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Permit CITY OF TIGARD MECHANICAL PERMIT 1111 r_ COMMUNITY DEVELOPMENT k' Permit #: MEC2012 -00285 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 2 /,Z • Date Issued: 06/04/2012 TIGARD 9 0 Parcel: 2S102CA00205 Jurisdiction: Tigard Site address: 13285 SW ASH DR Project: Miner Subdivision: VIEWCREST TERRACE Lot: 3 Project Description: Duct work. 8/1/2012: Additional work for gas fireplace, range hood, (3) exhaust fans and fuel piping for fire damage repair; additional investigation fees charged for work without permit for these items per inspector. Note: Does not include fumace installation. Contractor: SUNSET HEATING & COOLING Owner: MINER, EDGAR W & LUCINDA L 0607 SW IDAHO ST PO BOX 264 PORTLAND, OR 97239 LINCOLN CITY, OR 97367 PHONE: 503 - 234 -0611 PHONE: FAX: 503 - 234 -0439 FEES Specifics: Description Date Amount Gas Fireplace 06/04/2012 $33.39 Type of Use: SF Flue Vent for Water Heater or Gas 06/04/2012 $23.32 Class of Work: ALT Type of Const: Fireplace Occupancy Grp: Range Hood /Other Kitchen 08/02/2012 $33.39 Stories: Single Duct Exhaust (Bathrooms, Toilet, 08/02/2012 $69.96 Utility Rooms) Fuel Piping 06/04/2012 $14.15 12% State Surcharge - Mechanical 08/02/2012 $20.91 Investigation Fee (equals Mechanical 08/02/2012 $84.21 Fuel Permit) Investigation Mechanical 12% State 08/02/2012 $10.11 Fuel Types: Surcharge Gas Pressure: Total $289.44 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: 0A/ d---d---,,Z_/ - ,� en- -rip / Call 503.639.4175 by 7:00 a.m. for the next available Inspection date. VVV 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 111 COMMUNITY DEVELOPMENT Permit #: MEC2012 -00285 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2012 Parcel: 2S102CA00205 Jurisdiction: Tigard Site address: 13285 SW ASH DR Project: Miner Subdivision: VIEWCREST TERRACE Lot: 3 Project Description: Duct work. 8/1/2012: Additional work for gas fireplace, range hood, (3) exhaust fans and fuel piping for fire damage repair; additional investigation fees charged for work without permit for these items per inspector. Note: Does not include furnace installation. Contractor: SUNSET HEATING & COOLING Owner: MINER, EDGAR W & LUCINDA L 0607 SW IDAHO ST PO BOX 264 PORTLAND, OR 97239 LINCOLN CITY, OR 97367 PHONE: 503 - 234 -0611 PHONE: FAX: 503 - 234 -0439 FEES Specifics: Description Date Amount Gas Fireplace 06/04/2012 $33.39 Type of Use: SF Flue Vent for Water Heater or Gas 06/04/2012 $23.32 Class of Work: ALT Type of Const: Fireplace Occupancy Grp: Range Hood /Other Kitchen 08/02/2012 $33.39 Stories: Single Duct Exhaust (Bathrooms, Toilet, 08/02/2012 $69.96 Utility Rooms) Fuel Piping 06/04/2012 $14.15 12% State Surcharge - Mechanical 08/02/2012 $20.91 Investigation Fee (equals Mechanical 08/02/2012 $84.21 Fuel Permit) Investigation Mechanical 12% State 08/02/2012 $10.11 Fuel Types: Surcharge Gas Pressure: Total $289.44 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: OA,7- ff��L� C�� 6 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. CITY OF TIGARD MECHANICAL PERMIT s COMMUNITY DEVELOPMENT Permit #: MEC2012 -00285 T I GA R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2012 Parcel: 2S102CA00205 Jurisdiction: Tigard Site address: 13285 SW ASH DR Project: Miner Subdivision: VIEWCREST TERRACE Lot: 3 Project Description: Duct work Contractor: