Loading...
Permit CITY OF TIGARD MECHANICAL PERMIT 11 1- COMMUNITY DEVELOPMENT Permit #: MEC2011 -00566 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/09/2011 Parcel: 25111 DB05400 Jurisdiction: Tigard Site address: 15297 SW ALDERBROOK PL Project: TYLER Subdivision: SUMMERFIELD NO.7 Lot: 406 Project Description: Gas piping and gas logs. Contractor: T & K MECHANICAL Owner: TYLER, DARLENE J PO BOX 116 15297 SW ALDERBROOK PL FOREST GROVE, OR 97116 PORTLAND, OR 97224 PHONE: 503 - 844 -9173 PHONE: FAX: 503 - 846 -0195 FEES Specifics: Description Date Amount Other, Fuel Appliances 12/09/2011 $23.32 Type of Use: SF Fuel Piping 12/09/2011 $14.15 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/09/2011 $10.80 Occupancy Grp: Minimum Fee Adjustment - Mechanical 12/09/2011 $52.53 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 1.800.332.2344. 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. Mechanical Permit Appl _ ED FO o Et USE oNLI' City of Tigard ( Received r p No.: ° 13125 SW Hall Blvd., Tigard, OR 9 20 11 DateBy: . 1% Aa �_ . /1 - Phone: 503.639.4171 Fax: 503.598.1960❑ Plan Rev ew Other Permit In ection Line: 503.639.4 CITY O L' T IGARD Other I I (.3, R. F� p Date Ready/By: luris: l3 See Page 2 for Internet: www.tigard- or.gov B UILDING D IVISION Notified/Method: /— , Supplemental Inforntation TYPE OF ‘i ORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST ❑ New construction Addition/alteration /replacement Mechanical permit fees' are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION Value: $ RESIDENTIAL EQUIPMENT ISYSTEMS FEES* and 2- family dwelling ❑ Commercial/industrial © Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. Ga. i Total JOB SITE INFORIYIATION AND LOCATION Heatiiigkooling Job site address: al tv ��`l.v � r .] ' `� , L Air condition p Y 1 y [� (requires site plan showing placement) 46.75 City/State/Z1P: ---r\ C 0NA.6 ©.1 , -- 7 a.a`-( Furnace 100.000 BTU(ducts/vents) 46.75 Furnace 100,000+ BTU (duets/vents) 54.91 Suite/bldg./apt. no.: Project name: Q.."l.l 1 G - Heat pump 61.06 Cross street/directions to job site: ._. ..Ductwork __ 23.32 Hydronic hot water system 23.32 Residential boiler (radiator or hydronic) 23.32 - Unit heaters (fuel -type, not electric), 1 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 DESCRIPTION OF WORK Water heater 23.32 Gas fireplace 33.39 (3C1 S ' i y -, a ce Q ck S L /) Flue vent for water heater or gas J fireplace 23.32 Log lighter (gas) 23.32 , Wood/pelletstove i 33.39 Wood fireplace /insert 23.32 ❑ PROPERTY OWNER Chimney/liner /flue/vent ! 23.32 Q TEVAItiT Other: i ()ule" i 1 23.32 _ a 3a Name: ----1--- Environmental rr oust and ventilation 5L) a 1 (• Q:V bra, L equipment Range hood/other kitchen Address: l a l L f equipment 33.39 City/State/ZIP: Clothes dryer exhaust 33.39 Single -duct exhaust (bathrooms, Phone: (scN t -a),_ 0_0 (o I Fax: ( ) toilet compartments, utility rooms) 23.32 ❑ APPLICANT I ❑ CONTACT PERSON Attie./crawlspace fans 23.32 Business name: �^ , Other: 23.32 T �� I T 1 �� Ct.%' 1 I Fuel piping Contact name: 4; >/ S14.t5 for first four; 54.03 for each additional Address: O ` J p N 1‘10 Furnace, etc. VI t 1 LP Gas heat pump City /State/ZIP: Gy. q s i r 0„ , (,i"1 --t.�� Wall /suspended/unit heater Phone: ( q�) 44 L.f _ 9 1 - 7 - - 2 Fax:: ( ,*2,) S Cy O { `c Water heater Fireplace E -mail: Range CONTRACTOR Barbecue Clothes dryer (gas) Business name: ame: ` 1-- Q LV 1 L� O �+, �` � Other: ((1 ) (� ( S Address: �v p)c X t 1.to b ttlIANICAL PERMIT FEES* City /State/ZIP: ] uv. e___ t -V. Cy qv L a / co 1 U U. I Subtotal 31 , 1-I 3 _ Minimum permit fee (590.00) CiO,C; Phone: ( tr T5) t�� i �l k 2 Fax: (f G`l 4 -- G , G, Plan review (25% of permit fee) CCB lie.: A‘ 1u, 5--- _ l State surcharge (12 %of permit fee) I II - a TOTAL PERMIT FEE i � 63'C) Authorized signature: c \\\/, ` nip permit application expires if a permit is not obtained within 180 days after it has been accepted as complete. Print name: i\ V1 r\ c_, L. lA) Arvy Q i Date: , 7-- — I 4 Fee methodology set by Tri-County Building Industry Service Board l:i Buildine \Permits\MEC PermitAeo. 10/01 /09 440-06171(77 /02/COM/WEB) 'd 961 euu/(M euqy dZ 6:6 l4 80 oea