Permit PIP CITY OF TIGARD MECHANICAL PERMIT
C OMMUNITY DEVELOPMENT P ermit #: MEC2011 -00611
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/30/2011
Parcel: 2S 104CA01100
Jurisdiction: Tigard
Site address: 13241 SW ESSEX DR
Project: Jankovich Subdivision: HILLSHIRE Lot: 11
Project Description: Install new pellet stove and venting.
Contractor: FIRESIDE DISTRIBUTORS Owner: JANKOVICH, BILL & MELISSA
13980 SW TV HIGHWAY 13241 SW ESSEX DR
BEAVERTON, OR 97005 TIGARD, OR 97223
PHONE: 503 - 641 -1919 PHONE: 503 - 319 -8049
FAX: 503 - 526 -9478
FEES
Specifics: Description Date Amount
Wood /Pellet Stove 12/30/2011 $33.39
Type of Use: SF 12% State Surcharge - Mechanical 12/30/2011 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 12/30/2011 $56.61
Occupancy Grp:
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 questions too OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: � / v �� Permittee Signature: 6V �Pi°� ��/� �"�Q//
' ` �/ 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.
, Val 0
Mechanical Permit Applica .l li FOR OFFICE USE ONLY
City of Tigard I' Received ,,,, eerm Flo-
Date/By: �� /.:3 i i Cep // — d 16//
a 13125 SW Hall Blvd., Tigard, OR 97223n Z011 Plan Review
.1114 - Phone: 503.718.2439 Fax: 503.598.1960+ 3 0 D ate/By: Other Permit:
TIGARD Inspection Line: 503 DateReady/By: Juris. H See Page 2for
Internet: www.tigard-or.gov GIB OF TIGA D i Notified/Mcthod: , / 7 (i1 Supplemental Information
BUILDING DIVISION
t
' TYPE OF WORK Authorized signature: 1"//1
❑ New construction ® Addition/alteration/replacement Print name:
❑ Demolition ❑ Other: II �� +7 Kv�''
COMMERCIAL FEE* SCHEDULE; — USE CHECKLIST
CATEGORY OF CONSTRUCTION Mechanical permit fees* are based on the value of the work
® I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit.
❑ Multi - family ❑ Master builder ❑ Other:
Value: $
JOB SITE INFORMATION AND LOCATION RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
Job site address: 13241 SW Essex Dr. For special information use checklist.
City /State /Z1P: Tigard, OR 97223 Description Qty. Ea. I Total
Heating/cooling:
Suite/bldg. /apt. no.: Project name: Jankovich Air conditioning
(requires site plan showing placement) 46.75
Cross street/directions to job site: Furnace 100,000 BTU (ducts/vents) 46.75
SW Walnut to SW 135 Go up hill (135` till it dead ends. That is Essex Dr. Furnace 100,000+ BTU (ducts/vents) 54.91
Heat pump
House is directly in front- cream and stone with 3 maple trees in front. (requires site plan showing placement) 61.06
Duct work 23.32
Hydronic hot water system 23.32
Subdivision: Hilishire Lot no.: Residential boiler (radiator or
hydronic) 23.32
Tax map /parcel no.: R2032428 2S104CA01100 Unit heaters (fuel -type, not electric),
DESCRIPTION OF WORK in -wall, in -duct, suspended, etc. 46.75
' Flue /vent for any of above 23.32
Install new pellet stove with new venting and outside air kit. Other: 23.32
Other fuel appliances:
Water heater 23.32
Gas fireplace 33.39
Flue vent for water heater or gas
fireplace 23.32
' ® PROPERTY OWNER, ❑ TENANT Log lighter (gas) 23.32
Name: Bill and Melissa Jankovich Wood/pellet stove 1 33.39 33.39
Wood fireplace/insert 23.32
Address: 13241 SW Essex Dr. Chimney/liner /flue /vent 23.32
City/State /ZIP: Tigard OR 97223 Other: 23.32
Environmental exhaust and ventilation:
Phone: (503)319 - 8049 Fax: ( ) Range hood/other kitchen
® APPLICANT ❑ CONTACT PERSON equipment 33.39
Clothes dryer exhaust 33.39
Business name: Single -duct exhaust (bathrooms,
Contact name: Bill Jankovich toilet compartments, utility rooms) 23.32
Attic /crawlspace fans 23.32
Address: 13241 SW Essex Dr. Other: 23.32
City /State /ZIP: Tigard OR 97223 Fuel piping:
$14.15 for first four; $4.03 for each additional
Phone: (503) 319 -8049 Fax: : ( ) Furnace, etc.
E -mail: harmelissa @yahoo.com Gas heat pump
CONTRACTOR Wall /suspended/unit heater
Water heater
Business name: Fireside Distributors of Oregon Fireplace
Address: 13980 SW TV Highway Range
City/State /ZIP: Beaverton OR 97005 Barbecue
Clothes dryer (gas)
Phone: (503) 641 -1919 Fax: (503) 526 -9478 Other:
CCB lie.: 40979 MECHANICAL. PERMIT FEES* '
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