Permit CITY OF TIGARD MECHANICAL PERMIT
: • • ' COMMUNITY DEVELOPMENT Permit #: MEC2009 -00624
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 11/24/2009
Parcel: 1 S134DB01100
Jurisdiction: Tigard
•
Site address: 11045 SW 114TH PL
Subdivision: WINTERS ADDITION Lot: 5
Project: Conner
Project Description: Install wood insert and venting.
Owner: FEES
CONNER, STEVEN L Description Date Amount
11045 SW 114TH PL Wood Fireplace/Insert 11/24/2009 $23.32
TIGARD, OR 97223 12% State Surcharge - Mechanical 11/24/2009 $10.80
PHONE: 503 - 552 -5366 • Minimum Fee Adjustment - Mechanical 11/24/2009 $66.68
Contractor:
ALL FUEL INSTALLATION & SERVICE LLC
PO BOX 69
TROUTDALE, OR 97060
PHONE: 503 - 674 -2350
FAX: 503 - 674 -2693
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Other
Gas Pressue:
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 -0100. You may obtain a copy of the rules
or direct questions to by calling 503.246.6699 or 1.800.332.2344.
issued By: (1 ni 9 (I I t .j Permittee Signature: Sg 9 App
Call 503.639.4175 by 7:00 a.m. for an inspection that business day.
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.
• h
Mechanical Permit A 1 Ili �ii-'47t j! i 1. D FOR OFFICE ONLY
ONL
1,1 City of Tigard � EBRIIIIIIIIIII _ 1 " ,
• 13125 SW Hall Blvd., Tigard, OR y> i 4 119 Q 2009 J J ' 1 , r
n1 �
C �'(�[� Plan Review
Phone: 503.639.4171 Fax: 503.598.1961 9 Da,e/By. Other Permit:
TI G A R D Inspection Line: 503.639.4175Cr a p n Date Rcady/By: la See Page 2 for
Internet: www.tigard- or.gog li a t "- t b ARD Notifled/Method il Supplemental Information
V SION
TYPE OF WORK ; COMMERCIAL FEE* SCHEDULE - USE CHECIQ.IST
❑ New construction ® Additionialtcration/replacement Mechanical permit fees' are based on the value of the.vork
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
Value: $ $1,137.00
CATEGORY OF CONSTRUCTION .
® I - and 2 dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial /industrial ❑ Accessory building
❑ Multi - family ❑ blaster builder ❑ Other: Tor special information use checklist.
! Description !' I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION ; Heating/cooling
Job site address: 11045 SW 114 Place Air conditioning
(requires site plan shoeing placement) 46.75
City /State/ZIP: Tigard, OR 97223 : Furnace 100,000 BTU (ducls&vents) 46.75
Furnace 100,000+ BTI: (duus%rcnts) 54.91
• Suite/b]dgJapt. no.: Project name: Heat pump 61.06
• Cross street/directions to job site: Ductwork 23.32
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: I Lot no.: Other: f 23.32
Tax map/parcel no.: • Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Gas fireplace 33.39
Install new wood insert and venting Flue vent for water healer or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 1 23.32 23.32
® PROPERTY OWNER I ❑ TENANT Chimneyl'linerfilue/vent 1 23.32 23.32
Other: 2332 •
Name: Steve Conner Environmental exhaust and ventilation
Range hoodiother kitchen
4ddrs: Same as above equipment 33.39
-
City/State/ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: {503)579 -3418 Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attickrawlspace fans 23.32
Business name: Sec below Other: 2332 _
Fuel piping
Contact name: 514.15 for first four: $4.03 for each additional
Address: Furnace etc
-- - -- Gas heat pump _ _
City /State/ZIP: Walllsuspended/unit heater
Phone: ( )
1 Fax:: ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue 1
Business name: All Fuel Installation and Service
Clothes dryer (gas)
Other:
Address: PO Box 69 MECHANICAL PERMIT FEES"
City/Slate/ZIP: Troutdale, OR 97060 Subtotal 46.64
Phone: (503) 674 -2350 I Fax: (503) 674 -2693 Minimum permit fcc ($90.00) 90.00 -
Plan review (25% of permit fee)
CCB lie-: 169503 State surcharge (12% of permit fez) 10.80
V
�-- TOTAL PERMIT FEE 100.80
Authorized signature: This permit application expires if a permit is not obtained within ISO
' � days after it has been accepted as complete.
Print name: Eric Camp Date: 1120/09 • Fee methodology set by Tri County Building Industry Scr ioe Board
1.' cBuildins \ Perm itslMHC- PecaitApp.doe 1010'. /09 1 L /'�.. 61:FT(11 :azcoM/wFB)
£'d £69ZtL9£09 � uone fe)sui lend Ilb' OL£:90 60 OZ AON