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Permit le CI TY OF TUGARD MECHANICAL 'PERMIT it ;- COMMUNITY DEVELOPMENT Permit, #: MEC2010 -00093 Ti 0,, 9 13125 SWHall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/03/2010 . :1 Parcel: 1 S133DC17200 Jurisdiction: Tigard Site address: 13194 SW LAURMONT DR Subdivision: VILLAGE AT SUMMER LAKE NO. 1 Lot: 27 Project: Voorhees Project Description: Install gas line and gas fireplace. • • • Owner: FEES VOORHEES, JAY & KAY Description Date Amount 13194 SW LAURMONT DR TIGARD, OR 97223 Gas Fireplace 03/03/2010 $33.39 Fuel Piping 03/03/2010 $14.15 PHONE: 503 - 521 -0728 12% State Surcharge - Mechanical 03/03/2010 $10.80 Minimum Fee Adjustment - Mechanical 03/03/2010 $42.46 Contractor: FIRESIDE DISTRIBUTORS 18389 SW BOONES FERRY RD PORTLAND, OR 97224 PHONE: 503 - 684 -8535 FAX: 503 - 670 -7285 Type of Use: SF Class of Work: ALT Type of Const: Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas Gas Pressue: Total $100.80 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law dldl be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance r if work `is suspehded for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility otification Center. Tho - ule are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain a copy of the rules or ' ect questions to OUN .y callin. 5U .46.6699 or 1.800.332.2344. I sued By: y if / Permittee ignature: a mit`rl tf c Call 503.639.4175 by 7:00 a.m. for an inspection that business. day. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 7 �pyj�y ,ry 6]y�yy cy {p! �a�}'. }�t!'q� //y� •v• �; A l µ_ 1 � e c h a iu ca - L JF. e ■ 18 � !-7d ii , o Ec f. ,,,, I t ,: , , i 1 ,' � Y.,,„, M W' rIN M tt {.'k,,, r a.p. ql -, ,,,, } ,ae , 4 ' , I r . 'lr w�+ .••• � , f ., - . LsSi ON t t i, ,,t , i1 4 k eceived �� �'� `�����` �"�t� � City of Tigard - " , ° 13125 SW Hall Blvd., Tigard, OR 97 2 3 2010 Ua te B } 1 Permit No,: t s 8 , 'Phone 503 634.4171 Fax 503.59$..960`' flan R ev r ew Date/By Other Permit: � • 1TIGALD Inspection i t TIGARD ` nspecon Lne: 503.639,4175 y A ' a I *a Internet: www.tigard- or.gov Date Ready /by: nir ® See Page 2 SUMO DIVISION Notified /Method: , 6. Supplemetitalttrifgrmatien r p1Fp�1 61FV y�3 ! T %,P,E OF :i1!ORI G0 ME. 04 "'.SSI � C4014t `''C?Sk'r (�.°tI.*:90?ST , ❑'New construction ,[ Addition /alte - anon /replacement Mechanical permit fees* are based on the value of the work ❑ Demolition Other: performed. Indicate the value (rounded to the nearest dollar) of all mechanical materials, equipment, labor, overhead, and profit. ' ,. C XA'Ii CORY O 'Co M PX V . 1- and 2- family dwelling 0 Commer cial /industrial Accessory g RESIDEINT1ALx>Y1pgsgr ' y}} •[]Accessorrbuildin .F El ❑ Master builder 0 Other: For special irrformatiotruse checklist. w u Description a . 0� ". ,{10.0 244', .0.):0' AND LQ4.T"JON - Qty. Ea. I Total "` ^� C Heati'ng/cooling, Job site address: r 3 C1 1€ s ,/,,r J �.r m Air conditioning - (requires site plan showing placement) 46.75 City /State /ZIP: "�'�' t „p v � l 't. 7 ,� o s Furnace 100,000 BTU (duets/vents) 46:7 Suite /bldg. /apt. no.: Project name: { 7 U {- Furnace 100,000+ BTU (ducts /vents) � 54.91 V O hee `-- Heat mum. _ 61:06 Cross street /directions to job site: Duct work 23.32 Hydronic horwater 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: Flue /vent for any of above • 23.32 i Lot no.: Other: 23,32 • Tax map /parcel no Other fuel appliances n..;' !;f DE CRIP`I lON O +'' vVORTC:l' Water heater 23.32 f � �� Gas fireplace 1 33.39 J re4 qo s Lli a. t- go 3 Flue vent for water heater or gas e re (0 a,� fireplace 23.32 Log lighter (gas) 23.32 • Wood /pellet stove 33.39 Wood 5iR'ORERT Y UW LR`, ` t s Chi ney /liner/fllue /vent 23.32 : 0 T Name; � / Other: 23.32 kia..44 y- k y j!or h6n,� Environmental exhaust and ventilation Address: � / equipment hood /other kitchen t.v �.Q1 L f -- 1G�? jar equipment 33.39 - City /State /Z1P: 7-71 a-k6 O 19 -7 Clothes dryer,exhaust 33.79 Phone ( `)Q° Single -duct exhaust (bathrooms, 5T / - 0' &�L Fa ( ) toilet compartments, utility rooms) 23.32 ' t%P ?L *IANT y , 2,i t , D CO11T CT ,T' RSON "" Atticicrawlspace fans 23.32 _ !t^P r t' e. /Di 4. � Business name: r -� ''5 n � Other: 23.32 ' t-� Fuel piping Contact',name: L��/', L (Jd S14.15 for first four; $4.03 for each additional Address w , eta ��3 S L t� � �u�n� .. ei-r. i Gas Furnace heat pump City /State /ZIP:. P€5.1 ` / lh � �/e I 70 0 Wall /suspended /unit heater Phone: (5'25 ,`5 q5- 3 i 3 i Fax :: (.576j d — 7 '� Water heater 7 r E-mail: �t� p //� a+ rf t1�/ ' R ang e i -/I > t1� S'� GC'37� — _ Ran ''r r >;CON`I'RACTOR t`' Barbecue Business name: / Clothes dryer (gas) 1 +' 51 8iQ Lt 5 ,' 4 Gf '74! n • C � ,-) ", Other; Address: MECRANIC4'PE FE E$ "` `1 City /State /Z1P: Subtotal Phone: ( ) ` F ( ) Minimum permit fee ($90.00) .0 , Plan review (25% of permit fee) CCB lie.: q 7 9 i State surcharge (12% of permit fee) /Q4 TOTAL PERMIT FEE 100 80 ( I(2!COM {WEB) Authorized signature: / /� This permit application expires if a permit is not obtained within 180 `/h � ", , .,( days after it has been accepted as complete. [ name: 2 6 r�� /e t- . L- eJ�r�� � Date: ✓ 1 3 / / 0 I ` Pee methodology set by Tri- County Building Industry Service Board I Building '\Permiis4MEC- Permi,App.dec. 10/01409 4 4617T (] 1 J ZO 39t7d SMSQQIM 906L0L9E05 6E :ST OTr /E©/E0