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Permit
CITY OF TIGARD MECHANICAL PERMIT ., COMMUNITY DEVELOPMENT Permit #: MEC2010 -00100 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/10/2010 [ Parcel: 2S1 02 BC04400 Jurisdiction: Tigard Site address: 10605 SW WATKINS PL Subdivision: WATKINS PLACE Lot: 1 Project: Northridge Development Project Description: Install gas fireplace and associated gas line. Owner: FEES NORTHRIDGE DEVELOPMENT Description Date Amount 10605 SW WATKINS PL TIGARD, OR 97223 Gas Fireplace 03/10/2010 $33.39 Fuel Piping 03/10/2010 $14.15 PHONE: 503 - 579 -1698 12% State Surcharge - Mechanical 03/10/2010 $10.80 Minimum Fee Adjustment - Mechanical 03/10/2010 $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. 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 -0100. You may obtain a copy of the rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued By: ga Signature: ^ f� /J Permittee Si nature: .. 10 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. Cory of Tiga°Yro Received . 1114 • ti c 722 Dnte /By: — `/ ,' 1 Permit Nc. n �(�(+� 13125 SW rJ.d! Blvd ., Tteard, OR J' /?3 a y 1 / Q , r) n Phone. 503.639.4[71 Fax: ' 503.598.196 I LIAR ® � 2 13 Plan Review — yed� G i Inspection Line: 503.639.4175 Date/By: Othe Permit: Internet: www.tigard- or.gov +° t kr . Date ReadyiBy: 81 S I'&e. 2 for • Notified/Method. Notified/Method. pp ee men a Iloformation e Su t to Jlr of `wP . .. • - ' 0,4 0 3 t k04: 0 '., t 1 'Aga New construction ❑ Addition /alterati m /replacement Mechanical permit fees* are based on the value Of the worts ❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all ❑ O ther mechanical materials, t b overhead, and profit. is equtpmen , labor, o ad ,, ATLGdRt1 O- 0 0 ]W ue $ 1- and 2 d -. g ❑ Cornmerct ' mat '' "''' ❑ Accessory '' — ... ;. Val nd '. ❑ Multi-family 0 Master builder ❑Other: For special information use checklist, r a Description Qty: l Ea. Total JO1, StFE NF40, , i), IO i A ND LOCM1'LO ` `.. . ... ._- ... . �. Heating/ctwlin Job site address: :i Air conditioning or heat pump 1069 O' 5 I ) 1 ,L)!3 _ tic. [..,/�. .fill tL, (requires site plan showing placement) I 14.00 1 City /State/Z1P: �. TZq.h_CJ7.- i U ( . 7 t 9 � ; 3 Furnace 100,000 BTU (ducts/vents) 14.00 Suite/bldg. /apt. no.: t Project name: Furnace 100,000+ BTU (ducts/vents) 17.90 Gas heat pump 14.00 _ Cross street /directions to job site: Duct work 10.00 Hydronic hot water system 1 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), r in -wall, in -duct, suspended, etc. I 14.00 Subdivision: Lot no.: Fluelvent for any of above 6,50 Other; i 10.00 Tax map /parcel no.: Other fuel appliances j D S,o IN;J< rl OF y ;,.o Water heater it' 10.00 r Gas fireplace 1 1 10.00 in .& e .0 . rI a ,r7 .T IA. , 1 ] er D r "1� + 36 � t� Flue vent for water heater or gas ey� /6t., 1_Q.�a1. v e ` fireplace 10.00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 ER LY © FIIi Q ' } : Ot ylliner /flue /vent 10.00 PROP , Other: 10.00 Name: CYL-F t'1 1�ve /t ipn'1P , In-b i� Environmental exhaust and ventilation Address: i j4J a t, ` ' „ -t I _ LA \ -'- )(IQ a # 9�p en od/other kitchen 10.00 t City /State /ZIP: 774' 1_, ,x . .,G 1 Ole z 1 ? ,.- Clothes dryer exhaust 10.00 Phone ( l 57 €-.? /4,„ Fax 7 toilet compartments, r (util roo , V ( ) toilet compartments utility rooms) � 6.80 JPPL1ICAl 0ON`R A ty T 1';FRSQN r;` Attic /crawispace fans 10.00 F.--; Other: i 10.00 Business name: !— t re, k i:.l. �-�_, D i . <V ok... Fuel piping Contact name: I + �R ��1 te I / s l(jC'1 ;I $5.40 for first four; $LUO for each additional Address: 147)5c:3 1 �r 6 tie Furnace, etc, Gas heat pump City /State/ZIP: 'r / /,, ,_ '` ! i _ r t /.� , (1 . f - 7�� 1 Wall /suspended /unit heater Phone: (�" y ✓✓ ) 5 3- -1--10 i. J F i ax::: ( (fJ -0 - Water heater ��/�' / - / � Fireplace Mp mail: V.Si_ ) e_i .1 i---1 ('P,s r c _C if - 4._-----„_ Range C):NTRACTOR Barbecue 3usincss na1 _.` . 1) D Clothes d er as _ — Other: { tlJires,s: / Q�/� _ iii — -- r l �X 9J, /._._._�L LAY �_ ._ LCYIANt,CALI'1�¢t1e417,1EES -- — C{ C� e7, Subt ;ity /State /ZJP: huue: r^ [Fax: ( � � } q 7 � 5 � / _ Min imum permit fee (, ) [ J � j — Ott' �a -- --'.._ T _ 3.2c- B...__._� ''`)3 LP-70— .7r7YL Plan I evicw(25 %ofpermi - "l` ___ -._ D _ sn 7_ State tchar e !2% of permit fi e __ SO ! l� __ TOTAL f'ERM FEE lit11 signature: � G = ,l/ This permit application expires if a permit is tint ahtanee u t a 0 [ ��} - days after it has been accepted as complete. l0 U ' rint name: ' a 7 �C -�tGtyf L , ,,_ ( Date: 3_ y.... 1 " Fee methodology set by Tri- County Building Industry Service oard i wilding \Pennitslb_EC- PennitApp.doc 01/19/07 � .[.� 440 -4617T 1I I'02/COM /WEB) TO 3917d stoauIM 5e6LaL9E09 ET:LT eieZ/80 /Ee