Permit CITY OF TIGARD MECHANICAL PERMIT
2 COMMUNITY DEVELOPMENT Permit #: MEC2013 -00178
T [GA R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 04/02/2013
Parcel: 2S114BCO3300
Jurisdiction: Tigard
Site address: 10276 SW RIVERWOOD LN
Project: Whited Subdivision: RIVERVIEW ESTATES NO.2 Lot: 70
Project Description: Repipe for gas range
Contractor: CECIL E BRUNK III /PMGC Owner: WHITED, BRYCE AND ELISSA
7755 SW BARNARD DR 10276 SW RIVERWOOD LN
BEAVERTON, OR 97007 TIGARD, OR 97224
PHONE: 503 - 358 -0451 PHONE: 336- 707 -4970
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping 04/02/2013 $14.15
Type of Use: SF 12% State Surcharge - Mechanical 04/02/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 04/02/2013 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types: Natural Gas
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 ado•ted by the Oregon
Utility N [cation Cen - Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may a copy of the rules
or dir t questions to OUNC • 03.232.1987 or 1.800.332.2344.
Issu By: /- / Permittee Signature: 14
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 Application FOR OFFICE USE ONLY
City of Tigard Received
: ¢ j �
`J g IYatelt3y � �d �• � Permit No ��� ✓ �� O /7 �/
II
• 13125 SW Hall Blvd., Tigard, OR
- R EC EIV ED Plan Review `Y/1� b
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit:
T I G A R D Inspection Line: 503.639A175 APR 0 2 2013 Date Ready/By: _Turfs Fa See Page 2 for
Internet: www.tigard- or.gov Notified/Method: Supplemental Information
CITYLETIGn COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
TYPE " �� v tI �s ��� 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.
Value: $
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. I Ea. 'Total
JOB SITE INFORMATION AND LOCATION Heating/cooling:
Air conditioning
Job site address: 10276 sw riverwood lane (requires site plan showing placement) 46.75
City /State/ZIP: tigard, or 97224 Furnace 100,000 BTU (ducts/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: Project name: additional gas line Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: sw 104th 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, etc. 46.75
Subdivision: 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 I I 23.32
adding a 3/4" gas line from meter to supply natural gas to new cooktop Gas f
Flue veent nt for water wate r 33.39
fr heater or gas
fireplace 23.32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
® PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 23.32
Other: 23.32
Name: Bryce and Elissa Whited Environmental exhaust and ventilation:
Address: 10276 SW Riverwood Lane Range hood/other kitchen
equipment 33.39
City /State /ZIP: tigard, Or 97224 Clothes dryer exhaust 33.39
Phone: (336)707 Fax: ( ) Single -duct exhaust (bathrooms,
toilet compartments, utility rooms) 23.32
® APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: PMGC
Other: 23.32
Fuel piping:
Contact name: C.E. Brunk Ill 514.15 for first four; $4.03 for each additional
Address: 7755 SW Barnard Dr Furnace, etc.
Gas heat pump
City /State /ZIP: Beaverton, Or 97007 WalUsuspended/unit heater
Phone: (503 ) 358 - 0451 Fax: : ( ) Water heater
E - mail: propmaintgencontr@hotmail.com Fireplace
Range 4 2* l ilfr04
CONTRACTOR Barbecue
Business name: C.E. Brunk 111 /PMGC Clothes dryer (gas)
Other:
Address: 7755 SW Barnard Dr MECHANICAL PERMIT FEES*
City /State /ZIP: Beaverton, Or 97007 Subtotal ?,4.00
Phone: (503) 358 - 0451 Fax: ( ) Minimum permit fee ($90.00)
Plan review (25% of permit fee)
CCBlic.: I j1 r State surcharge (12% of permit fee) /0 Sy)
f / TOTAL PERMIT FEE /0C . V iO
Authorized signature: This permit application expires if a permit is not obtained within 180
2
072 G / J days after it has been accepted as complete.
1 _
Location:
Record Type:
Inspection Type:
Comments:
Inspection Date:
Record ID:
Result:
City of Tigard
13125 SW Hal Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10276 SW RIVERWOOD LN, TIGARD, OR,
97224
Residential - Mechanical
699 Mechanical final
04/03/2013 00:00
MEC2013-00178
PASS - No C of O
Violation Summary:
Inspector Contractor