Permit CITY OF TIGARD MECHANICAL PERMIT
n COMMUNITY DEVELOPMENT Permit #: MEC2012 -00590
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/14/2012
Parcel: 1 S133DCO3500
Jurisdiction: Tigard
Site address: 13190 SW FALCON RISE DR
Project: Neuman Subdivision: MORNING HILL NO.1 Lot: 28
Project Description: (1) gas insert and (1) gas piping
Contractor: GASPRO INC Owner: NEUMAN, DUSTIN
7603 SE LOUNSBERRY LN 13190 SW FALCON RISE DR
PORTLAND, OR 972056 TIGARD, OR 97223
PHONE: 503 - 775 -7020 PHONE: 503 - 927 -2587
FAX: 503 - 775 -7019
FEES
Specifics: Description Date Amount
Gas Fireplace 11/14/2012 $33.39
Type of Use: SF Fuel Piping 11/14/2012 '$14.15
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 11/14/2012 $42.46
Occupancy Grp: -
Stories:
Fuel
Fuel Types:
Gas Pressure:
•
Total $90.00
Required Items and Reports (Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules
or direct questions to 4biliti OUNCby calling 503.232.1987 or 1.800.332.2344. /� n /� /
Issued By: °1 AP P1 " Permittee Signature: D i f e 14Th AJ
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
• This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each Inspection.
•
•
Mechanical Permit Applic ECEIvED 14111 ()t 1.1(. L t!SL ti L\
lJ �I Received M�Co$O(� - (� �7.t+
City of Tigard Date/BY: I I Permit No.:
'
13125 SW Hall Blvd., Tigard, OR 972100 V 1 3 2012 Plan Review Other Permit.
_ Phone: 503.718.2439 Fax: 503.598.19
Date/ By:
T 11, R. D Inspection Line: 150 .639.4175 CITY �'^ A Dn ) Rey /By: ' M Sec P 2 for
Internet www.ti d- or.gov V IGARD Notified/Method: supplemental Information
BUILDING 1. •,a
I.Itii � r i �,1 } t .. 1 1 ti 1 „ •'�C + � . �- I t f l r l r; 1F i f 'f=t7= s ' . ' r ____ F I) , ii , 2 � l• t _ '.
s... _� .. _..:__......_ __._.� .,..•.._ L.:, �.t..... _ i , _ _.L:_...__. � � 1 ..:". ' ‘.. •._ , . r ''''' '. rI. t:.. _ .... , t. Mechanical permit fees' are based on the value of the work
0 New construction Addition/alteration/replacement performed. Indicate the value (rounded to the neatest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
♦•- r J : r j ' 4 t i r� N t 11.41 Value $
t 1 : 7 Tr':
I ..i, , .r.,, , ... . .. t. . ...n ... .. ,r . '::}: I. . .,i.la: .. . . . : . , .r, . ...> : ..1.... :.1 . l:' X1 J 7 f t f11 1 1101E i 7 1l/ j t. C ! I .
Z 1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special Worroration use checklist
❑ Multi family 0 Master builder 0 Other:
Description I Qty. I Ea I Total
„9 Il +fi F7, rut, (, r tf S .- � e ur . t ,, I yr 1: .`
Healing/cooling: - `
. nditioning
Job site address: ' I 3 , ix/ a . f . - • R. (requires site plan showing placement) 46.75
�- Furnace 100,000 BTU (ducts/vents) 46.75
City/State/ZTP: / AA 04 97a_ Furnace 100.000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Project name: Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system , 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric).
in -wall, in -duct, suspended, eto. _ , 46.75
Subdivision; Lot no.: Flue/vent for any of above 23.32
Other: 23.32 ,
Tax map /parcel no.: Other fuel appliances:
' 1 t 'c J r 1 6 ' r - -'; . ,(. •
� a t.: ^a Wa f terheater 23.32
v:i x.. ..,. ! ti - .:. - �-� .._. L , ii inJ f '. . . . .La.:l"Jr „ :. ; Vs fl f 33.39
replace/insert
Flue vent for water heater or gas
fireplace 2.3.32
= - Log lighter (gas) 23.32
Wood/pellet stove 3339
Wood fireplace/insert 23.32
g_a 4 u ; ;; t r •; i ; r 1 ' 2 y e „ Chimneylliner /fluelvent 23.32
a I.
- '`'. , .:_ 1 L' __:t.- - .: .3 ,; f; - - :!.I,lAst..,..:_.._.- Other: 23.32
Environmental exhaust and ventilation:
Address: • / 5 /* ` k hood/other kitchen
�, equipment 33.39
City/State/ZIP: / ' �i 7.22 Clothes dryer exhaust _ 33.39
Single -duct exhaust (bathrooms,
Phone: ( v') 9 -). 5 ; 7 Fax ( ) toilet compartments, utility rooms) 23.32
i� e t r n � ,' r„ , h r � . �. Attidcrawlspace fans 23.32
�•.Y r - t ! . . r. ! I h L l 4 � 7 a J'' s f 1..i t, 4� ) t . 1 4
.i...: .i'I .i- • 1 ?ae.i... -. ,] ...a:r_� .,, t..�._. _. , _,..__�....._ s�._._.._....._..._... en.. N. _...�.:.w._....� ...,r.:.... 1.._
Business name: r Other: 23.32 _
• • / _ Fuel piping:
Contact name: IIp . r: # i $14.15 for first four; $4.03 for each additional
Furnace. etc.
Address: ' r .1 • I. , /A.. .. r Gas heat pump ,
liAi _ , .,.• 10111111 Wall/suspended/unit heater _
Water heater
Phone: ( s) / ._ j w '
- y Fireplace
�,'� !•i . Range
4 , / t '- , ti � 1 .. ` }i F v t .,,.: Barbecue
Business name: Ei Clothes dryer (gas) •
Address: 7 5 1 , , ` r J' i + f *J �• , r r t f
=9I d .- r C7 ` 9 I_ r ta Subtotal
Minimum permit fee ($90.00)
' hone: ( d r _ C Plan review (25% of permit fee)
State surcharge (12% of permit fee)
/ TOTAL PERMIT FEE Q'a. at)
signature: / Wer,lqi
Thu permit application b if a permit i9 ant d within 180
Authorized si
doysya after er it t bas aa been accepted as complete-
Print name: l j wi D ate : //AMIE ► Fee methodology set by Tri -County Building industry Service Board
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