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Permit
, CITY OF TIGARD MECHANICAL PERMIT II 2 COMMUNITY DEVELOPMENT Permit #: MEC2011 00179 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/26/2011 Parcel: 2S103CB09700 Jurisdiction: Tigard Site address: 12290 SW QUAIL CREEK LN Project: Wyatt Subdivision: QUAIL HOLLOW - EAST Lot: 55 Project Description: Gas line to barbeque. Contractor: HEAT RELIEF CO Owner: WYATT, COREY R 13122 NE DAVID CIR # 800 12290 SW QUAIL CREEK LN PORTLAND, OR 97230 TIGARD, OR 97223 PHONE: 503 - 261 -9915 PHONE: 503 - 957 -6523 FAX: 503 - 261 -9814 FEES Specifics: Description Date Amount Fuel Piping 04/26/2011 $14.15 Type of Use: SF 12% State Surcharge - Mechanical 04/26/2011 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/26/2011 $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, o • - ' suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility ••otification Center. hose rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or • rect questions to OUN .Ili r • 03.232.1987 or 1.800.332.2344. ssued By: . AP , �� ,, LA i Permittee i nature: !�___� 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. 04/25/2011 MON 12:24 FAX 5032619814 a1001/002 Mechanical Permit ApplicatlCE FOR 0141(1 li OVI,Z' q City of Tigard , APR _ Pe rmit No.: .J1/� `, 17 13125 SW Hall Blvd Ti gard, O 97223 Fi R 2 6 2011 Date/By: � v Phone: 503.718.2439 Fax: 503.598.1960 Plan Review Other Permit: Date/By: TI GARD Inspection Line: 503.639.4175 CITY OF TIGARD Date Ready /By: >uris: RI See Page 2 for Internet: www.tigard - or.gov BUILDING DIVISION Notified/Method: Supplemental Information t, •`- .3 . . 1,4,431- ".z.. �® � '" ;^ , ,.1 _ ' " `"` Y r'y, -;, -f f © wj li �• , .: r , ( Dl, l(„ P' . ( �' V i . ylelITIV »°.`� _ M1..caGr T- ,rf- '�..3�:' m;.. ' �c'riaeti�txa , c"'3�':'...:,c,.-- � ...,.... n :. ..), % d - )�..'� . . � .. - .. Mechanical permit fees* 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. y � , _ � -� rrn ' Value: $ „.44: , t w5-.' n a + „.. 8 t , ,..... .r r. ,^^§k.., -. r`^i *"# ta" '- a�w.. , g . ,- ws. ® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. m ❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. I Ea. I Total r r -, v % 110 y , 1 . s •', o • 3 t °& ® x 'PIXPI Heating/cooling: o - _ -- u to i" ..',L • *-rs` .° Air conditioning Job site address: 12290 SW QUAIL CREEK LANE (requires site plan showing placement) 46.75 City /State /ZIP: TIGARD OR 97223 Furnace 100,000 BTU (ducts vents) 46.75 Furnace 100,000+ BTU (ducts /vents) 54.91 Suite/bldgJapt. no.: I Project name: 02eSidatidi= LAD l `/ 14-77 Heat pump (requires site plan showing placement) 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: I Lot no.: Flue/vent for any of above 23.32 Other: 23.32 Tax map /parcel no Other fuel appliances: " r , P:.. ' ._-5.._..r. ._._ o .,A„,,� �,, & sl, .C® ',� : ,.. n: '. Water heater 23.32 GASLINE TO BBQ Gas fireplace 33.39 Flue vent for water heater or gas fireplace 23.32 Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert 23.32 i . Li t 4R- h y <f tvt , -- ,; ` ,,,� ,s Chimney /liner /flue/vent 23.32 -Icz m 4 < -:.: �''}- -5,.. :. +wc,..�e,s...i ° Other: 23.32 Name: COREY WYATT Environmental exhaust and ventilation: Address: SAME AS ABOVE Range hood/other kitchen equipment 33.39 City / State/ZIP: Clothes dryer exhaust 33.39 Single-duct exhaust (bathrooms, Phone: ((503))957 -6523 Fax: ( ) toilet compartments, utility moms) 23.32 `" iXiVI < MIrO . . .7 . '- x t E.k�„ ® � e • 'a Attic/e awispace fans 23.32 Business name: HEAT RELIEF Other 23.32 Fuel piping: Contact name: KARINA GRANT $14.15 for first four; $4.03 for each additional Address: 13122 NE DAVID aft Furnace, etc. Gas heat pump City/State/ZIP: PORTLAND OR 97230 Wall/suspended/unit heater Phone: (503) 261 -9915 I Fax: : (503) 261 -9814 Water heater Fireplace E -mail: HROFFICE @IIEATRELIEFTODAY.COM Range ..k . : ;,r» t - - - • ... tilr eu .. J i I Barbe 1 14.15 Business name: SAME AS ABOVE Clothes dryer (gas) Other Address: R : r x7 City/State/ZIP: Subtotal 14.15 Phone: ( ) Fax: ( ) Minimum permit fee ($90.00) 90.00 Plan review (25% ofpermit fee) 0.00 CCB lic.: 122424 l, I y I 1 ( State surcharge (12% of permit fee) 10.80 TOTAL PERMIT FEE 100.80 Authorized signature: 6,1(---34-- This permit application expires if a permit is not obtained within 180 V days after it has been accepted as complete. Print name: KARINA G T Date: 04/25/2011 • Fee methodology set by Tri -County Building Industry Service Board 1: \Building1 Permits \MEC-PermitApp.doc 09/09 /10 440-4617r (11/02/C01\4/WEB)