Permit y CITY OF TIGARD MECHANICAL PERMIT
g * , COMMUNITY DEVELOPMENT Permit #: MEC2011 -00059
Date Issued: 02/08/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Parcel: 2S1038A00140
Jurisdiction: Tigard
Site address: 12035 SW LYNN ST
Project: Foglio Subdivision: LERON HEIGHTS NO. 2 Lot: 30
Project Description: Install wood stove insert and chimney liner.
Contractor: TOM BISHOP CONSTRUCTION Owner: FOGLIO, DAMIEN
4578 SE 103RD AVE 12035 SW LYNN ST
BEAVERTON, OR 97005 TIGARD, OR 97223
PHONE: 503 - 644 -7868 PHONE: 206- 353 -1035
FAX: 503 - 626 -9138
FEES
Specifics: Description Date Amount f
Wood Fireplace /Insert 02/08/2011 $23.32
Type of Use: SF Chimney /Liner /FlueNent 02/08/2011 $33.39
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 02/08/2011 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 02/08/2011 $33.29
Stories:
Fuel
Fuel Types:
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 ques ' UNC by calling 503.232.1987 or 1.800.332.2344.
,
Issued B Permittee Signatur .
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.
02/08/2011 14:37 5036269138 HOT SPOT FIREPLACE PAGE 03/04
Mechanical hermit Application ( ( 1 I; c l i t 1 ( t . I ` , 1 ( \ t "
Received Petenit Nu.: Id i a 11- F
City of Tigard ? " . Dewar. 02 ,
13125 SW Ball Blvd., Tigard, OR I - Hen Review other Permit.
Phone: 503.639.4171 Fax: 503.598:1960 Drte/9y:
Inspection Line. 503. 639.4175 Doe Ready/By.
` �: a Intl rnet www_tigard-or.gov Notiaed/Mathod: 11111LEEM
TYPE OF WORK COMMERCIAL FEE* SCHEDULE -- USE CHECKLIST
Mechanical permit fees* are based on the value of the work
ID New construction Addition/alteration/replacement perfumed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials equipntetlt, labor. o , e and a rofit.
0 Demolition [a Other: � value: 5 _
CATEGORY EGO)itY OF CONSTRUCTION _ BESIDENPIIAL EQUIPMENT / SYSTEMS FEES"
1- and 2- family dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist.
0 Multi- family 0 Master builder ❑Other. Description 1 i. ty. I Ea. J Total
JOB SITE 1NFORMATIOPI AND LOCATION Hello , ^ ' ,
____'- A ir conditioning 46.75
Job site address: r p� ) 35 _560 �, c4 kl site , iaa shoo+ :.lacement 11111
p� d p n Furnace 100,000 BTU d ctalve� NM 46.75
City /StaterLIP: 7 ( avei o `.v Furnace 100.000+BTU ductslvcats MI 54.91
Suite/bldg./apt. no.: Project came: �D 6 Li D - , Beat ■ tun. NM 61-06 MN
Duct work 23.32
Cross meet/directions to job site: Hyd p is hot water system 23 -32
Residential boiler (radiator or 23.32
t dron °) .
- Unit heabeaters (fuel type, not electric), 46.75
in -wall, in -duct, sugpendedyetc. El
_ - Flue/vent for any of above MI
Subdivision: Lot no.: Other 23 "
Tax map/parcel no.: Other fuel Appliances -
Water heater z33z
DESCRIPTION o WORK �� Gas . Awe 33.39 MN
WOO cam' 11 € ill S'Q • 14)-
AU e..14-
." 14 - • ' 1 i L ' fire face for water beater or gas 23.32
I P
— Lollighter (gas) . . 23,32
Wood], - llet strive J 33.39 MI
- _ " . Wood fire .lace /insert 111r1MI "
Ghimn alueJvcnt 111111 ' AN
sk ^� PROPERTY OWN El TA Other. 23 -32
} Environmental exhaust and ventilation
Name: 1,a t�Y) J Q h i i 1 Range bood/odter kitchen
Address: /a 03 . 5 d L , si -, u e - t 33 -39
Clothes ^ exhaust 3339 �
City/State/ZIP;
- "-- ; ■ 7 -3 Single -duct exhaust (bathrooms,
lone : _ 6 F ( ) toilet corn — e .. mill rooms
tate ^d L .r Attideispaite fans 23.32
P. APPLICANT ID CONTACT PERSON Other. 23.32
Business name: 1- 14 S a A E. re 'J IOC " Fueii+iplag
514.15 t'or first Inert $4.03 for each additional
Cerra tint... -: • t1 t�� K
' Furnace, etc.
Address; I i J6 5 • ) ea 14. -lever n ' ' Gas heat PAP
City /State/ZIP: Z e j Q y - 4. y-‘ i Or [ 7 .- - walvsusputded/uttit6eater
: (5b3)( - q/ 3 8 Water hearer _
Phone: ( 3 ) �poP— Ile 5 Fax: - Fi ,lace NM
E-mail: n i D ! • 4 g ire + 0 e -_ Cd ho _ r I . e a ►
CONTRACTOR Barbecue ��
_ - Clothes .. _
Business name: QV1n 1J15 � 1 lZ�l/�S U L� �l� r Other
c w - -
Address: /5 ! c . a 0 . YC. MECHAANICA1a PERMIT FEES
/� Cr ,. Subtotal ty/StaLelZll': r +I \(e 4 V t J ✓ M permit feu ($90.00) 'U . O€)
1 )t ?how: 12 )3 ) w , / - s7 ..& k Fax:( ) Plan review (25% of permit fee)
cat lie.: !
f � S Y 6 , n ' State sucharge (12 %of permit fee) /0 . at
TOTAL PERMIT 1F'1~E C)
/ ifs :t eat obtained within 19(1
This psi spptie:106i wino P
Authorized signature: I I f days after Rios bete aoxpted ss tempter
0 - WIENTAMINI • Fee methodology feet by iri- County Building mellow Service amid I'rint Hartle: A. gl * Q i ■A
. _ - - . .......... 498 - 4617x' (l t cowwa8)