Permit CITY OF TIGARD MECHANICAL PERMIT
II
I COMMUNITY DEVELOPMENT Permit #: MEC2010 00519
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 10/22/2010
Parcel: 2S112BB08900
Jurisdiction: Tigard
Site address: 14265 SW FANNO CREEK LP
Subdivision: Lot: 0
Project: Yrigoyen
Project Description: Wood stove installation.
Owner: FEES
YRIGOYEN, GREGG N & SHARON M Description Date Amount
14265 SW FANNO CREEK LOOP Wood/Pellet Stove 10/22/2010 $33.39
TIGARD, OR 97223 12% State Surcharge - Mechanical 10/22/2010 $10.80
PHONE: Minimum Fee Adjustment - Mechanical 10/22/2010 $56.61
Contractor:
TOM BISHOP CONSTRUCTION
4578 SE 103RD AVE
BEAVERTON, OR 97005
PHONE: 503 -644 -7868
FAX: 503 - 626 -9138
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 1.800.332.2344. `
Issued By: Permittee Signature: -yG > /.Z
K -0°
CaII 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.
10/21/2010 11:34 5036269138 HOT SPOT FIREPLACE PAGE 02/02
Mechanical Permit ApplicatitR , , /lz l ), i ,, i ,,,, ,,,,,
City of Tigard Received
i0 )1 v I. Permit No,; /3 _
13125 SW Hall Blvd., Tigard, OR 97223 OCT 2 1 2010 Review ' Phone: 503;639.4171 Fax: 503.598 -1960 DatelBy. Other Permit:
1 . , ,, , Inspection Line: 503.639A175 CITY OF TIGARD Date Ready/By: NI tE Sec Page 2 for
Internet: www.hgard- or.gav BUILDING DIVISION N°" /Metio4: �3 Supplementa1 1 °rma
TYPE OF WORK COMMERCIAL FEE" SCHEDULE - USE CHECKLIST
Mechanical permit fees* ate based on the value of the work
[] New construction : Addition/alteration/replacement perlbnned. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, mipment, labor, overhead rind profit
, Value: $
1 CATEGORY OF CONSTRUCIION REELEENTIAL EQUIPMENT / SYSTEMS FEES'
— 'I 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building . . „
For • - ,, l trdonrmfion use checklist.
❑ Multi - fancily 0 Master builder 0 Other: Description Qty. Ea Total
JOB SITE INFORMATION AND LOCATION Head , I coon
i
Air conditiaoing
Job site address: Age.., 5 5L4.) f v►vto ('v �p t _. load site 'Ian sh - ,: •lricement 46.75
MY/Stater/ I l a ✓d O. 97G� `t Furnace n 100,000 BM (ductrivents) _ 46
Q Furnace 100,000+ BTU dacts/vents — 54.91 MIMI
Suite/bldg./apt. raw jFroject name: Vri jo 1 �v / Hest punter 61.06
Cross street/directions to job site: Duct work IIII 2332
. Tonic hot water . tem 23.32
Residential boiler (radiator or
•nic ill 23.32
Unit heaters (fuel -type, not electric),
in - well, in -duct, suspended, etc. 46.75
Flue/vent for any of above 2.3.32
Subdivision: I Lot no.: Other 23.32
Tax map/parcel no.: Other fuel appliances
• DFSCRIPTION OF WORK Water heater IIIII 2332 IIII
' Gas , , lace 33.39
• •.. S ti' de) . . ' • ' L lr .. , - Flue vent for water heater or gar
-.lace ._ 23.32 MI
Lo: 1i: ter �I
_~ w.. . (let stave Warrilk _
Wood 1 , lace/insert 23.32
Chimney/liner/flue/vent 2332
w PROPERTY OWNER ❑ TENANT
Other. 23.32
Name: Gyve Environmental exhaust and ventilation
, r i O Range hood/other kitchen / UP equipment 3339 -
Addrt:t:s: /r�a (�, QNLto� � Clothes �� � exhaust � 3339 �
City/State/ZIP: rf i L7 0 l ...... Single -duct exhaust (bathrooms,
Phone: j F ax ( ) toilet com. a .1,, 1,_ utili 1001115 2332 ME
J2, APPLICANT ❑ CONTACT PERSON Attic/crawls • ace fans — 23.32
...- Other 2332
Business trams: , .1 .p f i Pp Dt Q _ Duel piping
Contact name: Qe vir.t 514.15 for fret four; $4.0.3 for each additional
Furuaee, etc.
Address: / ei ...h. Gas heat t , LL .
City/State/ZIP: .... . L; • A r 00s waly ednmit bearer I r_
Phone: 6)3)1!0. , . l ie 2■ Fax: : C3)&0/6; -.- 9! i . E - mail: 4'-S it �� re 1r e c c v o f /l of . CO w �:
CONTRACTOR Barbecue ■��
Clothes _
Business name .. S " - 1 • / � ✓I • L . -. _ [ • Other
e S 9 sr 8 /c) 3 e MECHANICAL FERN= FEES'
City/State/ZIP: • at , , , O/ flocs' Subtotal
Minimum permit fee (590.00) `O
Phone: ( ) (p 1 - :64 Fax: ( ) Plan review (25% of . - - fee) ��
CCB l;o.: / 5 7 9 _ State sum-huge (12% of permit fec) _.,
- - TOTAL PERMIT FEE j •
Ms permit application expires if a permit is sot obtai*ad wlthi» 180
Authorized signature: r �-� ,..:411F../jr L , , . : a • Fee methodology set by Tri-Cowny HuikiaE lodusaY Satvix 9�od
Print,: . e Vt Date. /d a/ /d
BHUM P fl ts VdF- C' fnl n/ �P .doc 10/01/09 4484617r (I 1M, /COMAVEO)