Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit #: MEC2011 -00442
Date Issued: 10/06/2011
TiC„ARD 13125 SW Hall Blvd , Tigard OR 97223 503.718 2439 Parcel: 2S103DB00600
Jurisdiction: Tigard
Site address: 11025 SW PARK ST
Project: CURLEY Subdivision: MIRA PARK Lot: 2
Project Description: Gas fireplace insert with gas piping
Contractor: ALL FUEL INSTALLATION & SERVICE LLC Owner: CURLEY, JOHN G & ROSEMARIE
PO BOX 69 11025 SW PARK ST
TROUTDALE, OR 97060 TIGARD, OR 97223
PHONE: 503 - 674 -2350 PHONE
FAX 503 - 674 -2693
FEES
•
Specifics: Description Date Amount
Flue Vent for Water Heater or Gas 10/06/2011 $23.32
Type of Use: SF Fireplace
Class of Work: ALT Type of Const: Wood Fireplace /Insert 10/06/2011 $23.32
Occupancy Grp: 12% State Surcharge - Mechanical 10/06/2011 $10 80
Stories: Minimum Fee Adjustment - Mechanical 10/06/2011 $43 36
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 Permittee Signature: / I
Call 503. .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.
Mechanical Permit Application °� hoi o r r lc E l ltit ON L1�
City of p RE:E8 G / I
q / Y Permit No �� 13125 SW Hall Blvd., Tigard, 0 r1 Pl 2 Phone: 503.718.2439 Fax. 503. , . a r L Pl r
Cc Other Permit
inspection Linc: 501639.4175
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l'1'Gr\f�L) Internet: wtvw.[igarfl- or.gov OC� O ,°�� DateReadyBy runs. Ef SeePage2for
oq ` ,77 a C� k''' `Ok� I lOtified/Method: Supplements[ information
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❑ New construction s '-- Mechanical permit fees* are based on the value of the work
® Addition /altera 'on/replaoement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit,
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® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For 'pedal lrformation use checklist,
❑ Multi - family ❑ Master builder ❑ Other: Description t Ea. Total
Ti4m�1 1R 4R. a:.:4 '� e. 1•. 1Teafin QtY
'.1'i` ''' t1i:Y` i�l,!li3 el i l i 'llr :i ;'1. ,; i r �►' t4; ':4014 ., ^:fi 7�i�1 (1?'�t ° j(!P,;�� 99 'ti " gicooling: _
,, - irUA41:§fi {I`,ii' r; , • i, a iii a: ,is; ,lf!4.fi4t , . i,gi +Riii4 Air conditioning r
Job site address: 11025 SW Park _Legutres site plan showing placement) 46.75
City/State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 1 00,000+ BTU ducts /vents 54 91
Suite /bldg. /apt. no.: Project name: Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work • 23.32
drone hot water system 23 32
Residential boiler (radiator 'or
hydronic) 23,32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc 46.75
Subdivision: Lot no : Flue/vent for any of above 23,32
Other: 23.32
Tax map /parcel no.:
a{ ;li' l'`r6' + sy {, , nLr ri i Other fuel appliances:
..141 ro ' E l 0 # ., . 0 .0, :$4,2 `f + t ,, i,: ,� 1 0 ,i1 . 4 ,. 'i V,,,,k;,,..l v -y; n y i ':.1W I
,: d • i ∎1 r s•flz,c, :,i„ 6.r „1„ ti , o „r , ilti Mini iiol , , ! ,,, , , ∎ , i oz ( p L ,. Water heater 23,32
• c , ...�• x dig � � ..: ` i; . n, a”
�tlt_ u� o�inVl' ?!R?iYf,r l � �r �e u• c lt .�.l,.! . ,
Install gas line, venting and new gas insert •reas-firepluc°
Flue vent for water heater or gas
fireplace 1 23,32 23 32
Log lighter (gas) 23.32
Wood /pellet stove 33,39
Wood fireplace/insert / 23 32 )-3 .3 j
i Chime /liner /flue /vent 23.32
i ' „r• ¢� G ' Yhrq ��,yya`U r� - ,�if ° 1 = y'i'o ?�hfi; , 3usi ; ll 'r�7'c r �I i• 2TI ..•ri�': d ��E•. , i.6:,�rti elr �
;•� �� 1�,taia�i4 f {�..,w:,. 'Y�'�,.,, ,t s r - ,.'Vtilik- 4�i?�Vlr. �,,,31�' �'rk 1 iF ,111 ��6��„fs,'�' �3.! ilf; i��a4 ;t,�91;✓sRt�'s ±Cj.���;d:iC',f Other:
23.32
Name: John Curley M Environmental exhaust and ventilation:
Address: Sante as Above
Rang hood/other kitchen
equipment 33.39
City/State/Z1P: Clothes dryer exhaust 33,39
Phone: (503)544 -5318 Fax Single -duct exhaust (bathrooms,
� , r : ( ) toilet compartments, utility rooms) 23.32
°
��i o ip ICY � t � + { I' 1(p,� +, pyEl•�1a rY. y �rw • � z .. i, .. —�
Nt)nl_la3 f Eiitr {:9"tFi�� �j!71 °, 00 .,.��•. , ' ilk41[I�I{3;IF' P')�p 1intlr 'i a l� '� Y1Wrt1 �iiil iiIV�! 11 ttic/craws ace fans 2
i rr 'm�7u�. �� ���,•a,r <,,i�y y A l P 3.32
Business name: See Below Other: 23.32
Fuel piping:
Contact name: Erie Camp $14.15 for first four; 24.03 for each additional
Address: Furnace etc
Gas heat pump
City/State /GIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail: allfuel@comcast.net
Fireplace 1 14.15
� . c °. 1f �1 f • do� ,!') r i:;i; ..g Slinb 4 U ” 1" r d'i M.,' G. ''I •y,' 4 '� 8 (pfr.1. a + 1 � ; �a cw. . _� ..r Ra nge
' �... soi plc ; 1 }� 1 �i� ;i' 7::P 1 44: 3 1 1 >arv.. 6 ' ii" . 111i1!i •� !' i 4 Qi7rr, 1 GR'V . c 1 ' !llil �i l's i ll. • �$Q i r (j 1`(elf Ill Idk - orp [ tF li t ti - Ik o {lil Barbecue
l Ufftlj ,. i . .,.. ,, . Ai '610 ,k. ,,,, .1 {i, ■ : _: , 'P!1' , ' M311 i
Business name: All Fuel Installation and Service, LLC. Clothes dryer (gas)
Address: PO Box 69 Other: y
• City /State /Z1P: Troutdale, OR 97060 1" ^N l,Hi # F`fi� � ; ' . +� ;•f " z } ti : i ,ll�bn
Subtotal 70.86
Phone: (503) 674 - 2350 Fax: (503) 674 - 2693 Minimum permit fee ($90.00) 90.00
Plan review (25% of permit fee) _
CCB lic.: 169503 State surcharge (12% of permit fee) 10.80
wed 'TOTAL PERMIT FEE 100.80
Authorized signature: ( MIS permit sppllcstion expires its permit is not obtained Within [80
days after it has been accepted as complete.
Print name: Eric Camp Date: 10/6/11 . FCC methodology get by Trt -County Building Industry Service Board
1 '\Building\Pennlie\MPC- Parmi:App doe 09/09/10 440.4617r 0 1/01/C0M/w3S)