Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00521
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/17/2011
Parcel: 2S101AB00500
Jurisdiction: Tigard
Site address: 7100 SW ELMHURST ST
Project: LAU Subdivision:CONDO SUPPLEMENTAL PLAT NO.1: Lot: 22858 -2.
Project Description: Liner to vent gas furnace.
Contractor: PORTLAND CHIMNEY INC Owner: LAU, JOSHUA L &
1441 SE 122ND AVE STEM MARCHWICK, SARAH B
PORTLAND, OR 97233 PO BOX 392
BEND, OR 97709
PHONE: 503 - 256 -9140 PHONE:
FAX: 503- 256 -3020
FEES
Specifics: Description Date Amount
Flue/Vent For Any of Above 11/17/2011 $23.32
Type of Use: SF 12% State Surcharge - Mechanical 11/17/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/17/2011 $66.68
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 is •UNC by calling 503.232.1987 or 1.800.3 - .
Issued B `
Permittee Signature:
Call 5�' .• 175 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.
Mechanical Permit AmlicatioRECEIVED _ ,,, -
City of Tigard Received
I // milm
Date/Ry: Permit No.: 4 , ff ...do _ .S
I 1.3125 SW Hall Blvd.. Tigard. OR 97223 NOV 1 7 2011 rim Review
111 Phone: 503,718,24:19 Fax: 503.598,1960 Datc/Ety: Other Permit:
Inspection Line; 503.639.4175 Jurk PI See fru'
'1 i Ci A RD CITY OF TIGARD Date Rcady/By: Page 2
Internet: www.tigarcl-orgov
BUILDING DIVISION Notifiedimetlied. - ",......6 Supplemental tatinralatton
. . , , . .., . .;...: ; ;; ;;::. , .:; • . .. .;:tvot.o : .; ,:....•..,.••• :••:::!•: •• . •••:... ii: •
Mechanical permit fccs am based on the value of the work
0 New construction ECAdditiontalteration/replaccmcnt performed. Indicate the value (rounded to the nearest dollar of all
Demolition Other:
mechanical materials. equipment. labor, overhead, and profit.
0 ill
• Value: $
• • •••.••'•'"•:::::::::!:••. _.:ataottv, kiieikoN,,; !.!;.!:;:!,.:.•:...••••:::;:!,;:;;,..,•;••.:•• ‘,....„,.., ) „,.. tottitiNitiotto , s i ttolvs i tts , .,,,,;,,,,•,.•;.
.. ,., • , „•,• , .. .• . . .., . ,. ,, ,,„ .. .,
.' • . .. • - •: • .••• - - - • . • ,•• • ,•• .... -,,,,•-•,, ,.., , ......i • "••.•-:A. •i;. • ., miim .;,• .;,•,,.,,.„ • ,,,' ;.. ,.,., s•_ ••• • • •, •••• ' .
Ki I - and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special (reformation use Macklin
0 Multi-family 0 Master builder 0Other: .,:,..,,,,,,, itinonlina:
Description I Qty, l Ea. I Total
.:: '::•:::':. !i:..::!.::,,: : ,,;j ciii.:if.t:;INFORMA)404, :iD ..4.fitk.t : . ;;::;;;!,;:, ; . . i
..;;;;:;;;; . ,. ... Air conditionrng
Job site address: -7.1 'op 51--) E10-01,,,L615.1' (requires site plan showing placement) 46.15
46.75
City/State/ZIP: 1 y etr a 0?- 1 2 - 2 - 3 - Furnace 100,000 BTU (duets/vents)
Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldg./apt, no.: Project name: LI 1/4.) Heat pump
re sires site Ian sbowin .lacement 61.06
Cross strectidircutions to job site: Duct work 23.52
.
Hydronic ht water system 23.32 ._
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel-type, not electric),
in in-duct. suspended. etc. 46,75
Subdivision; Lot no.:
Flue/vent for, any of above rj 23.32
_ Z.5.32=
I
Other: 23.32
Tax map/parcel no.: Other fuel appliances:
, .• • -.:•...:•.:;.,•...:.,: " .•'.-• :!•:•:2••?• : ,::,.::....:. :1:,:;H:,,,.: Water heater j 23.32 F .
Gas 'Fireplace 33.39
5,, , I - & _ et. - - -. Li Flue vent for water heater or gas
1
1 fireplace 23.32
1 , k_g.r. '6 VtA- LI 4,,s__,A- ii..__
LI fi
,0E ii iltLi.roVL132
- Wood/pellet stove 33.39
.
wood fireplace/insert 23.32
-
.. . . ,. . - -.
.......... . t• /f1 icivcrit 23.32
• " ' ' •••"•': [i .:immore...9wNER'.. • . 2 [ , .: .. -...:.:... , D..i. , EN!ol.t.:: : '::." • ','.i., chimnevillner
■
Other: 23.32
_
Name:
1, , -.1 0$ Environmental exhaust and ventila Ion:
Address:: 6 3 o r" ) 1.---).1, to) Range hood/other kitchen
, equipment 33.39
- -
City/State/ZIP: ( ..n. 1 Ii0 Clothes d er ex _ haust 33,39
Single-dud exhaust (bathrooms,
Phone: ( So3 ) 130 - i3 is B Fax: ( ) toilet compartments, utility rooms) 23.32
• ..• • :''':' ..:• Ll':A kotteAtilt,' , . '. . ::,!,:: :: !.::;' :;:" .itr: coSti40 Attic/erawlspace fans 23.32
Other: 23.32
Business "arm: ?Or ) rkiv‘it C_11.1fr‘Aci 4/%.1 " t■1 f/ ht1(-- Fuel i i:
Contact name: r L . 1 a5z. k r 514.1S for first four; 54,03 for each additional
Furnace, etc,
Address: . 641 sk - 17-2. avc . Stit_,_±1
Gas heat pump . •
City/State/ZIP: I tr,i-,3 OR '133 Wall/suspended/unit heater _
Phone: (Sti ) 1 Lio Fat:: ($ k - 5 ,... ) . 13( , ' ' 4 ) z 0 Water heater ,_ ,
a Fireplace
b-mail: 17111n e _
,.. ,. .. _
• .• :: ••••:: :: ;.i:.• .;:•:•,' ....: . .::'........: •.... •• .! CONTRiAbralt::', :.:.''..• : • 1 : '''.:•il: :.:• •• :iii '; ' •-• : Barbecue
Clotl,_2=1 rsigas)
Business name: ?prkk . - -
• Other:
ylstf
Addr 3.,_2,...........it_Ar.,4„, AI .
•.;,,,:.;: otAmokiet.ri.ttoot,pr! •i:...,;.: .•..
Cily/State/ZIP: w . OSL CO 3_, . ,. Subtotal l_ .
' Minimum permit fce ($90.00) qo 22
Phone: (esi\ ) 7 _ - Lii v O Fax: ( S 1 3 ) 9 34 2 iz)
Plan review (25% of permit fee)
-"'" •... " r
CC.B lie.: Ltryi.S e 2-te / State surcharge (12% of permit Fee) \O AP _
TOTAL PERMIT FEE
This permit applicsaion expires if A permit Is nhtnincli within Ian
Authorized signature: r--.. days after i not t hns hero necepted as complete.
Print name; 1 2 ) A Fcf- Date: It / III II . Fee methodology set by Tri-County Building Indwary Service Board
I Ariiilld Ins \ Permira 1 MEC-Permit App.dne OnfOnti 0 44(.1 (I 1/07/(7))/1/WF.3)