Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2010 -00492
1 3125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/07/2010
T [ Parcel: 25101 DB00501
Jurisdiction: Tigard
Site address: 7505 SW CRESTVIEW ST
Subdivision: Lot: 0
Project: King
Project Description: Wood stove insert with chimney liner.
Owner: FEES
KING, SONYA Description Date Amount
7505 SW CRESTVIEW
TIGARD, OR 97223 Wood Fireplace /Insert 10/07/2010 $23.32
Chimney /Liner /FlueNent 10/07/2010 $33.39
PHONE: 503 - 624 -9483 12% State Surcharge - Mechanical 10/07/2010 $10.80
Minimum Fee Adjustment - Mechanical 10/07/2010 $33.29
Contractor:
PETRA HEATING & AIR CONDITIONING
PO BOX 301205
PORTLAND, OR 97294
PHONE: 503 - 253 -3263
FAX: 503- 253 -3261
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types:
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 32:234.
/ r
Issued By: vim Permittee Signature: • - ,
/
Call 50 . • 9.4175 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.
10/06/2010 12:03 5036269138 HOT SPOT FIREPLACE PAGE 01/02
Mechanical Permit Application
?tli
010 () I� t l i j 1 1 i l ()Nix
i and t ,11, Recr d
City of 't' g Date/By: 1 6 >rr W _
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
it Phone: 503.639.4171 Fax: 503.598.19 Date/B Other Permit:
i I , , ; Inspection Line: 503.639.4175 0° Dale pate RcadyBy: Se Face s for
Internet: www.tigard- or.gov P� �\� IIIM Supplemental Information
TYPE OF WORK . •, v . COIYIMERaIAL FEE* SCHEDULE — USE clIIfcIi.T.I8r .
• �( - Mechanical permit fees'" are based on the value of the work
[l New construction Addition /alteration/r'eplacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition. ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF: CONSTRUCTION • • • Value: S
RESIDENTIAL EQUIPMENT / SYST>EMS FEES'
X1- and 2- family dwelling ❑ Commercial/mdustrial ❑ Accessory building
For special information use checklist.
❑ Multi - family • ❑ Master builder ❑ Other: Description I Qty. j Ira. 1 Total
OB SUE INFORMATION AND LOCATION Heatltti/cooliog
( 7 r .5 � `� v f P r(,L) Air conditioning 5 1t, ea
Job site address: p wires site , tab ehowin _ • lacement 46.75
City / State/ZIP: 11 cr Furnace 100,000 BTU (ducts/vents) 46.75
t o Q � Furnace 100,000+ BTU (duets/vents) 54.91
Suite/bldg. /apt. no.: name; Project name: t Heat pump 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
. hydronic) 23.32
Unit heaters (fuel-type, not electric),
in -wall, in -dud suspended, etc. 46.75
Flue/vent for any of above 23.32
Subdivision: I Lot no.:
Other: 23.32
•
Tax map /parcel no.: Other fuel appliances
• 1 • • • 1 . • . • DESCRIPTION OF WORK • . Water heater 23.32
r W k e.d � Gas .lace 33.39
CO Q od i51 e- t Yt. S B v1� t i i Vvt ii Vl. 2 r Flue vent for water heater or gas
4 fireplace 23,32
Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert / 23.32
Chimney/liner /flue/vent / 23.32
. Of PRO, • ' TY OWNER • • ❑ TENANT • Other: 23.32
Name: yV C� VI ?n 4 Environmental exhaust and vennladon
Range hood/other kitchen
Address:
95 rte) ev Psd- V t s t_ ) equipment 33.39
cit , a1- i • q'7 '�, Clothes dryer exhaust _ 33.39
t
d Single -duct exhaust (bathrooms,
Phone: , ) 4pa. .. % 9 /8. 1. 3 Fax: ( ) toilet compartments, utility rooms) 23.32
■• ❑ CONTACT PERSON Attic/crawlspace fans 23.32
I
Other; 23.32
i
Business name. hej 3 poi Fi rep 14e Fuel piping
Contact name: (l � nle\ S14.15 for first four; $4.03 for each addltlonat
Furnace, etc.
Address: 11 S a.5 J eel 1.41 0 ■••-. Oas heat pump
City /State/ZIP: ?B ack() e 6 0 `17045 Wallsuspended/unitheater
Phone: (rte CGI ' Y4 Sa-- Fax:: (55) 6,Q6 - 61138 Water heater
p +_ Fireplace
E -mail: V1 •SPo+ftVgP O hO ("Kai 14 CO W\ Range
CCTOR
•
Business name: 4 ((et. H t?Olfi Yl c 4' i✓ eo : I i • t
`• Other:
Address: 8105 /■l /8 / S `t' r� � • ` 4 / • LiMECHANI(CAL rERMIT FEES• . .
City/State/ZIP: To ,r4t,hd 1 n 41 _ Subtotal
Phone: (5 3) a 53 -%163 . I Fax: ( ) Minimum permit 5% of itfee Jp • •
Plan review 5% of etmit fee)
lie.: / rj 0 3 ?S State surcharge (12% of permit fee) /0 T`
TOTAL PERMIT FEE /00,10
This permit application expires if a permit is mot obtained within lea
Authorized si �� days after it has ban accepted as complete.
Print name a e a e i N. D 141/'
A j b * Fes methodology set by Txi•Coanty Building Industry Service Board
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