Permit CITY OF TIGARD MECHANICAL PERMIT
• COMMUNITY DEVELOPMENT Permit #: MEC2012 -00457
Date Issued: 09/05/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S112CD02100
Jurisdiction: Tigard
Site address: 7895 SW BOND ST
Project: Mallicoat Subdivision: BOND PARK Lot: 1
Project Description: (1) gas furnace, fuel piping to (1) fireplace & (1) range, vent range hood
Contractor: MATHIS HEATING LLC Owner: MALLICOAT, SALLY J
19855 HUBBARD CUTOFF NE 7895 SW BOND ST
AURORA, OR 97002 TIGARD, OR 97224
PHONE: 503 - 381 -4901 PHONE:
FAX: 503 - 678 -7912
FEES
Specifics: Description Date Amount
Furnaces < 100K BTU 09/05/2012 $46.75
• Type of Use: SF Range Hood /Other Kitchen 09/05/2012 $33.39
Class of Work: ALT Type of Const: Fuel Piping 09/05/2012 $14.15
Occupancy Grp: 12% State Surcharge - Mechanical 09/05/2012 $11.31
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total - $105.60
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. I /� /� n /�
Issued By: O f Liu Permittee Signature: Da AP PL C 41-1 d kJ
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.
Sep 05 12 02:46p Mathis Heating 5036787912 p.1
Mechanical Permit Apolicat � � R eceived FOR OFFICE USE ONLY
City of Tigard et _ Permit No,I,i�iLit e2o)� D0 v
• 13125 SW HaII Blvd., Tigard, OR 97223 Plan R y'
Phone: 503.718.2439 Fax: 503.598.1960 SEP 0 5 20 12 P]anRetiiew OtPermit.
T I tl A R D Inspection Line: 503.639.4175 D't Other g��/2 —0041
Internet: waw.tigard or.gov BUILDING OF TIICD
� AR Date : lUt
fy e: / la See Page 2 for
BtUILDING DIUISIO j) Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST 1
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, u'
eq tpment, labor, overhead, and profct.
CATEGORY OF CONSTRUCTION Value $
® 1 - and 2 dwelling RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
y g ❑ Commercial Industrial ❑ Accessory building For
❑ Multi family ❑ Master builder special information use checklist
❑ Other: Description Qty. f Ea 1 Total 1
JOB SITE INFORMATION AND LOCATION HealIng/coallag:
Air conditioning
Job site address: 7895 SW Bond St. (requires site plan showing placement) _ 46.75
City /State/ZIP: Tigard OR. 97224 Furnace 100.000 BTU (ducts'veats) 1 46.75
Furnace 100,000+ BTU (ducts'venis) 54,91
Suite/bldg. /apt. no.: Project name: TKO Heat pump
(requires site plan showing placement) 6tA6
Cross street/directions to job site: Duct work 2332
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 2332
Unit heaters (fuel -type, not electric),
in -wall, in-duct, suspended, etc. 46.75
Subdivision: I Lot no.: Flue/vent for any of above 1 2
Other 23.32
Tax map /parcel no.: Other fuel appliances:
DESCRIPTION OF WORK Water heater 23.32
Gas
run new gas lines to fireplace being installed by others, change out failed gas fireplace/insert 33.39
Flue vent for water heater or gas
furnace to new high efficiency gas furnace. Run new gas line to cook top and fireplace 23.32
'
Log lighter (gas) 2332
vent range hood. Wood/pellet stove • 3339
Wood fireplace/insert 23.32
❑ PROPERTY OWNER I 0 TENANT Chitrutey/ finer /fltte/vent 23.32
Name:
Other: 23.32
Environmental exhaust and ventilation: _
Address: Range hood/other kitchen
equipment I 1 33.39
City /State/ZIP: Clothes dryer exhaust 33.39
Phone: ( ) Fax: ( ) Single-duct exhaust (bathrooms,
toilet compartments, utility rooms) _
® APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 23.32
•
Business name: Mathis Heating LLC Other: 23.32
•
Fuel piping:
Contact name: Bill Mathis
S14.15 for Fast tour S4.03 for each additional
Address: 19855 Hubbard Cutoff Furnace, etc.
Gas heat pump
City/State/ZIP: Aurora , Or. 97002 WalI/suepended,'unithcater •
Phone: (503) 3814901 I Fax: : (503) 6787912 Water heater •
E-mail:
Fireplace I
Range (
CONTRACTOR Barbecue
Business name: Mathis Heating LLC Clothes dryer (gas)
Address: 19855 Hubbard Cutoff
Other:
MECHANICAL PERMIT FEES*
City /State/ZIP: Aurora, Or. 97002 Subtotal , 94.29
Phone: (503) 3814901 I Minimum permit fee ($90.00)
( ) Fax: (503) 6787912 Plan review (25% of permit fee)
CCB lie.: 167149 i ( State surcharge (12% of permit fee)
/
TOTAL PERMIT FEE /p .1,t)
• Authorized 51 This permit application expires if a permit is nut obtained within ia0
days after it has been accepted as complete.
Print narmr/ e ">/f4T// /f Date: 09/05/2012 • Fee methodology set by Tri -County Building Industry. Service !lead
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