Permit ,, CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT COMMUNITY MEC2011 -00550
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/01/2011
. . Parcel: 2S103DB05000
Jurisdiction: Tigard
Site address: 11165 SW NOVARE PL
Project: Snodgrass Subdivision: GENESIS NO.2 Lot: 47
Project Description: Install woodburning fireplace & venting.
Contractor: FIRESIDE DISTRIBUTORS Owner: SNODGRASS, DREW CHRIS
18389 SW BOONES FERRY RD 11165 SW NOVARE CT
PORTLAND, OR 97224 TIGARD, OR 97223
PHONE: 971 - 235 -0521 PHONE: 503 - 939 -9783
FAX: 503 - 620 -5699
FEES
Specifics: Description Date Amount
Wood Fireplace /Insert 12/01/2011 $23.32
Type of Use: SF Chimney /Liner /FlueNent 12/01/2011 $33.39
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/01/2011 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 12/01/2011 $33.29
Stories:
Fuel
Fuel Types: Solid Fuel
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 question o OU by callin. 503.232.1987 or 1.800.332.2344.
Issued By: , /, e p.. �,n� ,// a a Permittee Signatur 7i , : �� ' J -� -Ammo.— . Y [�ts� - Y[ { --- /
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.
11/30/2011 14:45 5036707905 WIDDOWS PAGE 02/02
Mechanical Permit Applica o jtp. CE h !�>tz OFFICE usr ONLY
City of Tigard • � Received � �
13125 SW Hall Blvd., Tigard, OR 972 3j � Date/By: C1j7 / ail Permit No.: ij /J„ (5^T
Phone: 503.539.4171 Fax: 503.598.1960v 3 2011 Plan Review �/t� /6 CJ
Ins Inspection Line: 503.639.4175 1 Date/By: Other Permit:
TIGARD p
Internet: www.tigard or,gov C ITY OF T IG Date Ready/By: rails: I la See Page 2 for
UILD N otified/Method:
I I R D Supplemental Information
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❑ New construction (Addition /alteration /replacement Mechanical permit fees* are based on the value of the work
performer. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other:
mechanic:tl materials, equipment, labor, ;ipil`4iii "'x +;ji;; I'I' }� , overhead, and profit.
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[ 1- and 2- family dwelling 11 Commercial /industrial . .....�lIllai ai ii , I �'- i i
❑ Accessory building .r ', ;.a �, � Lul, l - l�tl` fll �iifll�; ll i�li�l� .:��'..:i5?�,,tE�- �,fr��) i`IC�i;i� , 1:
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
;,rl .' ��ii; sl' . J;'nl,r,IY `i 1 ,: Description
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•`�!�;�.' .r!!Igil,l.. >.' :.'. � ., r,:g;? HeaNnglclloling
Job site address: 1 i Air conditioning
(requires sit, plan allowing placement) 46.75
City/State/ZIP:
A t et. re "' 7'_..3 Furnace 100,000 BTU (ducts /vents) 46.75
Furnace 1(0,000 +BTU (ducts/vents) 54.91
Suite/bldg./apt. no.: Project name:
' a •. / f Heat pump
Cross street/directions to job site:
Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heater; (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue /vent flu any of above 23.32
Tax map /parcel no.: Other: 23.32
uj rg y' _ li p, 1 ,,, Other fuel appliances
'ifjl(i;1..illl+ta' ';:iiii!ilISI i'idi' ,'4, 'p "ii " , IqI ;,- t•) 111,,1,,,,' m'
t I ; , I. .' +i, 1
i�,� '��.a: ��� i ,i Ii,l! I ! I! q 1uG��`I!1 I! 1 11!!Iill�(;I Water heats r 23.32
ti t e j till Gas fireplai e 33.39
r .o I Y L . s 1 l i t ■ / Flue vent fcr water heater or gas
' Ali . , � , fire
- 23.32
Log lighter gas) 23.32
Wood /peilei stove 33.39
Iii, rt Wood fireplace/insert LIE 23.32 !1�i i,� � l '�A�, (F:! r„C��
'a ]b.T'..�l �.:. . � i IlY ° t;l '�li Iilt:hli', ,.
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., -,,,.... .. ,, tier ' :0i'i i iii ( h Chimney /liner /flue /vet / ry� yyq -
' I,' , ,., , , ' �; Idly s ; n nG.7.,h.
,. i
I:�� ;, I !liiu 1i1�� i,l!: r:;'. {i1 23.32
. ,. . Other:
.& A 0,.. A / E
23.32
Environmental exhaust and ventilation
Address: r } 5 ` Range hood, other kitchen
City /State/ZIP: equipment 33.39
-' 1 Clothes dryer exhaust 33.39 •
Phone: (s05) 5 s ` it Fax: Single duct':xhaust(bathrooms,
I ' ;ill;'.` >: +Ili''`ln:'t- i , " h ,t 7r;r = e;;; r :,'r. { ) ,: toilet compa tments, utility rooms 2
l ` rooms) 23.32
: ,.! l�,iell, �I'y �'Ayt'Vt�' ,. ( ti. ti��i= -?;1 u : ,, �
ll I s ace '�, �,��' ;�O�g o � ,lll•Ei r ;l!; Attic /crawl I fans 23.32
1, Other: 23.32
a ,7 . /A!�
Fuel 1 1
Contact name: ` p'p'nR
d w�.� $14.15 for first four; $4.03 for each additional
Address: r , s Furnace, etc.
l
City /State /ZIP: n Gas heat pun 1p
• .1. 4` , J Wall /suspended /unit heater
Phone: (1'1/ ) a
I' i * • 6 Water heater
i i
a�rr /_� Fireplace
E -mail:
r !rtllitii ;�lci n P. ; i:i11 ?` ;:,1' i,i');'. `' ell's l.,,t a � .,.,. ;, ' a • A t Range
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Business name: t �, . ,r ( f ' Al s Clothes dryer (gas) •
Address: a 5 Other:
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City/State/ZIP: ,,, ,.1 ,1tiI �', uu
y na l ; : . ; E �1 ?� ; . l ub 1 ' Sul -• tnilou +s, . , rlfi:I
Cit
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!1. Subtotal l�-�
Phone: (`�7 ) '• _ 4 - 'Ad," / _.• , , �Mil t, ♦ y
Minimum permit fee ($90.00)
CCB lic.: • • V Plan review (25% of permit fee)
State surcharge (12% of permit fee) MIMI
Authorized signature: / i / / TOTAL PERMIT FEE A v a ./
This permit application expires if a permit is not obtained within 180
s
Print named -' r N days after it has been accepted as complete,
- - - miff I,rr Date: e d r Fee melhodo ogy set by Tri- County Building Industry Service Board .00 I (Building \Permits ■MEC- PcrmitApp,doc I0 /01/09
440 -96I7T (1 1 /02 /COM/WEA)