Permit Support Document CITY OF TIGARD MECHANICAL PERMIT
• 3 COMMUNITY DEVELOPMENT Permit#: MEC2020-00321
TIGAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 7 ? 7..,) 4,Q Date Issued: 06l01/2020
Parcel: 2S111 CB01744
Jurisdiction: Tigard
Site address: 10365 SW HOODVIEW DR
Project: Gas pressure Subdivision: HOOD VIEW NO.2 Lot: 43
Project Description: Installing a pressure regulator for the house line to seperate from the pressure of the exterior line, 7/7/2020:
REPRINT permit to add (1)fuel piping for outdoor fire pit.
Contractor: ALEXANDERS GENERAL CONTRACTING CO Owner: KLOSTERMAN, FRITZ K
3807 NE 151ST AVE 10365 SW HOODVIEW DR
VANCOUVER, OR 98682 TIGARD, OR 97224
PHONE: 360-635-1982 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Minimum Fee Adjustment-Mechanical 06/01/2020 $75.85
Type of Use: SF Fuel Piping 06/01/2020 $14.15
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 06/01/2020 $10.80
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: � Permittee Signature: �,ti/ 4�L i�'%7C)
•
JJJ/// 111 Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application I ()1{ 01 l t 1( 1 I S I 17\i '.
City of Tigard ;�-' '' 4 `i . '-_` Daieiey 7/7/Z0 .d t' Permit No
® F�ECZo20-G032/
III • 13125 S W Hall Blvd.,Tigard,OR 97223 2 2 O Plan Review
Phone: 503.7182439 Fax: 503.598.1960' ^J 2 2 Date/By: Other Permit:
t I c;',RI) Inspection Line: 503.639.4175 ff _ Date Ready/By: funs: BI See Page 2 for
Internet: www.tigard-or.gov 4 I 1 !' ( i ! ' ) Notified/Method: Supplemental information
fr-,i-`I
TYPE of WORK COMMERCIAL EEP.` SCHEDULE- USE Ctit•.CKLIST
Mechanical permit fees;are based on the value of the work
❑New construction , ,Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit.
❑Demolition ❑Other:
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL.EQUIPMENT 1 SYSTEMS FEES"
ice-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family 0 Master builder ❑Other. Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooing:
c' l� � Air conditioning 46.75
Job site address: , 0 31,5 �.7lS C�U 1,�31 Z c Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: V.I ,G froa VI Duct work 23.32
Cross sheet/directions to job site: w Hydronic hot water system 23.32
Residential boiler(radiator or
hydronic) 23.32
Unit beaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32
Other: 23.32
Subdivision: Lot no.: Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
'�DESGRIFFION OF WORK E, " Gasfireplacelinsert 33.39
Flue vent for water beater or gas
'P l� t�CD `(D l fireplace 23.32
Qe�� I `\u� �R J JI C r�C ) Log lighter t sto(gasve
23.32 .
/� Wood/pellet stove 33.32
b-1'./L-QJJ J���1 Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
O her: 23.32 .
PROPERTY OWNER ` ,rillTENANT f•,' Environmental exhaust and ventilation:
Name: p yC \ Range hood/oth�kitchen
�+lr - G -`�J e''� � m equipment 33.39
Address: 1 V '.3(‘J S at--) 4Ao4 V'l ell �,,- Clothes dryer exhaust 33.39
Single-duct exhaust(bathrooms,
Gty/State/ZIP:
�r.,At J'� toiletcompartments,utility rooms) 23.32
Phone:(3(00 1t///� , 9$Z Fax:( ) Attic/crawlsamce fans 23.32
❑ APPLICANTS' 0 CONTACT PERSON' "° Other: 23.32
J Fuel piping:
Business name: pxa pr)p ( Ct r� $14.15 for first four;S4.03 for each additional
Contact name:, DiYYY�7�� G��`e)�y J Furnace,etc.
N,. i S -�� ', Gas heat pump
Address: i Wall/suspended/unit heater
City/State/ZIP:3 QJ1 uverv'�Jr1 rr � 9 08� Water heater
Phone:(3(,p 6 ,3,5 l / g®� `�Faax:::( ) Fireplace
E-mail: a/exaIrlcjelrS (iJ�vl(115� r n' ni 1- Corn Barbecue
LI CONTRACTOR r^ Clothes dryer gas) 40 Ton i
Business name: 14'XUr��Y /Ind!1 4 ri 1t Other • a�E FES°
Address: `� 1 J '. �i/e, Ott` III'�22'!!!! -���llll } Subtotal
City/State/ZIP: V /1 vI eDvt vVf,Q�- cliAlii r r r) c Minimum permit fee($90.00)
VVULLL 44 ", • Plan review(25%of permit fee)
Phone:(r /03 —)98(9 Fax:( State surcharge(12%of permit fee)
CCB lic.: ,.. D$ TOTAL PERMIT FEE
/ This permit application expires if a permit is not obtained within 180
(// days after it has been accepted as complete.
Authorized signature:ur '4 ° Fee methodology set by Tri-County Building Industry Service Board
Print name:serer t A i_p c-1 i'fJ1i- Date:6'7 2UZe
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