Permit ///6h 4rf
l 1 d2SGv7 cal Ghat /fit/
CITY OF TIGARD MECHANICAL PERMIT
11 1- COMMUNITY DEVELOPMENT Permit #: MEC2011 -00502
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/08/2011
Parcel: 2S112CCO2100
Jurisdiction: Tigard
Site address: 8005 SW CHURCHILL CT
Project: DELP Subdivision: BOND PARK NO.3 Lot: 49
Project Description: Gas fireplace insert with venting and gas piping for fireplace. 11/15/11, Reprinted permit to correct description and
add gas piping to range.
Contractor: FIRESIDE DISTRIBUTORS Owner: DELP, WILLIAM W & TRUDY L
18389 SW BOONES FERRY RD 8005 SW CHURCHILL CT
PORTLAND, OR 97224 TIGARD, OR 97223
PHONE: 503 - 684 -8535 PHONE:
FAX: 503 - 670 -7285
FEES
•
Specifics: Description Date Amount
Wood Fireplace /Insert 11/08/2011 $23.32
Type of Use: SF Chimney /Liner /FlueNent 11/08/2011 $33.39
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 11/08/2011 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 11/08/2011 $33.29
Stories:
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: • - / ermittee Signature: •
Call 503.639.41 •�: 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.
CITY OF TIGARD MECHANICAL PERMIT
1111 COMMUNITY DEVELOPMENT Permit #: MEC2011 -00502
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 11/08/2011
Parcel: 2S112CCO2100
Jurisdiction: Tigard
Site address: 8005 SW CHURCHILL CT
Project: DELP Subdivision: BOND PARK NO.3 Lot: 49
Project Description: Gas fireplace insert with
Contractor: FIRESIDE DISTRIBUTORS Owner: DELP, WILLIAM W & TRUDY L
18389 SW BOONES FERRY RD 8005 SW CHURCHILL CT
PORTLAND, OR 97224 TIGARD, OR 97223
PHONE: 503 - 684 -8535 PHONE:
FAX: 503 - 670 -7285
FEES
Specifics: Description Date Amount
Wood Fireplace /Insert 11/08/2011 $23.32
Type of Use: SF Chimney /Liner /FlueNent 11/08/2011 $33.39
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 11/08/2011 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 11/08/2011 $33.29
Stories:
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: / •ermittee 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.
11/08/2011 11:14 5036707905 WIDDOWS PAGE 01/01
11/08/2011 12:25 5035981960 CITY OF TIGARD PAGE 01/01
11/07/2011 14;04 5036707905 WIDDOWS PAGE 02/02
Mechanical Permit Application RECEIVE
City of Tigard AterBY: jar 11 .:" limit No.: frigc
.14 _ . 1125 SIN irlaIl 131vd,, Tigard, OR 97223
-11. ' Phone: 503.539.4171 Fax: 503.598.1960 NOV 0 7 2011 a o Permit;
—
I 1,1f: :0,8503.6034g.dpv175 pate Reallyffliy:
WI Zpplem t
CITY OF 'TIGAik II rietinecum,i,,,d,
. •
_
, 1!! Idi114 . '0.'. ,ii ,,,,t, I im, ,,,,,a,. u,... m .6,, ..,,,,,,. d
NIMPi , ' : i rilariMMiZialt1 'I IS 14111.21 1
!,..:•! 1/11 t".. ' W "Ir r711P 1' 1 :1 7 71 7177 : F r il
Mechanical potnit JIM bre based 031 the value of the Werk
El New comaruction ,g Addition/alteration/replacement
petthrmed. Indicate Oie wens (rounded to the nearest dello) of en
EI Demolition 0 Other; mechanical materials, couipment, 'akar, overhead, and profit,
iryr Value: $
I i ; 47,9p. ‘ ..4 . ,,.4 4..* .11 7 , 211 , 1 ; , ; .,.... i .,1[,: : : ! , I Rbt:i 1 9 ,,,,, r, ,
- 01111111i11- ', QIIIWAIA;1!:4:1Alik.'"
• g
I- anti 2-family dwelling 0 Commercial/industrial 0 Accessory building 11W ;1
Per ec& WOrnialTall PM cheareltsi.
