Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2013-00568
T t G A.RD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/30/2013
Parcel: 2S114BB21500
Jurisdiction: Tigard
Site address: 16546 SW 103RD AVE
Project: JETT Subdivision: RIVERVIEW ESTATES NO.2 Lot: 59
Project Description: Gas line to range.
Contractor: POWER PLUMBING CO Owner: JETT, BRADLEY
PO BOX 19418 LARSEN, NICHOLE L
PORTLAND,OR 97280 16546 SW 103RD AVE
TIGARD,OR 97224
PHONE: 503-244-1900 PHONE:
FAX: 503-244-8825
FEES
Specifics: Description Date Amount
Fuel Piping 09/30/2013 $14.15
Type of Use: SF 12%State Surcharge-Mechanical 09/30/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 09/30/2013 $75.85
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature: \
.0111111-11 —1~
''
Call 503.639.41 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
SEP/27/2013/FRI 01 :59 PM POWER PLUMBING FAX No, 503 244 8825 P. 001
Mechanical Permit App ii( ",rt-I FOR OFFICE USE ONLY
Received
City of Tigard o .- -.,r
• V 13125 SW Hall Blvd.,Tigard,aR '7223 .
Date/By: ' 3d f 3 • _ -_ n
Phone; 503.713.2439 Fax: 503.59Sef b 30 2013 Plan Review Other Permit:
Inspection Line: 503.639.4175 Datc Rc
T i G A I?D Date Ready/By: gin % See Page 2 for
Internet www.tigard or.gov CITY OF TIGARD Notified/Method: Supplemental Information
y k�' t wvr c rn•n j1�S_ t...,... �}7r 7, - •`. ; ` rn.r`e�nS4-u ,V r. e".(--T: or
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Mechanical permit fees*are based on the value of the work
❑New construction 'ddition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
'n yy w iq� W , C17 7 mer r : - . M ?r-w » 3 4_Pn' l slla.. S
F .2 at rn U/. A4.c 4 m:
41,;t "1 ( .!::0 41' 1 ft ;-,- ,,. ti t;LJ ,,.„
1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑Multi-family ❑Master builder ❑Other. Description I Qty, I Ea. I Total
}{ , t x ).y ( r i V fir { C J�f a'c) ` \ �)�tyti rt i�[f r -P"r ,irV, , ,;. ,rN Heating/cooling:
..?,4ri. `_s.v �` ,a , tr;.�ia .a.. ....r!Ehri-1,y :_..h .:tr�5_ftiE r Is- d:.. . r• -. .
Job site address: Air conditioning 46.75
/64 , • _ 1 /_ . Furnace 100,000 BTU(duets/vents) 4 46.75
City/State/ZIP: - 4.01 g 7, ..,) Furnace 100,000+BTU(ducts/veats) 54.91
" ) ) Heat pump 61.06
Suite/bldgJapt.no.: Project name: rtALA__!. • _ y I., L Duct work 23.32
Cross street/directions to job site: Jt is 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 2332
Subdivision: Lot no.: Other 2332
Other fuel appliances:
Tax map/parcel no.: . Water heater 23.32
t r ,jiAv4bkc�ty�fti , 7Y^ ' ry'��•z +.�`a�1,� , ZPi� r r"'t C, ''',,l'-'...‘5.-..:PM.iflx,;,,';ra'' Gasfireplaeelnsert 3339
1/,. r?,4,Y. td. S •7 `Sjl:F t ,�ic',iattk4d ft...t.,.x, ;. w,:••...
�, r `"''�'•� ��u�.-��_•(d..v"" Flue vent for water heater or gas
"MOBIL �� 1 _�` d fireplace 23.32
/�
---Log-lighter-(gas) .
-23.32
6 V' ' Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 2332
, - , l.t ?` '` ..77 ca s . :`,'F�,, r t „,Fi"'.:.
Ether:
2332 k s rf t F',g-_.:r._-." A L 4 .er d _- rZ( t�+) t1 Y Environmental exhaust and ventilation..
�IEI M4 J//01 t
Range hood/other kitchen
equipment 33.39
Address: j thl �.t� Clothes
exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax ( ) Attic/crawlspace fans 23.32
` ` " .__ nti_1 .�w W rnr..w..,. � - d r '� Other: 2332
T p M t°. ¢E tl C,C:fi4..x.:a4ic.?x�w_ r.Cwl " .:. : f1.v .. 1 l v R .,
Fuel piping:
$14.15 for first foot;$4.03 for each additional
Contact name: • / ) J1v)JJ,, Furnace,etc.
Address: /!/
/� r/ Gas heat pump
9��� Wall/suspended/unit heater
City/State/ZIP: P1-' %l 6 Water heater
Phone:( ) , - w 0 a Fax::( ) - -s 8 Fireplace
Range / /I/-,
E-mail: Barbecue
Ii.�,, y y.,i .1- ..11 h r G.a,.i. ,Pr O i-7 V.'1t 7 o „: 't, �]�rat Y
Clothes dryer(gas)i k i.. .. 1 .�'j' ..' ,._..I , tea 1 t. Y+ ✓,.jF''!? :�l,.a��L f1[ir ft. , T 1lYtdi'
Business name:/ (/1�// Other
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+nd�K n_i ^r.-S-r�mFr_:/�r'` ���'i
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!
Address: ✓,/� //]T/e
Subtotal
City/Smte/ZIP: �^ '7 Minimum permit fee($90.00) 0()
•ne:( ) `7" f�Q C7 Fax'( ) -L/7' Pg2.±) State
Plan lurch iew(zs%ofpermitfee)
arge(12%of permit fee) /D YO
1'cCB lie.: 5,p3-7 7 TOTAL PERMIT FEE /0_0 r
r� - This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: l p ! • Fee methodology set by Tti-County Building Industry Service Board
1 Paint name: KA/S �hS'e ` I-Date: ��J/��j/
t%antdiastvennu•tMEC )) . f.•• ...maw 440-461rr(llro2JCOM e)
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