Permit r
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CITY OF TIGARD MECHANICAL PERMIT
' : 11 COMMUNITY DEVELOPMENT Permit ii: MEC2012 00608
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/26/2012
Parcel: 2S110BA04500
Jurisdiction: Tigard
Site address: 14335 SW MCFARLAND BLVD
Project: Fujitani Subdivision: SHADOW HILLS Lot: 20
Project Description: (1) fuel piping, (1) flue vent and (1) gas insert
Contractor: ALL FUEL INSTALLATION & SERVICE LLC Owner: FUJITANI, FRANK
PO BOX 69 14335 SW MCFARLAND BLVD
TROUTDALE, OR 97060 TIGARD, OR 97224
PHONE: 503 - 674 -2350 PHONE: 503 - 620 -1006
FAX: 503 - 674 -2693
FEES
Specifics: Description Date Amount
Flue Vent for Water Heater or Gas 11/26/2012 $23.32
Type of Use: SF Fireplace
Class of Work: ALT Type of Const: Fuel Piping 11/26/2012 $14.15
Occupancy Grp: 12% State Surcharge - Mechanical 11/26/2012 $10.80
Stories: Minimum Fee Adjustment - Mechanical 11/26/2012 $52.53
Gas Fireplace 11/26/2012 $33.39
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Fuel
Fuel Types:
Gas Pressure:
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Total $134.19
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�ODUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: ,J \� /� 1 Permittee Si i iPPt /cL4�D Kt
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/ 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 Appli 4a D FOR t )l l 1C E �Isr (>n I,N
City of Tigard ED Iteecived PemuitNo.:
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Date/BY: I ( l Xe (i a- I a = p� t000
13125 SW Hall Blvd.. Tigard, OR 972 • c
Phone: 503.718.2439 Fax: 503.598.1 P.4 V 2+ 6 2012 Plan Review Date/By: Other Permit
1 1 i . AR D Inspection Line: 503.639 Date ReadyBy: Iuri 0 See Page 2 for
Internet: www.tigard or.gov CITY OF TIGARD Notified/Method: T/6, Supplemental Information .
n l . • lilt h _Si:
r - HF ' i Ir .; t 7 m r i C' I� i _ "1 yti �i�t �i . ��``"� T 71 R� '24 1 r 1 , r m,, u •r-,, �, �,�Lf If . T7' g i t u F4 -- • i I d' ' !( ' l , , l I I G v z y t �- v 1, elf'. .0 if t! o 1 � . I'Li . „ It t'� 6 i,,vws1s51 • hit : �:.,,,; 1'��i . t 5 roil U - • a di . t a z / { ,
U L m r " idiI+, c t{,4 rr t t4 a ! ruti f l' r 1 f r n .' t 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, equipment, labor, overhead, and profit
f RAM: jtJ r >+ae:tlf t rr LL'i" -'v".:, �'{f7A ' rp z t ;1.11+,44t Value: $
qth :. 2i,"' a�rL 0, 7 _3 •aT0 tl; � 1 4 :!lLi r ! •` H^9 m t .'f n s i ni �! n i a ' :
t ' S . 7 1 . t :f. yy dirt � ': ' _ ' q u n. - - . '� }�' USA t . t it � , , , l �" r t > �
.L ��'ulcvn,Cr: , ... �ik�',J'rlmr -,�.Ir i"!l ..1 P �•, f� r [1,� P � E t' i � r/r t'I•:tll.,lt' U'n�'r {�' ft?�I
! Ii.EC11' ;uFrx_�:e- .. '' I � d.t:u�iteG;e.Y:�^ �.G- >
0 1- and 2- family dwelling El Commereial/industrial ❑ Accessory building For special information use checklist
❑ Multi-family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
{: 1i' ti ? (V T r? utsc e: Ufa+ � �uit.4. wy z•r•Fe pH'n 1 t.. 1y a,jy IFIe9 [iRg/000litrg:
(p.� � r U �. '1 �,Fl f } t� ! 4617 'r 1 ` tl r •' ',l 1 ; r ! U]!; 1 1 r r A 1 �y;,•Jf .:,,.
f1 � ;', '� i ; �I i V ` r n fi I tgi.'14.itil Jail . fir{Alkt' iii ! IS:,; C7 �n : Btr .'d' :(" W' ; l[9�lr� t y.
