Loading...
Permit CITY OF TIGARD MECHANICAL PERMIT ` ° '11 ' COMMUNITY DEVELOPMENT Permit #: MEC2011 -00456 TIGARD 13125 SW Hall Blvd , Tigard OR 97223 503 718 2439 Date Issued: 10/14/2011 Parcel: 2S 109AD08200 Jurisdiction: Tigard Site address: 12713 SW ROCKY MOUNTAIN CT Project: SEIBOLD Subdivision: ELK HORN RIDGE ESTATES Lot: 26 Project Description: Gas fireplace installation with venting and gas piping. Contractor: FIRESIDE DISTRIBUTORS Owner: SEIBOLD, DAVID & SUSAN 18389 SW BOONES FERRY RD 12713 SW ROCKY MOUNTAIN CT PORTLAND, OR 97224 TIGARD, OR 97224 PHONE: 503 - 684 -8535 PHONE. 503 - 620 -5389 FAX. 503 - 670 -7285 FEES Specifics: Description Date Amount Gas Fireplace 10/14/2011 $33.39 Type of Use: SF Flue Vent for Water Heater or Gas 10/14/2011 $23.32 Class of Work: ALT Type of Const: Fireplace Occupancy Grp: Fuel Piping 10/14/2011 $14.15 Stories: Minimum Fee Adjustment - Mechanical 10/14/2011 $19 14 12% State Surcharge - Mechanical 10/14/2011 $10 80 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: 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. 10/14/2011 11:46 5036707905 WIDDOWS PAGE 01 Mechanical Permit Application • FOR OFFICE 4 1ST ONLY • . C1 n Received p p `� of Tigard g Date/By: CU � PermitNo. t ' 13125 SW Hall Blvd., Tigard, O',.. a� .; 3 Plan Review 1 f — ( 1 P hone 503.639.4171 Fax: 503:"G'r.,l rLO1 Date/By: Other Permit: T;h A R D Inspection Line: 503.639.4175 Date Read /e .runs. el See Page 2 for _ Internet: www.ti and -or. o v c Ready /By: g g v '\er P o� Notified/Method: Supplemental Information ; , +. i';T „I'E'; #0,Ft'ill,,,y, , iill!'i:, 1j f;., 'JO p k q " ` 9i ,�`;�,” . ,,., ia gl ('I_,, , }•j � j' +' 1 �1C:, �'.��I I� �, "A. D l ( } 7 PD' ' . �,;: C';. i {;. � .�� 1 ;, P �` ,, . t �I�;��,Sl �� I ti' �' „�, ' i�11 , � ��}� � � h i i .rT r m "' a iun ', "' ❑ New construction ©Addition /alterat' acement Mechanic d permit fees* are based de the value of the work performer . Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanic,d materials, equipment, labor, overhead, and profit. :j, ij; 1!* : i l l; I �}, ,�u�,' a '+�' 'll' IIjE;;I` Ill I`ll< h l,li�' +' 'i, , , ; l ; ieXA0'WkLY;i!t�9III0dIt1t Ili 14 II tj�r�ti IIjjIr., II� IiIIjll'+ „ia Value' $ ly,,.; . qr 'iI'Itb y!, ., q'1;;17 :�1;'�Ii > , Il;fll: 1 �If IC11111 giilii lll 'fl I�,,.. ,, ; p ' ° ' {j1A 7 ' :D l l m 11 of t na i�r rar l 1° II ' , I - and 2- fam dwelling ❑ Commercial /industrial ❑ Accessory building , d(i '"��� I jj {'� ❑ Multi- family ❑ Master builder ❑ Other: For specral inforrnarron use checklist. Description Qty. I Ea. Total '! ,, ;I 1 r:!jillp,i” i , , pll ! � I � ,t'n !hC #' I'll i' IP� i `,rl It "t$I, !�'`!' .k ,tt,O,N �„A �; ��) UN,�1((��'��(� j, l •�lii I'jIIII!, `:Ii;I:�, P (• ., I ,� �1,TftalPRlir�rj,'li ���. � U ,Ilij,�! {I +,, ad t' ef �'_ Heating/c )BIIn,1r, Job site address: 127 )_ Air Condit oning e L q n,.u..in 4 Cijv et_ . (requires sit: plan showing placement) 46.75 City /State /ZIP: `"?