Permit CITY OF TIGARD MECHANICAL PERMIT
.111 s COMMUNITY DEVELOPMENT Permit #: MEC2010 00456
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/07/2010
Parcel: 2S114BA01500
Jurisdiction: Tigard
Site address: 16200 SW GRIMSON CT
Subdivision: PICKS LANDING NO. 2 Lot: 124
Project: Cline
Project Description: 275 gallon above ground heating oil tank on existing concrete with new fuel supply lines.
Owner: FEES
CLINE, JOAN D Description Date Amount
16200 SW GRIMSON CT Mechanical Permit - RES 10/07/2010 $90.00
TIGARD, OR 97223 Plan Review - Mechanical 10/07/2010 $22.50
PHONE: 12% State Surcharge - Mechanical 10/07/2010 $10.80
Contractor:
FIRST CALL HEATING & COOLING CO
1650 NE LOMBARD ST
PORTLAND, OR 97211
PHONE: 503 - 231 -3311
FAX: 503- 286 -5194
Type of Use: SF
Class of Work: ALT Type of Const: VB
Occupancy Grp: R -3
Stories:
Fuel
Fuel Types: Oil
Gas Pressue:
Total $123.30
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 • work,is_suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility 'cation Centel se rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules
or di ct questions to OUNC bb .aHing10 ..46.6699 or 1.800.332.2344.
'
Is ued By: ; I� PermitteeSig
CaII 503.639.4175 by 7:00 a.m. for an inspection that business • ay.
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.
09 / 21 / 2010 TUE 15:52 FAX 5032865194 FIRST CALL HEATING _ 0001 /005
Mechanical Permit A lggicigoilE FOlt OFFI(:E 11S1.; ONLY
City of Tigard Received „
Dato/BT 7 e 0 14 . Perm "* .14 /6 - 6 2 0/0 - JO . 5"
II ---- ° 13125 SW Hall Blvd., Tigard, OR 97223 ,.. , ., - in Rev , Si 1 A
• 111 • Phone: 503.639.4171 Fax: 503,598.1960 , L P 2 i "/ : • D:eigr /V 'A rS1 °ther Pennit iVEC 7 2 0/0 -•- /90 g /-
TIGARD Inspection Line: 503.639.4175
Date Ready/By: IIM am See Page 2 for
Internet: wwwilgard CITY OF TIGARD Notirm(Vmethod: Supplemental Information
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:'.. ! t 1( 0' 5 'Ys: 'YVORK' ::;:, .'' ', COMMERCIAL s iliEt s, :SCHEIAILE - USE CHECKLIST
0 New construction IgAddition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor overhead, and profit.
' ::-. 1. .. :. :?• ' ''‘ i i.; ' . 6 00 6 0iiiI*;:COl i iblit ' UdfHik:fi : ?.. 1 ,i.P■ l ig:04'1:....): . 111,!"; $ . •
s'",s sr RESMEiv /:SySTEMS FEES*
N and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special informsaion use checklist.
0 Multi 0 Master builder 0 Other:
Description 1 Qty. 1 Ea. 1 Total
4 0YislICAti#0044.r 0 0 = ;0. 1 ??,0411010i1 , .?!- , :::c , ' , ' , ? - .3';-: Heating/cooling
Job site address: I ( 4111 s 4 Cf, Air conditioning
(requires snot:Ilan allowing placement) , 46.75
d ,
City/State/ZIP. . --- 1 4 ,, Furnace 100,000 BTU (ducts/vents) 46.75
- 4
Project name: * Aik . A ■ - Furnace 100,000+ BTU tducts/vente) 54.91
Suite/bidg./apt. no.:
Heat pump 61.06
Cross sweet/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Y).1
, 1)7.1441 a .iii Residential boiler (radiator or
hydronic) 2332
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 46.75
Flue/vent for any of above 2332
Subdivision: I Lot no.:
Other 0/ c. 7"; N k 1 23.32
Tax map/parcel no.:
Other fuel appliances
.-..::.:• Wiiitk -;:..;:'!';;`:'•':- :'i'.; Water heater 23.32
1 Mia 9 -Clo, \ vw■ 0 0 .
‘44Q, Gas fireplace
Flue vent for water heater or gas 33.39
23.32
. II oi. 1 I. 41 , _ IA 1 JO firePilice
Log lighter (iuts) 2332
in111=1.01M1111=1114111711.10nm Wood/pellet stove 33.39
_
14 IA 1
Wood fireplace/insert
. Chininey/liner/fluelvent 23.32
; 2332
23.32 ..
Name: ,460, In i Environmental exhaust and ventilation
.
Range hood/other kitchen
Address: 1 1 t 'NA) el ) ii 4 equipment 33.39
City/State/ZIP: / Aill_A 0.4. % e _,.......... Clothes dryer achaust 33.39
Single-duct exhaust (bathrooms,
Phone: I i Fax: ( ) toilet compartments, utility rooms) 23.32
" 4 1 1 E 11 0 14 'ff.:'f'" , r;'-''''':-"'" . :1": , :' , : .,- t1:1'.`cogrAcco*ow:-P.2 Attic/crawlspace fans 2332
Other.
Business name: Ft vS+4, hen N 0 NO
Fuel piping 23.32
Contact name: RI II nil_ S14.IS for first four, $4.03 for each addidonal
Address: 1 CO k) L t ... _ aivne i ..,)\.._ Furnace, etc.
Gas heat pump
City/State/ZIP: 4 t/\ (V1 N I 9321 1 Wall/suspended/unit heater
Phone: (92) '2 ").1:5''25/ I Fax: : ( ) Q - 51(14 Water heater
Fireplace
E-mail:
Range
: ...,: ''" 1 ; : ..' :-' ':...' Barbecue
Business name: ory-y ac., n v
.......A.A. ‘. Clothes Myer (8,as)
Other; 0 ti.1744i, .A.ifey 1406 I
Address: '' ''. • '.• . : •• • i MECHAT41414PERM1TSFEES* A
City/State/ZIP: Subtotal jaQr-39 7 0'
Minimum permit flee ($90.00) ---
Phone: ( ) Fax: ( )
Plan review (25% of permit fee) ,2... 7)
CCB lie.: 1 U.1...CR State surcharge (12% of permit fee) , 16:6(dani
TOTAL PERMIT FEE 1 t 7v
Authorized .! a .- ''' viis 1 ). This permit application expires if a permit Is not obtain within 180
days after It 1189 been accepted as complete,
9 -..........
Print name: „,,,,, a , - Date: 41° .11031ffin i " Fee methodology set by Tri-County Building Industry Service Board