SUNSET HEATING & COOLING Owner: MINER, EDGAR W & LUCINDA L 0607 SW IDAHO ST PO BOX 264 PORTLAND, OR 97239 LINCOLN CITY, OR 97367 PHONE: 503 - 234 -0611 PHONE: FAX: 503 - 234 -0439 FEES Specifics: Description Date Amount Flue Vent for Water Heater or Gas 06/04/2012 $23.32 Type of Use: SF Fireplace Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/04/2012 $10.80 Occupancy Grp: Minimum Fee Adjustment - Mechanical 06/04/2012 $66.68 Stories: • Fuel Fuel Types: 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. /n� Issued By: W1 Permittee Signature: oN A e PCI CATI Vu 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. 05/30/2012 11:44 5032340439 SUNSET HEATING PAGE 02/02 „5 t P G Mechanical Permit Application" "l "'�" � rolz orrlt:l': USE ONLY • ; V ' ^ � : • : 'City of Tigard ti©� 'hid . t+� : tc/gy; 66,00/2,- ,_ : ,' - '^ 13125 SW Hall Blvd., Tigard; OR 97223 n Review te , /9r� l ''' D D I L, •„ a s; . Phone: 503.639.4171 Fox: 503. 598.1960 ' MAY 3 0 2012 Da Plam t P "'� /�' s. Inspection Line: 503.639.4175 • • D �dy/gy; °� to See Page 2 for '' ' kit. is: . Int wwiv.tigard- nr ;gov CITY OF TIGAR I N e ' ' SnpplemeataI Information ..b ,.�''99 �. �nfS✓�j���A� "i%::�,� .: ..i: �4 y � �: `.is� ��1. - ll , �l r., �0�lJ�i�r °iiU���iRJ±c)I{TJ�. '1' .. "� ••- •, ..i .:... r 'y M,.: r .:4)!,•'- ,.1 {: •' � :, �k..!'itu ��,�.:....: A•u b0:. x l..� �i.,yon.. .4•.. f' .N�.IfS'.•' .' • ..K .d. '.. :�+ Mechrmical permit fees' are based on the value of the work El Ncw construction ' Addition/alteration/replacement pertbrmed. indicate the value (rounded to the nearest dollar) of all 0 T1cmr,lition ❑ Other: mechanical materials, cquirment, labor, overhead, and profit .:' :..� j ' . . :. 4 . ",� .. - - . "pI -,Y, .. 'ice 4,,�. 't - .. . ..._ .... . �Y�§I�>1�1'!n�;�� �... , <51157'EMS'�1E9• I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building r For special information use checklist. ❑ Master builder C] Other: lbeaerlption Qty. Ea. Total >., ' ' ''.tbli ;lif 1:014 S.4 ' 't.e : .*,�..,t00 L.f�`0i714 ;:; ass �. ?; Y : ; Heatin- wells: .. ,. . 1 1 , .. - -- � " '" Air conditioning Job site uddress , 8e. �a (�v (461 - n ' rhea rile •lap ahoy/in, •terxmcnt 46.75 City/Statc/ZIP: -rti rte- e D Furnace 100,00013TU ducts/vents 46.75 l! / Furnace 100,000 +.FITU/ductsNent ■ 54.91 Suite/bldg. /apt. no.: Project name: Heat pump 61.06 � Cross.strcct/directions to job site: • Ductwork' IAN 23.32 FOP- - Hydronic hot water system 23.32 III Residential boiler (radiator or hydronic) 23.32 _„ Unit heaters (fuel -type, not electric), in -wall in-du- au- .ended eta. 46.75 - Flue/ventforan of above 23.32 Subdivision: Lot no.: Other _ 23.32 Tax'man/parcel no.: • , Other fuel appliances . � << ,..• n; r .. , > - ;' .'. :! Writer heater 23.32 . , �j` ,<'":' ?�.. ' w - , r y s , •..;! ^ „�c�'�' �.; ;..dS.> �tr`,...�;.:��. Qa5 fl lace 33.39 • V lr-JO k . . Flue vent for water heater or gas --' 1i dace i 23.32 L,n;' ter _as Wood /. Het stove _ . Wood fireplace/insert 23.32 Chimp. /liner /flue/vcnt 23,32 u.�.