Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2012 -00044
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 01/20/2012
Parcel: 2S112BC08100
Jurisdiction: Tigard
Site address: 8167 SW CAROLE CT
Project: Van Vleet Subdivision: I RAZE MEADOWS Lot: 4
Project Description: Replace existing water heater with tankless water heater
Contractor: OWNER Owner: VANVLEET, BRIAN R
8167 SW CAROLE CT
TIGARD, OR 97224
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PHONE:
PHONE: 541- 905 -6975
FAX:
FEES
Specifics: Description Date Amount
Water Heater 01/20/2012 $23.32
Type of Use: SF 12% State Surcharge - Mechanical 01/20/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 01/20/2012 $66.68
Occupancy Grp:
Stories:
Fuel
Fuel Types:
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 - • • i' -. . . : i i. '. 344.
Issued By: Permittee Signature: D , v - 4/° /G
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.
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Approved plans are required on the job site at the time of each inspection.
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01/20/2012 FRI 9:15 FAX Kerr Contractors 11002/002
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't 13125 SW I fall BIN% ,'Tigard, OR 9/223 / g 2 O 4 � R — 1k nit N ' / E �"�IJ� 2 � 06 O / y
Plan Revi •
h ° Phone: 503.718.2439 Fax: 503 JAN 2 U 2 01 2
Dated3y: Otherper
Ins •ection Line 503.6 . .
F tGARD I Dale Itcadyil 1 is' fit Sec Page 2 For
s,+ %,.:.�.:,�..,..,•::i I nternet: www.l or.gov OF TIGA D Notified / Method: J Supplemental Information
- -_ — — (HE
- ' SCHEDULE _- USE CHECKLIST -
TYPE OF Srv��K COMMERCUM, III SC
Mechanical permit tees " are based on the value of the work
❑ New construction El Addit ion /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
El I)enolition ❑ O ther: mechanical equipment, materials, ec ui rnrent, labor, overhead, and profit.
�_. .__._...._...._.._....--- _.___. I
Value: $
CATEGORY OF C'ONSTRIIC:"1•ION _. - .__..._.� -- --.___
RESIDENTIAL EQt IPMIiN't /SYS"TEMS FEES*
16 ,,_ and 2-family dwelling ❑ Commercial /industrial ❑ Accessory building ��— For special information use checklist
❑ Multi - family ❑ Master builder ® Other: Description Qty. Pa. 'Total
Ileattin coolie a:
.1013 SITE INFORMATION AND LOCATION--- - - - - -- _ _
_._...__......_..._... -- Air conditioning
Job site address: 8167 SW Carole Ct (requires site plan showinjjtlece 46.75
-- - -- Furnace 100,000 BTU (duels/vents) 46.75
City /state / /..IP:'T Tigard, OR 97224 _ „__.____ _ Furnace 100,000+ BTU (ducts /vents) 54.91
Suite /bldg. /apt. no.: Project name: Tauldess Water Heater 1lcat pump
(requires site plan showing placement) 61.06 _.. - . - .--
Cross street /directions to job site: 81 st Ave Duct work 23.32
Hydronic hex water system 23.32 -
Residential boiler (radiator or
hydrorue) 23.32
- — Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. _ 46.75
Subdivision: Raze Meadows 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 --
Replace existing storage tank style hot water heater with faithless heater Flue vent for water heater or gas
fireplace 23.32
—' - Log lighter (gas) 23.32
Note: City informed me that only a mechanical permit was required, no plumbing. Wood /pellet stove
()/., P i Wood fireplace /insert 23.32
(X] PROPERTY OWNER -� Chimney /liner /flue /vent 23.32 -�
❑ TENANT -
- -- — Other: 23.32
Name: Brian Van Vlect - -
Environmental exhaust and ventilation:
Address: 8167 SW Carole Cl Range hood /other kitchen --
_-. ._.-___.____ equipment _ 33.39 —
City /State /ZIP: Tigard, OR 97224 Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
Phone: (541)905 6975 Fax: ( ) toilet compartments, utility rooms) 23.32
® APPLICANT l ❑ CONTACT PERSON Attic /era yj5p tee fans 23.32
Business name: Other: 23.32
Fuel piping:
Contact name: Brian Van Vleet $14.15 for first four; 54.03 for each additional
Address: 8167 SW Carole Ct _ Furnace, etc. -
_.._�- _ --_ -.- - Gas heat pump
City /State /ZIP: Tigard, OR 97224
Wall/suspended/unit heater
Phone: (541) 9056975 I Pax:: ( ) Water heater
Fireplace Mm
E-mail vanvlebr @gmaiI.cottl Range
CONTRACTOR Barbecue
Business name: 0 IVN t� - - - Clothes dryer (gas) �- _ -
- Other:
Address: MECHANICAL PERMIT FETES"
City /Slate /ZIP: - - Subtotal
Minimum permit fee ($90.00) 90.00
Phone: ( _ ) Fax: ( ) Pfau review (25% of permit lee) n/a
CCB lie.: State surcharge (12% of permit fee) _ 10,80
V TOTAL PERMIT FEE 100.80 I
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Authorized signature:
This permit application expires if a permit is not obtained within IRO
days after it has been accepted as complete.
Print name: Brian Van Vleet Date: 1/20/2012 a Fee methodology set by Tri County Building Industry Service 13oant
1:• milling /l'eunii<MI:C- i'enuhApp.doe 09109110 4d0.isl7'r(I t :02i(;oxywnl3)
TRANSMISSION VERIFICATION REPORT
TIME : 01/20/2012 18:14
NAME : CITY OF TIGARD
FAX : 5035981960
TEL : 5037182449
SER.# : BR0H7J690762
DATE,TIME 01/20 18:14
FAX NO. /NAME 5039811161
DURATION 00:00:39
PAGE(S) 01
RESULT OK
MODE STANDARD
, , ,
CITY F TIGARD MECHANICAL PERMIT
ill 1 COMMUNITY DEVELOPMENT Permit g: MEC2012.00044
TiQARD 13125 SW Hall Blvd., Tigard OR 97223 503 - 718.2439 Date Issued: 01/20/2012
Parcel: 2S1128C08100
Jurisdiction: Tigard
Site address: 8167 SW CAROLE CT
Project: Van Vreet Subdivision: , RAZE MEADOWS Lot: 4
Project Description: Replace existing water heater with tankless water heater
Contractor: OWNER Owner: VANVLEET, BRIAN R
0167 SW CAROLE CT
TIGARD, OR 97224
PHONE: PHONE 541 - 905 -6975
FAX:
FEES ---- ,., .,,.,_
Specifics: Description Date Amount
Water Heater 01120/2012 $23.32
Type of use: SF 12% State Surcharge - Mechanical 01/2012012 $10.80
Class of Work: ALT Type of Canst: Minimum Fee Adjustment - Mechanical 01/2012012 $66.88
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
01/19/2012 THU 13:58 FAX Kerr Contractors 2001/003
FAX COVER SHEET
DATE: 01/19/12
TIME: 2:00 PM
# OF PAGES (Including Cover Sheet): 3
TO: City of Tigard Building Department
COMPANY: City of Tigard Building Department
FAX #: 503.598.1960
FROM: Brian Van Vleet
NOTES: Please fax the permit to 503.981.1161 Attn:
Brian Van Vleet
P.O. Box 1060, Woodburn, OR 97071
PH 971.216.0050 * FAX 971.216.0079