Air conditioning
Job site address: 14335 SW McFarland Blvd (requires site plan showbgplaeament) , 46.75 ' _
Furnace 100,000 BTU (ducts/vents) 46.75
City /State/ZIP: Tigard, OR 97224 Furnace 100.000+ BTU (ducte/vents) 54.91
Suite/bldg /apt: no.: i 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 V 2132
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Residential boiler (radiator or
• hydronic) 23.32
Unit heaters (fuel -type, not electric),
in- walk -duct; suspended, etc. 46.75 .-
Subdivision: I Lot no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: • Other fuel appliances:
_, I r�yi E �; } MEgrrl ?t 4 : .1 u r, i t�"a) : F { + ' 'tE • , t { ft `L' AV 32
Water heater 23.
_. , �: ; r , �7,, alt..IIU a tn.' : L ., - "'.t it, 444 r kb -- uar]a71'' �„I,`Fi.: r NI .f ��nti .
Gas fireplace/insert 1 33.39 33.39
Install gas line, venting and new gas insert '
Flue vent for water heater or gas
fireplace 1 23.32 23.32 _
. - Log lighter (gas) 23.32
Wood/pellet stove 33.39
• Wood fireplace/insert 23.32
•
If as ,��t!t2.l �a { �w e dit r" ' �a' '�' � a tm ; }�y' "r 'i . ua7 rate 1 ....A..4 , v 'IT
Chimney/liner /flue/vent 23.32
.7 . .: xi J i :'f itw Nllr nnriiii5l tim:F �llli1. ' 9"9t 1�1. °.1 !_',ykia, 1 - t i a ? dn- ! ty 1 t m' • .
' Other:' 23.32
Name: Frank Fujitani Environmental exhaust and ventilation:
Address: Same as above Range hood/other kitchen ,
. equipment 33,39 •
. City/State /23P: Clothes dryer exhaust 3139
Single -duct exhaust (bathrooms,
Phone: (503)620-10% Fax:
� (Jo b ( ) toilet compartments, utility rooms) 23.32
! i l n1'r s a F= yn t l b 4'1.. s
! 1 ,, • ts�+ + i I nc .:.I"Ulf" Attic/crawlspace fans 23.32
V < 1 r ! n L °r rXbu,u rx�ttilL];;
Business name: See Below Other: 23.32 -
Fuel piping:
Contact name: Eric Camp $14.15 for first four, $4.03 for each additional
Address: Furnace, etc.
Gas heat pump _
City/State/ZIP: heater
Phone: ( ) J Fax: : ( ) Water beater
Fireplace 1 14.15
E -mail: allfuel @comcast.net
Ir J 7 u0i '. Z�! e.,...,. ., ::r, -r. U ,5:f 1• r: r uu!r , Range - •
u tith , .a r. h p i �'�ak affeda' :..tF:! _ 't.= f 1 EO. .ig ll'I:!I. 4�r1i; Barbecue
Business name: AU Fuel Installation and Service, LLC. Clothes dffer (gas)
Other.
Address! PO Box 69 • j� f! ,�,,����rf t rr7!� t u i � ; -,y� u ;jilt �T�a I :� r p ;i�n�, •
lii�1LY Y:if.n'� �i t r 1 nn5i0 f .3 6U i ,'t�r,�.*i�. {rrnr;:n� .
City /State /ZIP: Troutdale, OR 97060 Subtotal 70.86
- Minimum permit fee ($90.00) 90.00
Phone: (503) 674 -2350 Fax (503) 674-2693 Plan review (25% of permit fee)
CCB lic.: 169503 State surcharge (12% of permit fee) 10.80 _
TOTAL PERMIT FEE 100.80
This permit application expires if a permit is not obtained within 180
Authorized signature: . days after it has been accepted as complete. •
. Print name: Eric Camp Date: 11/23/12 Building Service • Fee me set by Tri- County Bung Industry Sece Board .
1:1 Buildi ng\PermitelMSC.PermitApp.doe 03/07/12 940- 1617T(Il /02JCOMIWSS) •