Permit r'' 0 CITY OF TOGARD MECHANICAL PERMIT
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V a a COMMUNITY DEVELOPMENT Permit #: MEC2010 00158
V Date Issued: 04/09/2010
IyT o r 6 r R,CS 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
Parcel: 2S11 1 AD20900
Jurisdiction: Tigard
Site address: 8813 SW SCHECKLA DR
Subdivision: LADY APPLE Lot: 33
Project: Whitlow
Project Description: Install gas piping to outdoor firepit.
Owner: FEES
WHITLOW, CHRIS Description Date Amount
8813 SW SCHECKLA DR Fuel Piping 04/09/2010 $14.15
TIGARD, OR 97224 12% State Surcharge - Mechanical 04 /09/2010 $10.80
PHONE: 503 - 639 -6822 Minimum Fee Adjustment - Mechanical 04 /09/2010 $75.85
Contractor:
CUSTOME STOVE INSTALLATIONS, LLC
21707 NE 159TH ST.
BRUSH PRAIRIE, WA 98606
PHONE: 360 - 254 -3866
FAX: 360 - 254 -3866
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: 0 a 1 tA Q UUlthUN Permittee Signature: `' J
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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.
Mechanical Permit Applica4qij.. EIVED ,ort ,),,,,
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City of Tigard Received
Date/Fly: ' lis 1 emit N. e. 1 1
t■ I ! ' . as
4 1 13125 SW 1-Tall Blvd„ Tig,ard, OR 97223 ESIMIMI e.
MIIIV - _ •• ew s .•• - _
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Phone: 503.639.417) Fax: ^
"3-598 0 8 2010 other Permit
Iection Lim; 503.639,4175
riGARD nsp Dale Ready/13y: FS Sec Page 2 for
Internet: wmv.tigard-orgov
CITY OF TIGARD Notified/methed: FIN SIII I mental Information
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Mechanical permit fees* arc based on the value of thc work
ED Ncw construction 1:31 Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition El Other: mechanical materials, equipment, labor, overhead, and profit
Value: $ $1 500-00
' 1 ' ' '''' f " ' l' ''' '''' ',' ''' • """ ' ''. ' ' .' . ...."..' ' ' . ' ' .. ' " ' ' ' ' ' - . . ' ' ' ' h.': ." ''. • . • , 1 1, ‘ : gt6itht Ntibitit
123 1- and 2-family dwelling 0 Commercial/industrial 0 Accessoy building
For special information use checklist.
0 Multi-family 0 Master builder 0 Other: Description I Qty. 1 Ea. I Total
:: .,':,':.:;:,:,' :: , :: 2 : ' ,::::`,':. Heating/cooling
Air conditioning
Job site address: 8813 SW Seheekla Dr. _ re afros site ulna Amin htertiLi,_ 46.75
City/State/ZIP: 'Tigard. OR 97224 Furnace 100,000 BTU (ducts/vent) 46.75
— Furnace 100.000+ BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Project name: Heat pump 61.06
Cross street/directions to job site: : Duct work 23.32 ,
14ydronic hot water system 23,32
Residential boiler (radiator or
hydronie) 23.32
- Unit heaters (Mel-type, not electric).
in-wall, in-duct. uvended, dc. 46.75
- Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other. 23.32
'fax map/parcel no.: Other fuel am:Mantes
•:':; '':': ' ::',::';':';,.,,,''',-,'„:;:;;',':: i: ''',/;',;'41C$ItitiPlitteSttitiiitte:j ',., .!.. ,.' - , ,: . , ,,, water heater 23,32
3339
Run gas piping to outdoor fireph. Floe vent for water heater or gas
fireplace 23.32
1 23.32
Wood/pellet stove 33,39
Wood fireplace/insert 23.32
Chimneyner/flue/vent 23.32
Name: Chris Whitlow Environmental exhaust and ventilation
Range hood/other kitchen
Address: 8813 SW Seheekla T)r. equipment 33.39
City/State/ZIP: Tigard, OR 97224 Clothes dryer exhaust 33.39
single-dud exhaust (bathrooms,
Phone: (503)639-6822 Fax: ( ) toilet compartmcnts, t.ilil,.■ rom 2332
.,,, ,, :;;;,:. : •:,:,:.: .'!?.. '. Attie/crawls ace fans 23.32
Other: 23.32
Business name: Custom Stove Installations, LLC Fuel piping
Contact name: Deborah Romanchnek $14,15 for first lbw; $4.03 for each a dd 1 ti o n a I
Address: 21 707 NE 159 St. Furnace, etc. ______
Gaa heat poi*
City/State/ZIP: Brash Prairie, WA 98606 Wall/suspended/unit heater
Phone: (360) 254-3866 I Fax: : (360) 254-3866 Water heater
Fireplace I 14.15 14,15
E-mail: djrmonnehnek@msn.com Range
I3arb
1 Business name: Custom Stove Installations, LLC Clothes drystiens) . .
Other:
Address: 21 707 NE 159 St. ':::' •-';,':'''
City/State/ZIP: finish Prnirie, WA 98606 Subtotal 14.15
Phone: (360) 254-3866 Fax: (360) 254-3866 Minimum permit fee ($90.00) 90.00
Phut review (25% of permit fee)
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CCB lie.: 189206 /// -1-fiai--- State surcharge (12% of pennit fee) 10.80
TOTAL PERMIT FEE 100.80
Authorized signature: 4,L.,__._--- Thi,; permit application expires If a persolt is not obtained within 1330
dor after it has bccti accepted As complete.
Print name: Deborah Romanchock Date: 418/10 • Fee methodology Ret by Tri-Conoty Building Industry Service Board
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