.39
Single-duct exhaust(bathrooms,
City/State/ZIP: toilet corn. encs,utility rooms _ 23.32
Phone:( ) Fax.( )
Attic/crawl,'ace fans 23.32
0 APPLICANT
CONTACT PERSON Other:
Fuel �i.in:-
Duaine9c name: tt3 fnr each additional
Li-tiny i e-xli?11C��ifJnS 14.ts for first tour;5�..
-- Furnace,etc. rr_
Contact name����.�.i� ����
Address:� 5� Std CIOfl 1Ce-1f 0 LI-
city/state/7
'� walUsus,•tded�unitheater
_.
sy
city/state/�lpP�v�,e , C�2 q�7eo
Phone: �
)J�� q Fax:: . . 1 1111 I 1=IN i I
R ut_e
E-mail: Ell 111111111
la/neweirdl1G1lin.-tnc; ova e0rn Barbecue
CUNT Clothes d er 'as) ��
Business name: , rive C Other: ®�
�J MECB AMCAL FE12MfTEEES�
Address: 2` , - /77M. Subtotal
=I
City/State/ZIP: ( Mintanum 1. --
perm
fee(590.00)
CC- r
Phone•) e'er-3"3 —__3/3.3Far: ' - " Plan review{2Sao of permit fee)
State surcharge(12/o of permit fee) _
CCB lic.: j i 7` • TOTAL PERMIT FEE i /ri
C ! This permit appiicatien esgtres if a permit is not obtained within 181/
""'s dais after it has been accepted as complete.
Authorized signature: w► i f f * Fce melhodotogy set 4y 1"ri-County Building tndustN Service iioarc#
iirammilF
Print name: _ , v'r t- Date: 0 07,00/
1
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