El Multi 0 Master builder 0 Other.
Description I Qty. I Es. L Total
IL l i ilit Ficatin- coo
Air conditimnig
s.
.1ob • site address: ' b e , . .. a _' • ,k _ a ti.nloirei sitc &11 allowing placement) 45,75 .. •
Ci Fiancee 10/100 13T1) News/wets) T
t Ti' i A q751 46,75
Furnace 101100+13111 jcipanivent4 , 54,91
.1miteiblIdglapt. no.: ' Project 'lento: i ,,
Haat . UM . _ 61.06
_
Cross street/directions to job site: Duct work 23 32
_ ,
14 dronic hot water system 23.32
Res xtential boller (radiator or
h .tonic 23.32
Unit haviten1 iscl-type, net
electric);
in-wall i .4114 suspended, etc. 46,75
Fluelvent fi•r my above 23_32
Other 2332
other Nei gasmen
0, I, i,;:? li , " - ...tli!!):; , " WI .!,:!P: EI wate' '1"T-- 23.32
Gas Omelet e 33,39
iiiii ,&1111F/1 1 ,1 rilMinirgall._ nue vent ft r water
ilphter heater or gas
n.
fireplace _ ,. 32
MilrilZWEIYI Log, heater
23,32
I Wood/ cite s ova 33.39
Wootlittol tic c/Inscrt I 23.32 2 3 , 31
.olat..v. ..? c Chimne
, 141, , ,nt, ,,i.....,+!; „ y/lino tflaro Vont __, 2332
Anti 11 '!M:il+iga . , 41■■ .; ., '.- ' , ''!:■ • '&11...% ':' :HI 9 ' 1 414 -: II '
EnvirOnmg ; I exhaust and ventilation
Address: in" .1.- c"." l' 1 1.../ . ; C IN 4 i. if Range neeeve:uer eitdien
equipment 33.39
,. ."
A .
, City/State/71P: -
1 A. lik I Clotho dry le exhaust _. 33,39
;. Single-dad e): haus/ (bathrooms,
' Phone: 02 , , , : ._ . I Fax: ( )
peRst cotnpirrt tient?, utility rooms) 2132 , ..
l... MIL Nip,; ,EallaiEL : il Attie/craw1T. es fans 2352
■ ' . "'-'
1 pthcc, 23.32
(... 3 ttaititAs narne:
r- --.. ' . • ...". Feet MOUS_
Id ,
44 A i r I r.ii 40 di S14.15 for first four 34.03 for each additional
.,a ' r"a4k 4616
1
Gas heat tutu
t
Wallisespooded/unit heater
- .t-
;;. Phone: ( n-) , Fax: : (533) 4042t) -, 6 /A/ Water
ECIPIVIMPVIV4IIMPAMMIME Fir4Placc —
, ,. . . „ . . .:!',, ;. I.: ..P. „ .,.' 0 -I if ,f All Range
....I 7, I NT I ' 0;l '1 :.,!' , 1; ', , ' ' ''.! .7 ilfr,.1. 'VP.: I . igimm 13 ,, i „,,,.. "'
M =
Business name; T • ■ • Clothes drari las IIIII MI
— Other: . MEIN
ii, ,
Til7 k 1
• 11 ilk _1 lo.' 0 0 a ._.___ Subtatati tpen a
.• --JL", F riX : ( , . 4 12,c2 cl. 47 . ... ,... .--,.., .., Minimum permit fbe (590.00) • ,,a 4, •
CCES 11.c.: A • A Plan review (25% uf vomit. fee)
r 2itete Rurcher (12% of permit fee) AO • ,.. 4i
O — .
TOTAL PERMTT FEE , , ;',41
Authoriwii signature; 4 . • .......• ......A.„,,,-,r,.
.
Tals parted...a entree int permit la slat obeclited within I NI
dem after it Mu been occepled et complete.
Print mann: piriims e • e , • Data: ... .. „,,,. L * Foe ateibcilel■my sat by TP.Camity Building !lnifttstry Service Board
ni.EtaileicetmomiteMECAtemits. i worm
440.44ITS I I travciamo,vgsy