` i 1 4 2g a-4 C. Furnace 100,000 BTU (ducts /vents) 46.75 � Furnace I <iQ000 + BTU (ductstvents) 54.91 t Suite/bldg. /apt. no.: Project name: Heat um p 1 61.06 Cross street/directions to job site: Duct work 23.32 l.._ } („ J 7h ( _ 4 t hot water system 23.32 U IV�JCJ` ) fi1.L.t �d Residential nti al boiler (radiator or hydronic) 23 32 Unit heate's (fuel -type, not electric), in -wall, in duct, suspended, etc. 46.75 Subdivision: I Lot no.: Flue/vent I or any of above 23.32 Tax map /parcel no.: Other: 23.32 Other fue appliances i`i91; ; "illi i,ii;!„ {,,,,± , � � 1'!I' , It'", tlr ^.+ , ry f,',1' - '' +� : `li .'i!!" -, , I,n. .,, 1 ' IVI :' OEl#b ii'Il Iiliii!ji l {ji 1,, :' , `i ��'li i''- ,IZQ,;, -,v . • Water heater 23.32 Gas fireplace ) 33 39 33 ,11"/ I 5-tait , J 42 5 '-i p qa.0 L,A J1.-/ , F - Flue vent for water heater or gas , j .fl r ) p V r n .,, 1. ` — fireplace 23.32 ,/2 , �y, Log lighter (gas) 23.32 Wood /pellet stove 33.39 Wood fireplace/insert 23.32 ,1jlif 11..' Q kiipYiireY ;iii lin „ V I'W�-i r .a,� li;!i;f Iq i . ; ,; , � " (��' �W �' , ,,.'•�.` ,..� � ,i; °`� : W''. T�N;(�1a .',� ,lf Chimney /I net /flue /vent 23.32 Other: 23 32 Name: ]-P j: tv..e Environmental exhaust and ventilation Address: 191 7 3 r � Range hoo.i /other kitchen ' Y ►F r ! i • equipment 33.39 `� City/State/ZIP: ' e 1 ,( /y SJ e j. ( Clothes dry er exhaust 33.39 Phone: ( s(, _ �$ Fax: ( ) `i Single -due exhaust (bathrooms, o toilet compartments, utility rooms) 23.32 i .'ti -;i, I - 'lli ' ,'.1: , , it r v , , I :II); m � . .. . ,ah'. 1 'L I �4 T , , , i ,, P,'' ill (11 ; :: , i � AC T q , � ;i l. ^, ini; Attic /crawl fans 2332 Business name: F �S �i5� b, Other: 23.32 I r ! t f Fuel piping Contact name: nel ly_,0 $1 1.15 for first four; $4.03 for each additional Address: t4 t,� . . s • I , Furnace, et S ! Gas heat pi mp City /State /ZIP: �` x't"� r �CJ �y s © , P q ' 7 . j Wall /suspe ided /unit heater Phone: (fig S -, � -� Fax:: (53) 40,,,,,O — cj1 Water heat,:r E -mail: � I� 6° a 1 t _ r i � Z Range r lege /4. C ',,• ':I�QI„, �?�� � Tl T � �� �1 i r l'� / Ran ;',,,, ,';;:;; , col� i i` CTfiii, ;r °, ' I, I! 1.:; ill;,! lly:q . "Lr�' ',,'� ,I„ ,'ll!�j'i' .,...I,i, {i;ll{ _Barbecue Business name: �i r .„, 5l d i 5 1 ri � 4- Clothes dryer (gas) �y�p ,� ["� Other: Address: 14 e 3 vP_l �. S ! Ill 1iiilI jij ii'{lll l li i g�l�pp�ntpn t u ! i , „ ; II „I;II tlllil I `;;I Ijlfl,, I. .n ttEa�t� . '„ j;i j,i�'$,:d�'.' djE�U City /State /ZIP: p / co �„t r C .7 ,, ^ ` '7 0 ( Phone: (_ a ?l 9 S �2 C Jr3 Fax: ( . r � • , ��7 Subtotal .1 �. 5 &9� Minimum permit fee ($90 00) �b.� �U l oKl - Plan review (25% of permit fee) CCB lie.: T -) ( 7h 9 State surcharge (12% of permit fee) /o. R) �� !! � f TOTAL PERMIT FEE /25/), gd Authorized signature. This permit application expires if a permit is not obtained within 190 7 - J— ` A ' � / 1 1 0 , 4 days after it has been accepted as complete. Print name: 1-4.)40 11 Date: l(', it l * Fee meth, dology set by Tn- County Building Industry Service Board I /Bull&ng\PermitsIMEC•PermaApp doe 10!01 /09 4404617T ( 11102/COM/WEB)