Permit V CITY OF TIGARD MECHANICAL PERMIT
``1 a :. COMMUNITY DEVELOPMENT Permit #: MEC2012 -00576
T [ G AR O 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/06/2012
Parcel: 25111 BA02400
Jurisdiction: Tigard
Site address: 14350 SW 100TH AVE
Project: C & L Properties LLC Subdivision: INGEBRAND HEIGHTS Lot: 29
Project Description: (1) radon mitigation system installation
Contractor: SOIL SOLUTIONS Owner: C & L PROPERTIES LLC
3540 SE 28TH AVE 14350 SW 100TH ST
PORTLAND, OR 97202 TIGARD, OR 97224 •
PHONE: 503 - 234 -2118 PHONE: 503 - 939 -2310
FAX: 503 - 331 -7133
FEES
Specifics: Description Date Amount
Other, ExhaustNentilation 11/06/2012 $23.32
Type of Use: SF - 12% State Surcharge - Mechanical 11/06/2012 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/06/2012 $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 by calling 503.232.1987 or 1.800.332.2344. ' I ,� ,^� . /
Issued By: Permittee Signature: D/U 4#�(�'�, /D AL )21411)
•
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.
From: Soil Solutions 503 331 7133 11/05/2012 18 : 30 11350 P.001/002
ift
Mechanical Permit Application REcEly. FOR OFFICE IISE 0:N1.1
City of Tigard Received
: -- 13125 SW Hall Blvd., Tigard, OR 97223
Ph g NOV 0E2012 DaldBY: 14 ( 5- 1)
Plan Review Permit Nola
, •
• Phone: 503.718.2439 Fax 503.598.1960 Other Permit: P LOA . 2 0 7 ,>,.., tv 3
Datelly:
Inspection Line: 503.639.4175
1 i GARD CITY OF TIG • il pat Read Y_ d __H B Y : ID See Page 2 for
Internet: www.tigrud-orgov
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BUILDING (NISI ii .-+ ' edim-: N Supplemental Information
ytoifiir:0 i=::=Koolitottit .
Mechanical permit fees* are based on the value of the work
0 New construction X5kddition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, and Profit.
Value: S
77: St - TPA -70 4'1#0.07 1 01*Iyifill . 11I0170 - 141 5 : 1.1 7077..:i , X7.E.;V:?-U.M
I -. and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special Worrnadon sue checklist
0 Multi-family 0 Master builder 0 Other: Description 1 Qty. 1 Ea. I Total
n:',.."._ n. Heatia rimaliall:
Air conditioning
Job site address 14 35-b Sin/ 1 De' AN-t, (requires site plan showing placement) 46.75
Furnace 100,000 BTU (duets/vents) 46.75
City/State/ZIP: - 1 - 3 3 ,,.„ 0 1 , OR. 1 :12.1-f . FLII1l8C0 100,00(H- BTU (duns/vents) 54.91
Suite/bldgJapt. no.: Project name: W Heat pump
(requires site plan showing placement) 61.06
Cross slreet/directicms to job site: 0 () 5E u-proe_,r- 4 F. t-cryth Duct work . 23.32
t..4 « Vieu./ 1 Hydfoni. hot water system 23.32
Residential boiler (radiator or •
hydronic) 23.32 -
Unit heaters (fuel.type, not electric),
in-walljn-duct, suspended, etc. 46.75
Subdivision: 1 Lot no.: Flue/vent for any of above _ 23.32
Other . 23.32
Tax map/parcel no.:
Other feel appliances:
;,'5.4".•'''Ketitl`fat-W7 :7- " :2 . °7 7.77: 771 ). - FTWiT 6 / 11 WW-14711 1 7, - - ' ''.-•-' W ater heater 23.32 .
Gas fireplace/insert 33.39
Flue vent for water heater or gas
9
• o /i ii.A - . " •
0 .1 OA
.1_ , 1 ' .__±.1 01. fireplace 23.32 _
Log lighter (gas) 23.32 •
Wood/pellet stove 33.39
_ _
Wood fireplace/insert 23.32
c-w :. ---- .70E - owoymtiv i emulamisgaio rfrwa ChinmeWliner/flue/vent 23.32
Other: 23.32 ,_
Name:
VII I) lid i'lltie.) Environmental exhaust and ventilation:
Range hood/other kitchen
Address: 52+71.1E
equipment 33.39
City/State/ZIP:
Clothes dryer exhaust 33.39 .
Single-duct exhaust (bathrooms,
Phone: ( ) Fax ( )
toilet compartments, utility rooms) 23.32
g1.!':21E,24414tfir''C.kfT'''.gf12t.aP,V;:TZVrfgglliircp'lNW4W_ckiZg:,2:g Atfic/crawl space fans 23.32 -
Other: cettien coal I 23.32 ,
Business name: 01 I 5011,14 0 elj. -
Fuel piping:
Contact name: M y 6 ety Fp
-
S14.15 for first four; $4.03 for each additional •
Address: 35 iE ar e- A Furnace, etc.
Gas heat pump
City/State/ZIP: Vbe+tail c / Og. 9 -ta 0
WaWsuspendedAmit heater
Phone: ( 5 3) astt.-ai rel I Fax: : (D? ) 33j- - 4113 Water heater
1 .. Fireplace _
_ VIACUr 501150, kti 6 rim mai*, . cet.". Range
,f,::::,..z,ffe.z..4.4i-,:!.,::,,I...F.,,.6,,,Z,::..-:-,ti.,.„-?!.z:-,A.:V-.1.1-*".....!L-•”:Mtc5::-.,',-,g1;,,:g,2,2_:;_;.E.4-14:1..:ag2; , BarbeCue
Business name: 1ATA a ,& }Wove Clothes dryer (gas)
Other:
Address:
EMAINKETWOreAr..rialtrAiis.:232Wir59
City/State/ZIP:
Subtotal
Minimum permit fee ($90.00)
Phone: ( ) I Fax: ( ) Plan review (25% of permit fee)
CCB lic.: / 3 3/9'
State surcharge (12% of permit fee)
TOTAL PERMIT FEE I OD • r0 .
Authorized si ature: This permit application expires If. permit is not obtained within 150
days after it bas been accepted as complete.
■
Print name: I Date: ‘t 5 • Fee methodology set by Tri-County Building Industry Service Board .
1 ABuildinglPermits 1 MEC.PermilApp.doe 7/12 440.4I17T (11/02/COWWEB) ..
I