Permit CITY OF TIGARD MECHANICAL PERMIT
1111 " COMMUNITY DEVELOPMENT Permit #: MEC2013 00380
Date Issued: 07/10/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 parcel: 1 S135CCO2500
Jurisdiction: Tigard
Site address: 10265 SW KATHERINE ST
Project: Zwingraf Subdivision: GREENBURG HEIGHTS ADDITION Lot: 11
Project Description: Install outside gas pool heater, 100' of underground gas line (2 lb system).
Contractor: BEN'S HEATING & AIR CONDITIONING LLC Owner: ZWINGRAF, JOSEPH R & SUELLEN
PO BOX 80607 10265 SW KATHERINE ST
PORTLAND, OR 97280 TIGARD, OR 97223
PHONE: 503 - 233 -1779 PHONE:
FAX: 503 - 651 -3345
FEES
Specifics: Description Date Amount
Other, Fuel Appliances 07/10/2013 $23.32
Type of Use: SF Fuel Piping 07/10/2013 $14.15
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 07/10/2013 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 07/10/2013 $52.53
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 i , t started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to ollow les adopted by the Oregon
Utility • • enter. Tho : rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -00' I Yo :y o ain a copy of the rules
or .• ect questions to • ► C • calli . 503.232.1987 or 1.800.332.2344. � I
I.sued By: , /,/ Permitt a Si n ure: ! ► . I
y ..L� i e 9 at L I
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 ONIX
li City of Tigard Received ro ��� Permit N o.: A, 0 •
Date /By: 7 1!� -�Q/ 3� Q D 3
° 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
Inspection Line: 503.639.4175
T I G A'R D Date Ready /By: kris: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK' COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit tees* 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.
CATEGORY OF CONSTRUCTION Value: $ q 60
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
l' - and 2- fancily dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. Na . Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: /oa6,5' s u xir-theriWo s-1 ' Air conditioning gp placement) (requires uires site plan showing lacement 46.75
City/State/ZIP: 11- or gl a a 3 Furnace 100,000 BTU (duets/vents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite /bldg. /apt. no.: Projec name: Heat pump 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, etc. 46.75
Subdivision: Lot no.: Flue /vent for any of above 23.32
Other: 23 -32
Tax Wrap /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 23.32
I Gas fireplace 33 39
'Fa • < • A 'A t o - / , 71Q . '4' e - —
fireplace Flue vent for water heater or gas
✓0 i '-1 ( 4 e/ I er (QfeU/V� ,3.32
Log lighter (gas) 23 32
a 1 S y s f t ' Wood /pellet stove 33.39
i Wood fireplace /insert 23.32
KPROPERTY OWNER I ❑ TENANT Chimney /liner/ tie /vent I 23.32
Other:QQ� / / r�[�A�l C� P 23.32
Natne' Le-- Z ` W I N r Environ ental exhaust and ventilation
Address: / I? 6r. (w A/ en ° SF Range hood /other kitchen
equipment 33,39
City /State / /.I P: ' , y -C e f q--1 a a 3 Clothes dryer exhaust 33.39
J Single -duct exhaust (bathrooms,
('hone: (S03) Fax: ( ) toilet compartments, utility rooms) 23 -32
04 APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 23.32
Business name: Other: I I 23 -32 1
Fuel piping
Contact name: �l� L : i, .� - 514.15 for first four; 54.03 for each additional
Address:
' t N Furnace, etc.
Gas heat pump
City /State /!.I P: Wall /suspended/unit heater
Phone: (jt," i 3.3 I / g Fax: : ( ) Water heater
Fireplace
F -mail: Range
CONTRACTOR Barbecue .
Business name: i.._ e N S Jo 4'' 4— /4- / G Otheres dryer (gas) /
Address: 1 V I , 0Y: O K� .7 MECHANICAL PERMIT FEES*
City /Slate /LIP: Pa— 'flet,l,'6, 0/ .,- CI . Q Subtotal
t
e� �' Minimum permit fee ($90,00)
( —)J a 3 S . j — 7 '1 l Fax: (�S ) b .S' 3 3 /-/...,"-- Pl an review (25% of permit fee)
�ilic.: � ' '! S--C1 7 State surcharge (12% of permit fee)
Taw. PERMIT FEE
Authorized signatur : ; I p This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: l. Wit G Date: 77/67/ ' Fee methodology set by Tri- County Building Industry Service Board
I 'melding \Pen \M1 /C- PermiIAp 1 0/01/09 440 -4617T (11 /02/COM/Wt:B)