Permit ice. CITY OF TIGARD MECHANICAL PERMIT
71 COMMUNITY DEVELOPMENT Permit #: MEC2010 -00608
F ' D � 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/24/2010
TIGARD 2S111CD09100
Jurisdiction: Tigard
Site address: 15890 SW SERENA CT
Project: Combs Subdivision: KERWOOD ESTATES Lot: 35
Project Description: Gas fireplace installation.
Contractor: FIRESIDE DISTRIBUTORS Owner: COMBS, MICHAEL G AND CYNTHIA A
18389 SW BOONES FERRY RD 15890 SW SERENA CT
PORTLAND, OR 97224 TIGARD, OR 97224
PHONE: 503 -684 -8535 PHONE: 503 - 707 -1805
FAX: 503 - 670 -7285
FEES
Specifics: Description Date Amount
Gas Fireplace 11/24/2010 $33.39
Type of Use: SF Flue Vent for Water Heater or Gas 11/24/2010 $23.32
Class of Work: ALT Type of Const: Fireplace
Occupancy Grp: 12% State Surcharge - Mechanical 11/24/2010 $10.80
Stories: Minimum Fee Adjustment - Mechanical 11/24/2010 $33.29
Fuel
Fuel Types: Natural Gas
Gas Pressure:
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 -0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ��� . L / 6( 7 f Q.__ Permittee Signature: i`j,/ �j "C.../ – 7 - 70 ^
�R
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
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.
11/19/2010 14:03 5036707905 WIDDOWS PAGE 01
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SLC4� P ( ie wires s it< plan sliowing placement] ! .14,00.
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rig, ., e, ,LQ. g7 ,A,q Furnace ICO3000 B (thicts /vents . 14 p0
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Gas heat pt I '
Cross street /difee(ions to_ job site: 10.00.
Duct t , . 1QOU
Hydtonic h • rt water $4s.tom . 14.00
Resideritfa_1 boiler ((adiatoi''or
hydrontc) .1.4,00
Li. nit heaters (fuel =type not electric) • • - . •
in wail, in•c net su "speeded, etc.. 14.00
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Subdivisiont Lot. no,: • . Flue/vent fo any of 'aiiove . 6:g0:.
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fireplace / r.10 ��a
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Wood fireplar e/insert 10.00
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