Permit •
STY TIGARD
��R � �! MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00471
+R, DATE ISSUED: 7/31/2007
G D 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S103CD -02500
SITE ADDRESS: 13775 SW 116TH PL ZONING: R -4.5
SUBDIVISION: HOLLYTREE LOT: 007 JURISDICTION: TIG
PROJECT: VOYTKO
Project Description: Gas to range.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?:, 30 - 50 HP: WOODSTO UNITS:
GAS PRESSURE: 50 + HP: COO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 0
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
JENNIFER VOYTKO Description Date Amount
13775 SW 116TH PL.
TIGARD, OR 97223 [MECH] Permit Fee 7/31/20M $72.50
[TAX] 8% State Surcha 7/31/20W $5.80
Total $78.30
Phone: 503 -NA
Contractor:
MP PLUMBING CO
PO BOX 393
CLACKAMAS, OR 97015 -0393 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 655 -9161
FAX 503- 650 -7050
Reg #: LIC 5002
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By:
&'//Leed• ��,s /[�f� Permittee Signature: Al I .IP 1 •
Call 503.639.4175 by 7:00 a.m. for inspections 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.
From: 07/31/2007 08:25 #465 P.004/004
•
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Mechanical Permit Application � E. � � , € � :I ' 1 , ' ' �� � ;� �� . '
City of Tigard JIJ ) _ Received 7 PermirNv.:
13 125 SW Hall Blvd., Tigard, OR 97223 ` 1 C Of Date/By: .3' /1 Et- �.+r - • ri�.1
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 C ., xvtf.,.. 141 � °a Date/By: Other Permit
Inspection Line: 503.639.4175 e�,t`7jp', ,'' a cl I i Date Ready
Internet: www.ci.tigard.or.us `` ° 1 p Notif �� Supplemental See Page l information
.
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❑ New construction Addition/alteration/replacement Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other mechanical materials, equipment, labor, overhead, and profit.
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0 1- and 2- family dwelling ❑ CommerciaVindustrial ❑ Accessory building PII;I�II ! " " " " " ° "` ! "' � : °1 ° �� 1' I
El Multi - family ❑ Master builder ❑ Other:
For special 1>ljormarion use checklist.
Jr: ! };il7` e a ^ i a •_ -s• c' ( ! e u, tl Sf r r •s :euer,a.o r 1< r�rst 9 R , t rt , ,yl ax I tl !, { u ,i Heating/co
t Description I Qty. I Ea. I Total
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Job site address: � 377C - do //b 6 /.l • Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: '7 - Ae 97/ l3 Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: I Project name: c ijiy r i 7/10 100,000+ BTU ( ducts/vents) 17.90
v f� �'° Gas s b hea eat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.. Flue/vent for any of above , 10.00
Other. 10.00
Tax map /parcel no.: Other fuel appliances
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� ,. � ! , I ll1 � � � .,,_ t411S „illy �l till I �L ... � � �.. . � �,��, � Water heater 10.00
/L - � , v � � 4 n � w 2 ® U �0 Flue vent for water heater or gas
Gas fireplace 10.00
O.t ,<
• o fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
!` � 1 S t! 11 .. , x, a sn r is e a! i rt ii .. }' • ! e.. an � ` l; , h /liner /flue/vent 10.00
i Y �ul
�i ititOQp 1 .310 ,, ani ►�lE:z€iiliii �' II (� 1�,;..A10 , 100 111 ' Ot h er
r n...,.f n. +1 f d m is:.i n..ttxi. e..S to R.. I,....., n.r iv r a 3 I b } Other , 10.00
Name: a�� /! / � 4Q Environmental exhaust and ventilation
Address: �" Rangehood/otherkitchen
equipment 10.00
City /State /ZIP: 411 Clothes dryer exhaust 10.00 _
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility moms) 6.80
MGM i .:, r r - 'PC 11 r' °1i' T 'at K J e t '' 1 i y t t*x e I f : ! • 1
,: f s11jj1 nn l I01 ¢, (�E a r a +{ , ,{ t i l F! i e g N' L RSOIiI { l i 111 i(!: Attic /crawlspace fans 10.00
is±lE 11 ���+;,'�`Illl�l�h'-�• :. .,,..t.5. �. .. � alf,`n,! A�iE @n t �l� l.ilil�frl�3 -�{ �.�'3�1:it�:�rl�l., .. -^ l a� u, ,1�. - � = :., Lv,tl,�t, ...n 1 . t�lf'+.' i .if3t '
Business name: MP PLUMBING CO. Other 10.00
Fuel piping
Contact name: TAMI $5.40 for first four; $1.00 for each additional
Address: PO BOX 393 Furnace, etc.
Gas heat pump
City / State/ZIP: CLACKAMAS OR 97015 Wall/suspended/unit heater
Phone: (503) 655 -9161 Fax: : (503) 650 -7050 Water heater _
_Fireplace
E -mail: Range 1 , ,
l 1 l' ,.� i w-� et M n ! } a ! x tr I{
111•111(4011! 11111 X11111101 ' �1; �� ►, ' ,IMI jl�l IBINNiil i 1E IIIM RAINIIIIIIIIIIK Barbecue
Business name: MP PLUMBING Clothes dryer (gas)
- Other:
r '' , T cHbf ,.l NT,1�,, i Yx.•��, -tc�'' 1 - ,f
Address; PO BOX 393 (al!r 11If(11;1 INt ti�ti`t! sO Ys"!K � i'4l> ll i ll l " Alin!!
City /State/ZIP: CLACKAMAS OR 97015 i Subtotal . �
Minimum permit fee ($72.50) 1 ,2,'7/
Phone: (503) 655 -9161 I Fax: (503) 650 -7050 Plan review (25% of permit fee)
CCB tic.: 5002 qi °71 10 State surcharge (8% of permit fee) ��
• TOTAL PERMIT FEE 7f
'* This permit application expires If a permit Is not obtained within 180
Authorized signature: 2 ® ' " - / /irfi , days after It has been accepted as complete.
Print name: TAMI GEORGE I Date: 1. 30,07 I • Fee methodology set by Tri-Counly Building Industry Service Board
i s1 BuildinglPennits \MEC- PermitApp.dae 12/03 440-4617T(1.1/02/COM/WEB)