Permit CITY OF TIGARD MECHANICAL PERMIT
` 8 • COMMUNITY DEVELOPMENT Permit #: MEC2011 -00009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/04/2011
Parcel: 2S104BD00100
Jurisdiction: Tigard
Site address: 13535 SW WALNUT LN
Project: JOHANSSON Subdivision: Lot: 0
Project Description: Gas fireplace insert with fuel piping.
Contractor: ALL FUEL INSTALLATION & SERVICE LLC Owner: JOHANSSON, MARTIN L JOAN
PO BOX 69 13535 SW WALNUT LN
TROUTDALE, OR 97060 TIGARD, OR 97223
PHONE: 503 - 674 -2350 PHONE:
FAX: 503 - 674 -2693
FEES
Specifics: Description Date Amount
Gas Fireplace 01/04/2011 $33.39
Type of Use: SF Flue Vent for Water Heater or Gas 01/04/2011 $23.32
Class of Work: ALT Type of Const: Fireplace
Occupancy Grp: Fuel Piping 01/04/2011 $14.15
Stories: 12% State Surcharge - Mechanical 01/04/2011 $10.80
Minimum Fee Adjustment - Mechanical 01/04/2011 $19.14
Fuel
Fuel Types: Natural Gas
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:
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.
R
Mechanical Permit Application DEC 3 1 201 FOR OFFICE USE. ONLY
City of Ti CITY OF "MAR r �� Az Permit No.: --
13125 SW Hall Blvd., Tigard, OR 97223 i l/ r_ L0 l i •r_
Phone: 503.639.4171 Fax: 503.598.1960 BUILDING DIVISI "a OlhefPermit:
T 1 GARB Inspectio Line: 503.639.417 Dale Read ;B : fil Internet: µ'ww.tigard- or.gov Notified/Method: Effl SSup
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit foes* are based on the value of the work
❑ New construction ® Addition /alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
Demolition ❑Other: mechanical materials, equipment, labor, overhead, and profit.
•
CATEGORY OF CONSTRUCTION Value: S
I - and 2- family dwelling ❑ Commercial/industrial RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ Accessory building
ID ❑ Master builder For special information use checklist.
❑ Other: Description I Qty. I Ea. I Total
JOB SITE IINFORMAI1ON AND LOCATION Heating /cooling
Job site addrea�s: 13535 SW Walnut Lane Air conditioning
(requires site plan showing; placement) 46.75
City /State/ZIP: Togard, OR 97223 Furnace 100,000 BTU (duets/vents) 46.75
Suite/bldg. /apt. no.: Project name: `.�,�
Furnace 100,000+ BTU Mums/vents) 54.91
V (J cSQr1/ Heat pump 61.06 _
Cross street/directions to job site: Duct work 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
Subdivision: Flue/vent for any of above 2332
Lot no.:
Other. 23.32 _
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
Install gas line, venting and new gas insert Gas fireplace l _33.39 33.39
Flue vent for water heater or gas
fireplace 1 23.32 23.32
Log lighter (gas) _ 23.32
Wood/pellet stove _ 33.39
Wood fireplace/insert 23.32
® PROPERTY OWNER I 0 TENANT
Chimney/liner/flue/vent 23.32
Other. 23.32 _
Name: Joan Johanssoo Environmental exhaust and ventilation
Address: Same as above Range hood/other kitchen
equipment 33.39
CitylState/ZIP: Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (503)590 -8736 I Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT I 0 CONTACT PERSON Attic /crawlspacc fans 2332
Business name: All Fuel Installation and Service, LLC.
Other. 23.32
Fuel piping
Contact name: Eric Camp 514.15 for first four, S4.03 for each additional
Address: PO Box 69 Furnace. etc.
Gas heat pump
City /State /ZIP: Troutdale, OR 97060 Wall /suspended/unit heater
Phone: (503) 674 -2350 Fax: : (503) 674 -2693 Water heater
Fireplace 1 14.15
E -mail: allfuel @comeast.net Range
i , . CONTRACTOR Barbecue •
Business name: All Fuel Installation and Service, LLC. Clothes dryer (gas)
Other:
Address: PO Box 69 MECHANICAL PERMIT FEES*
City /State/ZIP: Troutdale, OR 97060 Subtotal 70.86 1
- Phone: (503) 674 -2350 I Fax: (503) 674 -2693 Minimum permit fee ($90.00) 90.00
Plan review (25% of permit fee)
CCB lie.: 169503 State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80
Authorized signature: This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Eric Camp Date: 12/31/10 I • Fee methodology set by Tri -County Building Service Board
I:1Buiding1PcrraitAMEC -1 Ji pp.dot 1001/09 440-0617F (l1/02/C0M/WEa)
L £69Z12L9£09 uol,epe)sul lend lib' d00:£0 0 L l£ oea