Permit 71 ,� CITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT Permit#: MEC2011 -00139
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 03/31/2011
Parcel: 2S 111 AA06700
Jurisdiction: Tigard
Site address: 14340 SW 90TH AVE
Project: BELDING Subdivision: GREENSWARD PARK NO. 2 Lot: 53
Project Description: Gas piping installation.
Contractor: FAST WATER HEATER COMPANY Owner: BELDING, STEPHAN P & JENNIFER M
12601 132ND AVE NE 14340 SW 90TH AVE
KIRKLAND, WA 98034 TIGARD, OR 97223
PHONE: 425 - 636 -7084 PHONE:
FAX: 425 - 636 -7085
FEES
Specifics: Description Date Amount
Fuel Piping 03/31/2011 $14.15
Type of Use: SF 12% State Surcharge - Mechanical 03/31/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 03/31/2011 $75.85
Occupancy Grp:
Stories:
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 1.800.332.2 •4.
Issued By:L/ Permittee Signature: .. _.ate _ ice '
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.
From: 03/31/2011 09:58 #680 P.002/003
Mechanical Permit Application . FOR oI F ICI: t SI: a� l.i
City of Tigard V t ,' Received /�7�-
} Date/By: it f..) it V /,' I M (
•
Il i I 13125 SW Hall Blvd., Tigard, OR 972 Plan Review
Phone: 503.7182439 Fax: 503.598. 1 r \\ Date /By: Other Permit:
T t G A R D Inspection Line: 503 c � l• Date Ready /By: Jura: PI See Page 2 for
Internet: www.tigard- or.gov \* t■ J 1 p :1N, Notified/Method: Supplemental Information
l'* ...r. Z. - .... r ' � k ez nc'sY e+, W `�,- - 3.4-1 ? �j � -.
' .,ems." " ?.'.ks. s. l 5 .. ...h .a' ... � .. i-rr, t hF ''L''' �:. v 'L, S .T - .r .. 3 a ,� fees � E.i ,..7,11,-.',4,,,,
Mechanical permit foes* are based on the value of the work
❑ New construction jg Addition / alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
- £�" xr ,�� ""`< �'T r e r n C'�2.r1 '� a - Value $
.j . `x- wa x .. '., s:.',. .t tr tblMla 1 r** .,ys.3` 1 . ., .' a a" �; y 'T' r opt as t Y:
1- and 2 -famil
,' 'Y's?' �, s�m.s ..., ..�.,.. r „z >.... ... �.... �M4`+r... '7r'z:: d�.d'ry` � �'�4' � -
dwelling Commercial /industrial p�kl���= ������ `'
2-family g ❑ ❑ Accessory building For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
Ar, a,� i � id s, -T .,r ,��,'t- ^�Cm-�. * - .,,_.� a. ar �.� s � .3..1" :. HBat1Rg/000t1ng:
3 ,:- .�? n ? w , �' S i?,rn `�7�i4'i`e` y Z 3 Y d e 6 Fas ",r " i
1 , _-�r. - <.r -3.-� , �. -,� ,f- .. ... ,e ..�„': Aie GOndrtl0nnig
Job site address: I✓ 1 34 5' q 0 j v /e ' (requires site plan showing placement) 46.75
City /State /ZIP: 'r g(,_C� 0'� 97 a Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: - I Project name: 5.e\ cA t 0 Q 1 e p � a � Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: C,r (,, S- -- C)\IN1 c s - e � fl 5 Duct work 23.32
) .rC, ,� '�0 ` Hydronic hot water system 23.32
�X�t (�1 Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
p i � r ��'�a '5 # e I 7V:f a a 3 .oz- W ater heater 23.32
zc f' os,'. .v $' .. .. _ a
Y 9 A\ \ - - O C S I \ { Gk rangy Gas fireplace 33.39
�-� 1 � / � cII t Flue vent for water heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood /pellet stove 3339
Wood fireplacelinsert 23.32
, "-4 ` ., ea f rs. ; -,; -> ;_ ... z¢ ; 1F a9 ,, S. h- Chimney/liner/flue/vent 2332
Other: 23.32
Name: p � ` ( e \ �; Environmental exhaust and ventilation:
Address: ) -\ 1 -j\c\I O` o Range hood/other kitchen
equipment 33.39
City /State/ZIP: -A---‘ a r A I (Ai 9- a Clothes dryer exhaust 33.39
S6-(-3 Single-duct exhaust (bathrooms,
Phone: (911) `Q --- \ 1 Fax ( )
toilet compartments, utility rooms) 23.32
r . ;e4-":"-', t ®t � h€ "a ��� T . r c, s �� € � r , Attic /crawlspace fans 23.32
Fa , ,\ f ... B t \ „(� `� �--- Other: 23.32
Business name: 1! v i t ll ACC. 'mow
Fuel piping:
Contact name: J \' a- s ‘v Q J $14.15 for first four; $4.03 for each additional
Address: ‘ 2Lt Q\ \ ?Y` 1 Nut l 3 Furnace, etc.
Gas heat pump
h,n'6‘50-31----k �-�
City/State/ZIP: �\ (kAar (\ti V v A 7-'5 7 WaWsuspended/unitheater
Phone: (t-f Zc ( 7 �� _7 csy I Fax: I : - ( rj n � , 3Lo- -7�g G� Water heater
E-mail: \4'c C C S ` (/3a�`�t V\Cya.T�'t c \ Fireplace
"'- a K ax -a- s' �,, � ;»L� s 6 \ mss' r 4f h s r-nn. i . ���, r � 1 ,. Range �i)
. lti ,._''4x, .., ".ril -W t , � � �YS:. ;.., .�"- ., a?. -�...n,`,' 4,, „1; '. Barbecue
Business name: Fa S\- \ Ck F 4e Clothes dryer (gas)
Other
�`,' \
Address: 1 ! O \ l'"57
f %s��`5 _�r..... ..�.j�r i13,}rr:. it
City/ State/ZIP: '\‘‘ r � ok ,v\ A 9 93 C) ' 3 � Subtotal \', I S �
Minimum permit fee ($90.00) { r W eJCJ
Phone: (CtZ�j) � �gi _Fax; (� ZS) Cpj ( 07 Plan review (25% of permit fe
CCB tic.: f % DI-4 61 State surcharge (12% of permit fee) ),2.$5t3 to .50
TOTAL PERMIT FEEL 1x,20
Authorized signature:
This permit application expires if a permit is not obta red within 180
days after it has been accepted as complete.
Print name: a u. 1 i e r , CC), s Date: I '31 / I ( • Fee methodology set by Tri- County Building Industry Service Board
I.',auildina \Permits \MEC- PermitApp.doc 09/09/10 440- 46I7T(I1 /02 /COM1WE8)