Permit CITY OF TIGARD MECHANICAL PERMIT
!' :"' COMMUNITY DEVELOPMENT 1 Permit#: MEC2020-00792
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/4/2020
Parcel: 2S 112CB09500
Jurisdiction: Tigard
Site address: 15254 SW KENTON DR
Project: THOMAS Subdivision: ASHFORD OAKS NO.2 Lot: 109
Project Description: Gas fireplace insert and flue.
Contractor: OWNER Owner: THOMAS, ERIC D&DENISE E
15254 SW KENTON DR
TIGARD, OR 97224
PHONE: PHONE:
FAX:
FEES
Specifics: Description Date Amount
Gas Fireplace 12/03/2020 $33.39
Type of Use: SF Flue Vent for Water Heater or Gas 12/03/2020 $23.32
Class of Work: ALT Type of Const: Fireplace
Occupancy Grp: 12%State Surcharge-Mechanical 12/03/2020 $10.80
Stories: Minimum Fee Adjustment-Mechanical 12/03/2020 $33.29
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Oka l CO)t3 Permittee Signature: D a `1C5y�� 1 1 0-...-..i
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept In a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit APPlica 1/$ I FOR OF It F r "
I s,:( I }
?" ,`•�..,, Received
City of Tigard Deraty: ' ;si 4M ,,
111 13125 SW Hall Blvd.,Tigard,OR 97223 N 0 V 2 0, 2020 Plan Review ' ,
I Phone: 503.718.2439 Fax: 503.598.1960 " Date By: ♦y,a Other Permit
Inspection Line: 503.639.4175 /B 21 Seep 2 for
T I C�1 h D (,'�..;. D�RA. Y Y sane
Internet. WWW.tIgaRl-0r.gov ,�,, ', Notified/Method: Saippkmennlfatormad®
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[� G Mechanical permit fees•are based on the value of the work
0 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 $
1-and 2-family dwelling ❑Commercial/industrial 0 Accessory building For special information are checklist
❑Multi-family El Master builder 0 Other: Description Qty. Ea. Total
; ATiON AND 'LOCATION Heatiagfeooling:
Av cortdit ming 46.75
Job site address: 1515y' sW KQ•�'Q n j)lr. Furnace 100,000 BTU(ducts/vew) 46.75
City/State/ZIP: ; qc y-d, op.._ �'L,Z h Furnace 100,000t BTU(duets/Yee/0 54.91
Heat 61.06
Suite/bldg./apt no.: J Project name: F.1 'T'hsQa'! Duct work ork 23.3322
Cross street/directions to job site: Ilydronic hot water system 23.32
/� (� {,� , Residential boiler(radiator or
VI a ' — ) AS I'1'1 U ' ' I `Q1 I y V J 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 __
Other; 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no. Water heater 23.32
wOR*. Gas fireplace/insert I 33.39 31,31
N/ n ( �''' (1 n ,,,1� ,1yI Flue vent for water heater or gas d .,
C W 7 11 `Fl 1 act, 1'h cC Y / 01) U 4-1 o- fireplace 23.32 Z3.�Z
�f Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32 Chimney/liner/flue/vent -- 23.32 1
's� r Outer: 23.32
�' '�'' lri r l:Z{-1 +,': , ':r4f EN S" Envlronmeotalexhaustandventilation:
Name: t„-r L. ' 0 I-ll CkS Range hood/other kitchen
eqAddress: I SZ S S W 11 h Clothes di 33.39
4 l \ � �1�- Clothes dryer exhaust 33.39
ty —rjy0t►rd, OR g7z�1-f Siletcouctexhaust(bitrooms,
Ci /State/LB': toilet compartments,utility rooms) 23.32
Phone:(fib j� ,„0!,gas I Fax:( ) Attie%rawrlspaee fans 23.32
r},�tiP1sucoI' 0 cogtikortlioN Other: 23.32
Fuel piping:
Business name: $14.15 for first four;$4.03 for each additional
Contact name: El-! c---r1 o ry,° , �j 1� Furnace,etc.
Address: ' S 0 IA/n l'.- r Gas heat pump
SA1Q Wall/suspended/unit heater
City/StatetZ1F Water heater
Phone:( )
Fax::( ) Fireplace
Range
toot /�
E-mail: tho1no r-OWllly Oeoaf.-e riSr . co01 Barbecue
c
i,• ;'; J_ - Clothes dryer(gas)
Business name.uOter.
Iv Address: /(...-
Subtotal
City/State/ZIP: Minimum permit fee(S90.00) I: Q,00
Plan review(25%of permit fee) e b
Phone:( ) Fax:( ) State surcharge(12%of permit fee) (O a a
CCB lie.: TOTAL PERMIT FEE .. IOU'
This permit application expires if a permit is eat obtained edible ISO
'' �t days after it has been accepted as complete.
Authorized signature: I tM./ • Fee methodology set by Tri-County Building Industry Service Board
Printname: e r 1 C, O h1CAs Date- IA— Z.9- ZV 4-n
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