Permit CITY OF TIGARD MECHANICAL PERMIT II e.. COMMUNITY DEVELOPMENT Permit#: MEC2013-00566
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/30/2013
Parcel: 1 S135DB07900
Jurisdiction: Tigard
Site address: 9125 SW NORTH DAKOTA ST
Project: Graham Subdivision: ASHBROOK FARM Lot: 25
Project Description: Installation of gas line for range.
Contractor: BRUNER PLUMBING Owner: GRAHAM,JASON ALAN&JOYCE M
PO BOX 23985 9125 SW NORTH DAKOTA ST
TIGARD,OR 97281 TIGARD,OR 97223
PHONE: 503-484-5105 PHONE:
FAX: 503-624-2173
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 $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance_or_-if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utili Notification Center Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
o direct questions to OUNC\by c• .•• 43.232.1987 or 1.800.332.2344.
sued By: r / Permittee Signature:
ks.
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Anplicati! 1 (>1t t l ti l( I. t I- (t\i.l
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City of Tigard CEIVED Received 7!' ► Permit No.: tee i ")--iC/56,0
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review' C Phone: 503.639.4171 Fax: 503.598.1960-. - . 0 ' '1 Date/By: Other Permit.
Inspection Line: 503.639.4175
i I c `r � Date Ready/By: kris: El See Page 2 for
Internet www.tigard-or.gov CITY OF TIGARD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE— USE CHECKLIST
❑New construction Addition/alteration/replacement Mechanical permit fees*are based on the value of the work
performed.Indicate the value(rounded to the nearest dollar)of all
❑Demolition ❑Other mechanical materials,equipment,labor,overhead,and profit
CATEGORY OF CONSTRUCTION • Value:$
RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
12-1-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
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 9/Z S 56j i/0)/-f r 1� S4_ ' conditioning heat
(requires site plan showing or placempump ent) 14.00
City/State/ZIP: el -( �
1 Furnace 100,000 BTU(ducts/vents) 14.00
Suite/bldg./apt no.: Project name: C y etit(i.'1/t'ti
Furnace 100,000+BTU(duets/vans) 17.90
Cross street/directions to job site: rj r) ���
l�"n��„ Li��
Gas heat pump 14.00
Duct work 10.00
Hydronic hot water system 14.00
Residential boiler(radiator or
Subdivision: I Lot no.: hydronic) 14.00
Tax map/parcel no.:
Unit heaters m-d(fuel-type,ded,etc. 14.00 .
• DESCRIPTION OF WORK
Flue/vent for any of above 6.80
6 etts +0 APAAJ RO-M-r-
Other. 10.00 _
Other fuel appliances
Water heater 10.00
❑ PROPERTY OWNER I ❑ TENANT Gas fireplace 10.00
Flue vent for water heater or gas
Name: fireplace 10.00
Address: Log lighter(gas) 10.00
•
City/State/ZIP: Wood/pellet stove 10.00
Phone:( ) Fax:( ) Wood fireplace/insert 10.00
❑ APPLICANT ❑ CONTACT PERSON
Business name: Chimneydiner/8ue/vent 10.00
Contact name: Other. 10.00
Environmental exha and ventr7atl o0
Address: Range hood/other kitchen
City/State/ZIP: equipment 10.00
Phone:( ) I Fax::( ) Clothes dryer exhaust _ 10.00
Single-duct exhaust(bathrooms,
E-mail: toilet compartments,utility rooms) 6.80
CONTRACTOR, . Attic/crawlspace fans 10.00
Business name: 1,V Yl eAe" 12 Lu W(. b / frus in r
Other: 10.00
Address: /O`0 3 2_-- 1 E c Fuel piping
City/State/ZIP: _ / $5.40 for first four,$1.00 for each a dditional
9 Gf///!n _� (
Phone:( $off ) �o L� �Z/ �l� I Fax:( So3 ) �Ly'ZI 73
CCB lie.: '/7 3 7 Gas heat pump
WaWsuspendedhmit heater
Authorized signature: