Permit (176) CITY OF TIGARD
ICPE
IiiiPCOMMUNITY DEVELOPMENT
ermitMEC#:HANMEC2019-AL00300RMIT
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/13/2019
Parcel: 2S103AB01100
Jurisdiction: Tigard
Site address: 11100 SW WALNUT ST
Project: Kahn Subdivision: ECHO HEIGHTS Lot: 7
Project Description: Range hood and gas fireplace installations with fuel piping to range and gas fireplace for kitchen area remodel.
Contractor: NW RESIDENTIAL Owner: KAHN, STEPHEN M&ANN L
PO BOX 230635 11100 SW WALNUT ST
TIGARD, OR 97281 TIGARD, OR 97223
PHONE: 503-860-2631 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Gas Fireplace 05/13/2019 $33.39
Type of Use: SF Range Hood/Other Kitchen 05/13/2019 $33.39
Class of Work: ALT Type of Const: Fuel Piping 05/13/2019 $14.15
Occupancy Grp: 12%State Surcharge-Mechanical 05/13/2019 $10.80
Stories: Minimum Fee Adjustment-Mechanical 05/13/2019 $9.07
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 - .:I S. . .
„----7
Issued By: Permittee Signature:
;
7for the next available
Call 503.639.41 5 b Y a.m. inspectio 7:00
This permit card shall be kept in a conspicuous place on the job site until comp on of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard Received
Date/By: j Perm
j / .. it No.: ,�
" 13125 SW Hall Blvd.,Tigard,OR 97223
® Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Date/By: Other Permit: 7 ..-t- 9- ,r )t't .
Inspection Line: 503.639.4175
T l G A R D Date Ready/By: IMI H See Page 2 for
Internet: www.tigard-or.gov RECEIVED Date
Supplemental Information
tiAY 13 2019
, W/ae�iicanT AF�D Mechanical permit fees*are based on the value of the work
❑New construction �Addition/alterati performed.Indicate the value(rounded to the nearest dollar)of all
BUIL ANG DIVISION
0 Demolition 0 Other: mechanical materials,equipment,ment,labor,overhead,and profit.
Value:$
A` GbR Q fll�l ' 13 I t S LAL EQV Plvii EtsN T it FE *
1-and 2-family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
O Multi-family 0 Master builder 0 Other: Description Qty. Ea. Total
B Tr'lt 1 Ff3Ilr1 . `IOI 11 A'a<`IIool�l
Heating/cooling:
. ..-.. ...�m
�O "-�- � Air conditioning 46.75
Job site address:
/1/ SW VVA2nr� S f- Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP: -176.4.y0 6)T e 72.15] Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name: Duct work _ 23.32
Cross street/directions to job site: 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: Lot no.: Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
SC11U'I'IOI�I €3`"'=--,..'' '''':-,''-':,.::
u Gas fireplace/insert 1 33.39 3 `Z
111:v0 Flue vent for water heater or gas
W 6"rid fr Gif 4-- 61-yr5 /...b.- (7r,-- fireplace , 23.32 ,
c- 4' az Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
❑ 'R PERT OMWER Other: 23.32
:'�' I�AI'I'..;
Environmental exhaust and ventilation:
Name: Range hood/other kitchen
Address: equipment 1 33.39 33-31
Clothes dryer exhaust 33.39
City/State/ZIP: Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:( ) Fax:( ) Attic/crawlspace fans 23.32
A 'UCANT ; Other: 23.32
Fuel piping:
Business name: Al V./ le/ -•-3761^r1(.i} - frit'. $14.15 for first four;$4.03 for each additional
Contact name: 121-01-1 fee /k 6-y-/ .� e Furnace,etc.
Address: ro (30 K 2 3 6 j tom- Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: -1/ dIZ- of 72$l Water heater
Phone:(5)-7) iy be .-2_b 3 l Fax::( ) Fireplace / / -CT
f ( / •
Range %
E-mail: yv�,j-Y-eS f �---5a 1 r t7 !JO /c. GUr='i Barbecue
-Q T€4 T Clothes dryer(aas)
Business name: ` Other:
34,414.- cid "1 jcillC_— 1.4t. 111;
Address: 73
Subtotal 70..
City/State/ZIP: Minimum permit fee($90.00) ' ) .cam
Phone:( ) Fax:( ) Plan review(25%of permit fee) -�
State surcharge(12%of permit fee),�+ /4";.,./0
CCB lie.: /C `-1 `- TOTAL PERMIT FEE `1 /t.1)
l This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: * Fee methodology set by Tri-County Building Industry Service Board
Print name: P14-it.( e Al-r-,/elge Date: 513 //I
I:\Building\Permits\MEC PermitApp_040113.doc 440-4617T` (11/0`2/COM/WEB)