Permit •� CITY OF TIGARD MECHANICAL PERMIT
:' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00269
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/14/2011
TIGARD_ g Parcel: 1 S134AC01200
Jurisdiction: Tigard
Site address: 11410 SW IRONWOOD LP
Project: Tait Subdivision: ENGLEWOOD Lot: 40
Project Description: Run gas line for new range.
Contractor: HAVEN SPAS AND POOLS Owner: TAIT, WILLIAM L & GAIL W
10560 SE HWY 212 11410 SW IRONWOOD LP
CLACKAMAS, OR 97015 TIGARD, OR 97223
PHONE: 503 - 655 -9440 PHONE: 503 - 267 -2342
FAX: 503 - 655 -9514
FEES
Specifics: Description Date Amount
Fuel Piping 06/14/2011 $14.15
Type of Use: SF 12% State Surcharge - Mechanical 06/14/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 06/14/2011 $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 ification Center. T •se rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 - 0090. You may obtain a copy of the rules
or dir t questions to OUNC 4 c- line 03.232.1987 or 1.800.332.2344.
i
Issu d By: /� fr Permie Signature: �'� / C Q
Call 503.639.4175 by 7:00 a.m. for the next availabl • pection 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.
06/14/2011 09:03 FAX Cj001 /003
Mechanical Permit Application FOR OFFICE IiSE ONLY
CI " � of Tigard RE:v.ew, D �� � Permit No.:, 6A � � F � � 13125 SW Hall Blvd., Tigard, OR 9722 �J �_,, ` B Datey: Phone: 503.718.2439 Fax: 503.598.1960 P lay: Other Permit:
1 1 t _ /a h t7 Inspection Line: 503.639.4175 JUN 14 2011 Date Ready/By: Iuris: ® See Page 2 for
Internet: 'www.tigard - or.gov Notified/Method: Supplemental Information
CITY OF TIGAR
..1' ., , I f t t i , .
. i ,L.. t o ,11(� .. . <, F i. .,
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.
., ..i, 1 „s. .'i, x 1 11 - 1 ;; ' ,t ttt: .,
. Value: $
- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special Information use checklist.
❑ Multi family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
1 ; Aeati oling:
.•,, ;- Air conditioning
Job site address: 1 % 5� �� , t o (requires site plan showing placement) 46.75
Furnace 100,000 BTU (du nts) 46
City/State/ZIP: =A1 C r '' en a s V 1- `_J .75 sob Furnace 100,000+ BTU (ducts/ uctsivents) 54.91
Suite/bldg. /apt. no.: Project name: ES $ he 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: lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: Other fuel appliances:
1
Water heat 23.32
Gas fireplace 33.39
' ‘ • ii `t 4 . ■ di Flue vent for water heater or gas
rL fireplace 23.32
• .7 ` G . • a �• �i! P v N.) 1- ` t Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
,, it,:, R t+l' Chimney/liner /flue/vent 23.32
. ,....:..:. .. : ...: ,. Other: 23.32
Name: !r 4/6 T Environmental exhaust and ventilation:
Address: ‘41 %C r +A+, W Vp Range hood/other kitchen
0 equipment 33.39
City/State/ZIP. � i � ,. � Clothes dryer exhaust 33.39
one: ■ Single -duct exhaust (bathrooms,
�S A [a►', Fax- ( ) toilet compartments, utility rooms) 23.32
Attic /crawlspace fans 23.32
Business name: j . .A.6 • 6 t I nn ,, dam Fuel 23.32
_ .�. . _ Fuel piping:
Contact name: , t. O 1 Y� • - $14.15 for first four; $4.03 for each additional
Address:. DO St, RXD a a. Furnace, etc.
Gas heat pump
City /State/ZIP: c_ , • .I 101 � � V✓all /suspendedJunit heater
Phone: ail i c1L 4 V Fax :: 01 1 a 09 51 ■M Water heater
� A, � ✓ Fireplace
E-mail. • ro i►.. Z. o&.ie.►1 .; • * •, L” ELI Range
t ,.
. .., <- Barbecue
Business name: a 4., , _ilk L • • • •_. . d i Clothes dryer (gas)
105100 SE, , % r� ^ Other
Address: t ` Ol� G�► ,tP ; , t
City/State /ZIP: 4 a , b12 ' b Subtotal
Minimum permit fee ($90.00)
Phone: 16 • • (4O Fax: qg51 Plan review (25% of permit fee) f
ERIMIIIIIII IMIl
r State surcharge (12% of permit fee) !Q $v )
TOTAL PERMIT FEE ter)
Allt110Ci ed Sign lure: This permit application expires if a permit is not obtain withi
days after it has been accepted as complete -
Print n • 7 D . : 111 1 ` - a Date: ' Fee methodology set by Tri- County Building Industry Service Board
IOW l ta,atrlin.,\P'rrn,t.\MPC_•� IA nn . rwinonn aan 4 I '/T n tmvrnM WFRI