Permit p CITY OF TIGARD MECHANICAL PERMIT
t; COMMUNITY DEVELOPMENT Permit #: MEC2013 -00363
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/02/2013
Parcel: 2S112BD07000
Jurisdiction: Tigard
Site address: 14709 SW 79TH AVE
Project: Brown Subdivision: BRITTANY MEADOWS Lot: 6
Project Description: Installation of gas line for bar -b -que
Contractor: ALAN NATHANIEL GOFFMOORE Owner: BROWN, JAMES E & KRISTA M
13950 SW BARLOW RD 14709 SW 79TH AVE
BEAVERTON, OR 97008 TIGARD, OR 97224
PHONE: 503 - 664 -6423 PHONE: 352 - 871 -2433
FAX:
FEES
Specifics: Description Date Amount
Fuel Piping • 07/02/2013 $14.15
Type of Use: SF 12% State Surcharge - Mechanical 07/02/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 07/02/2013 $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 odes .•nd all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if wor• is not st• ed withi 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to fo • the rules adopted b, the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. •u ma ob ain a co! of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By s CPermittee Signature: A �
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 An lie
- , l OFncy. USE ONLY,•
� EIVED
City of Tigard Received
Date /B,' /3 / Permit No . )y�/3 -ao 3
2 . Pr
13125 SW Hall 31vd., Tigard, OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.398.190 L O 2 2013 Date /By. Other Permit.
TIGARD Inspection Line. X03.639 Date Ready /By: Juris H See Page 2 for
Internet: ww'w.t igard- or.gov
CITY OFTIGARD Notified /Method Supplemental Information
TYPE OF M II G VISION COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
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 dwcluing ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description j Qty. La. I Total
.JOB SITE INFORMATION AND LOCATION Iteatm /eoolitl
Air conditioning 46.75
Job site address. 14709 Sw 79' Ave Furnace 100.000 BTU (ducts vents) 46.75
City /State /ZIP: Tigard, OR. Furnace 100.000= BTU (ducts /vents) 54.91
Heat pump 61.06
Suite/bldg. /apt. no: Project name: Brittany Meadows
Duct work 23.32
Cross street /directions to job site: Bonita 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
Flue /vent for any of above 23.32
Subdivision: Brittany Meadows Lot no.: 6
Other: 23.32
Other fuel appliances:
Tax map /parcel no.: Water heater 23.32
DESCRIPTION OF WORK I Gas fireplace /insert 33.39
Flue vent for water heater or gas
BBQ gas line Fireplace 23
�.3_ ' 2
Lod lighter (gas) 23.32
Wood: pellet stove 33.39
Wood l 23.32
Chimney 1iner!Iiue /sent 23.32
I Other: 1 23.32
® PROPERTY OWNER ❑ TENANT
Environmental exhaust and ventilation:
Name: Krista and James Brown Range hood /other kitchen
Address: 14709 SW 79' Ave equipment 33.39
Clothes dryer exhaust 33.39
City /State /ZIP: Tigard, OR Single -duct exhaust (bathrooms.
toilet compartments, utility rooms) 23.32
Phone: (352)871 - 2433 I Fax: ( ) Anic /crawlspace fans 23.32
® APPLICANT ❑ CONTACT PERSON Other' 23.32
Business name: .Alan Gofflloore
Fuel piping:
514.15 for first four; S4.03 for each additional
Contact name: Alan Furnace. etc.
Address: 13950 Sw Barlow Rd Gas heal pump
I
Wall /suspended /unit heater
City /State /ZIP: Beaverton, OR. 97008 Water heater
Phone: (503) 664 -6423 Fax: : 1 ) Fireplace
Range I
li-mail: alangoffmoore a,gmail.com f3ari)ecee 1
CONTRACTOR Clothe, (.!: el" ; gas) 1
Business name: Alan Goffkloore Other:
MECHANICAL PERMIT FEES*
Address: 13950 Sw Barlow Rd
Subtotal 900
City /State /ZIP: Beaverton, OR. 97008 — I Minimum permit fee ($90.00)
Plan review (25% of permit fee)
Phone: (503) 664 -6423 8", -.AL F ax: ( )
1 I State surcharge (12% of permit fee) /5..
CCB lic.: 187268 'I v /CO TOTAL PERMIT FEE � - � - This permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
f
Authorized signattyt� .` " Fee methodology set by "Fri-County Building Industry Service Board
Print name: Alan goffiMoore Date: 6/26/13 I
I \ Building \Permits 0.11iC_Permit App_0401 1 3 doc 440 (I 1 0 COB/VC En)