Permit CITY OF TIGARD MECHANICAL PERMIT
: n COMMUNITY DEVELOPMENT
Permit e: MEC2013 -00367
13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 07/03/2013
TIGARD Parcel: 2S104DC01900
Jurisdiction: Tigard
Site address: 13485 SW BENCHVIEW TER
Project: Subdivision: BENCHVIEW ESTATES Lot: 19
Project Description: Install gas line for barbecue.
Contractor: ROTH HEATING & COOLING Owner: ORSAY, PAUL
PO BOX 1265 13485 SW BENCHVIEW TER
CANBY, OR 97013 TIGARD, OR 97223
PHONE: 503 - 266 -1249 PHONE: 971 - 219 -7461
FAX: 503 - 266 -3478
FEES
Specifics: Description Date Amount
Fuel Piping 07/03/2013 $14.15
Type of Use: SF 12% State Surcharge - Mechanical 07/03/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 07/03/2013 $75.85
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.
Issued By: �( Permittee Signature: /N (97 f e�rp, J
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.
JUL -03 -2013 WED 12:17 PM ROR rIV 1 FAX NO. 5032663478 P. 01
Mechanical Permit Application
GOR oi'i IC'L us': ONLY
City of Tigard JUL 3 2013 Received .73 I :I% Permit No.:/yE e20/3 - 003 6, ,'
i l 4 13125 SW Hall Blvd., Tigard, OR 97223 ^C ^ a o Plan Review ■ phone: 503,71503,718.2439 Fax; 503.598.1960CITY Vf TIGARD Dumlfiy: Other Permit:
'I' I G A R u
Inspection Line: 503 BUILDING DIVISION Dula RoadyBy: m See Page 2 for
Internet: www,tigurcl- or.gov �l U1 V �7 Notified/Method: Supple:mmul Information
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`' • Mechanical permit f based on the value of the work
El New construction Addition /alteration/rcplaccment performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: mechanical materials, equipment, labor, overhead, undjrofit.
i Value: $
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,:' .,,I:i. i,.l.,''a „1. r.:';'; l � �� ;�� . 'bar. � � �I' �I�, �., ��rr,: r� :d��,,�r�Lr,,rlW.r.11.,E.1.,. I •• r�i °, r a'{�rM �;��,�� �
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® 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building Fat special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other; � p Description Qty. i Ea, ' Total
''I;lii;i'!V :::1'•: :, r.l ' 1i '. ,�' ;''� �1' ...,,, •,, ;b' wr..i h7:A�l i�;i!" 7 '� I i' �1; ,1i!
. Heating/cooling:
t1 c t1�f,p n � � a�/�y �y 6
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,.. r " Air COnditiani 46.75 -
Job site address: 13485 Uenehview Tarr Furnace 100.000 BTU (ducts/vents) 46.75
City /Statc/ZIP: Tigard, OR Furnace 100,000 BTU (duclUvents) 54.91 _
/� Heat pump 61.06 ,
r' �
Suite /bldg. /apt. no.: Project name: ESCM /40826 9/-S 7 Duct work 23.32
r - - 23.32
Cross street/directions to job site: Hydronic hot water system
Residential boiler (radiator or
hyd ronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75 _
Flue/vent for any of above 23,32
Other: 1 23.32
Subdivision: Lot no,:
_ Other fuel appliances:
Tax map/parcel no.: - Water heater 23.32
i 9';'1 i'. ti; t �, ",' ';; fill;. ; 0, lll:(:1 1'";'!iiin !;1''�1= :r!N,:, Gas fireplace/insert 33.39
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1!c,, Y f M ri�A!(►,.. R7�rl'•'', "'"., t , tr,l',''��Ji i'r'i 1111r71:rl:l,,.r':,�
'� r �� i '�' � ' lr; r Flue vent for water heater or gas
gas line for BBQ fireplace 23.32
Log lighter (p) 23.32 ,_
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32 .
,;r i .c it'll i;k" . , /. r ,, Other 23.32
a ., r ,,.,.., ,,,{" l' F i9''"ialr'lii;r';'it'I'Irli'r� l I ',11 r�r;'}' . 1• ' .,. :: i i;:
. :ili'.'rl'fi!.';ji;'L1 ^1 I� ,�^lil",l':'1' ll' „': ';!'rv''1.n.d '4 0• lfl! 1 ' *'.dl5'''ke '•'hl' ''. Environmentalexh „standventilatiolt:
Name: i02 s �7 ny Range hood /other kitchen -
equipment 33.39
Address: 1348.5 Benchview Terr
• _ Clothes dryer exhaust 33.39
Single -duct exhaust (bathrooms,
City /State /ZIP: Tigard, OR 97224
toilet concpartcnents, utility rooms) 23.32
Phone: (971)219 -7461 Fax; ( ) Attic/crawlspace fans 23.32
,; :,,[; ; ul:' II,'r „ �. „Ir;;''� -" ;;'r;'I ;11, i;u;7i : ;:.m:1:::L:., , „ ,. :-_,..... : :.,^.;;li;� Other- 23.32
1 l,i:il a 1 ;rlf'i0e$ Oi,I 4.4.,' `Z'1 :�' In I r'!,E ll• i ;::1111 I r I ..41p'll l ` i�'! r / , .i..k , l,,i,,:! :� Fueplping•
Business name: Roth Heating and Cooling _ $14.15 for first four: $4.03 for each additional _
Contact name: Angela McGraw Furnace, etc.
Gas heat pump
Address: PO Box 1265 Wall /suspended/unit heater ,_
City /State/ZIP: Canby OR 97013 Water heater -
Phone: (503) 266 -1249 Fax:: (503) 266 -3478 Fireplace
Range _- ,
E-mail: angelnmgroth- heitt,eom Barbecue 1 _ 14.15
,.:!:::.:f:!;.'; , ; r,I;l ;,":::;,,0`,'1:.,t , ;.,,�;Lr;.'1r, sir„ r. �. �7. �c?r ,.1r'..a�� :111r'';'r rlllrf.';ii;.li (,i ;i;i;i {?I {IYr l ' '1 Clothes d (gas) )
l r, ' ' I I, ,1; • 1 (L',,: I l 1' 1 , y) :; : �' F.. fl' "r, :. I I ri'!rl" :,. ,J r l , � I,..1 il H l
.1. �n 60 1. h .O., ry
usi
Business name: Roth Heating and Cooling i lA nP
13 t t; s i t l i h e11; ,,�' �,!,5<w r ,;�!.. .I;al1,l' .gr{l:ilil'I,IIi'
Address: PO Box 1265 Subtotal 14.15
City /State /ZIP: Canby, OR 97013 Minimum permit fee ($90.00) 90.00
Plan review (25% of permit fee)
Phone; (503) 266 -1249 , Fan: (503) 266 -3478 _ State surcharge (12% of permit fee) 10.80 /
CCB tic.: 14008 TOTAL PERMIT FEE 100,80 , ,/
This permit applied if permit un expires a per is nut o will ip 180
P � days after it has s f accepted m i t as mplete.
obtained
Authorized signature: ,. ,, \ ` , \ 1 Y / �\ n 7 ' Fee meA,odology set by Tri -County Building Industry Service Board
Print name: Angel ,ntw • 1 V` Date: 7 13
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