� p,l `"'`.. ,c y', f A'k 7 :':r i'1 :.!,�,;s rA f t', ':". :, T� ; .. • ,... • =: . �4:J,:'i�R�P'.li'_�n , �,: : ,Y. a rw *�.t "; ,� < :..;��: ;,; ,� . Other, 23.32 Name: • . . . Environmental exhaust and ventilation _ • Range hood/other kitchen Address: . . i . mcnt 33.39 City/ State/ZIP: • . ' Clothes dryer exhaust 33.39 • Single-duct exhaust (bathrooms, Phone: ( ) ' • Fax: ( ) toilet compartments, utility rooms) 23.32 ,'.3 ' r �1:'2y i 'err �:ri, t 1i 'rz'e ,';,�° " 'rj (l , W axe, ;.; yi d Attic/crawpacc fans 2332 .45. • ii SS .tAi i :' •.:.V. i.,f : ' 4.4 1, � A , 11�S6�NJl „: :,,,': : +} .,. • other 23.32 Business name: Fuel . i . i ' Contact name: 314.15 fur first four; $4.03 for each additional Furnace etc. Address: Gas heat pump IIII � City /State/ZIP: WalUmtm • ended/unit heater Phone: ( ) I Fax : ( ) Water heater Fireplace E - mail: • Range �::�- r " " • ✓c ..r: :'b','!',;:,,r�:n' t��•�1,�; ` '��'Sr „ ,r,'i.; r ^�� r.:•,; Barbecue III '��' -til` ':'i<(r �� r, .u, +r;•p�J4;!:� �,.,.- n a =. tl: r:''.n , .....7�a ,c5.'� H' Business 5'l,�Y) se,i- 1..1,¢ '1 crpti Clothes er las s namC: Other: Address: Qla Cll i dN-1D - h i :, . ; - ?= :M,, , ,. �I •• •• • � f iCll E9 City /State/ZIP'. 1 ' cy.illauk,, 011 3 • ... Subtotal ,7 F.N. Minimum permit fcc (590.00) ' 0,00 t/ One: (51.):?) 23+-011)11 L'Fax :•(5t3) Z 34 Plan review (25% of permit fee) CB G tic.: I (ii a gj te n i , - a State surcharge (12% of permit fee) 10, 9.0 TOTAL PEST FEE FM. s.D • s This permit application expires Ira permit is not obtained within 18a Authorized signature: . . I days after to has been accepted is complete. FErint 4 A d name I Date: . _. 7, I • Fee methodology act by Tti •County Building Industry Service Hoard 1VL1 . yl r , ..- .- ..................... 08/01/2012 12:18 5032340439 SUNSET HEATING __ — PAGE 02/02 A/I RECEIVE ` FOR UF[ +ICC USE ONLY I R v� ec�anxcal Per A Iicatio>ni r Permit No.: t e ,„..9 0 0, e6 . . • City of Tigard . AUG 01 7.712 Date/By ' 0 wwi OR 9727.3 Plan Review Other Penult: " 4 13125 SW Hall Blvd., Tigard,; D nre/By: CITY OFTIGAi► see Patin x car s.,::•: ;a Phone Phone 503.639.4171 Fax: 503.598.1960 Rcadyn3v: e iSe e Pa g 2 information . . In spectirm Line: ' 503.639.4175' . B UILDII•dGxII, I VISII lltto6fed/Melboa: 'I 'I v.tigsrd- cir.RO Ox �.: /.. y'•.7 11.r.�Kv " r ■ E v� r F • - , -• •Ij ,`� ;°iU � k tis >Ya ''+, ; �161i*f :- ass - ,l':;::cr,,;;��';'' '' . • , r�basedonthevat=ofthe / .1' �!Y ,,. ( : : Mechanical permit s TI w ,•.. �pddition /al[cration/replacomen perforh. indicate the (round to est dollar) o all New construction mechanical materials .ui value •men labor ed ove rlrcad and •refit ri Demolition Other: Va1uc $ • i,' :?s : :f.. ,.... a checklist. building Fo • dal information use ig) l- and 2- family dwelling 0 CommcrciaUindt 0 Accessory �,• � Total El Master builder , ❑ Other Description Molt, fmmly —7-7 ....... '..- t0 .., t1'.5G1��;' tIvi: QR1NA�?1t�. l' :. ~'�e ',. Air conditioning 5 ; C cite • Ian showin: .lacomcnt dub site address: •D..8,5' 560. Pomace 100 000 BAT ducts/vents 1111.11 46.75 MN 7'a Furnace 100 000+ BTU ducte/van NMI 54.91 a City/StatcJZ1P: l ' x/ ` 61.06 MIER Suite/bldg./Apt. no.: rtxtst/tr * 23.32 i Ductwork' — Crags .s y 0 �� sired/directions to job site: �� •tonic hot water ern + , _ Residential boiler (radiator or conic f[/G �ih �s� Unit heaters (flrct typ0. not electric), end . etc. 1: � • • in -wall in�u su 2332 Fluc/vent for an of above g . Lot no.: 23.32 Subdivision: Other•, • . Other hrel eat a • • Ilanear 23.32 Tax rasp /parcel no.: r ..: ,, �, a : ^b ; .. fi x• �T Water her • - -: ° � w'� T.S� 0�'r •.. ,. ....4.:: i .. ens fi •lace Prue vent for water heatar or gas I 23.32 ___.__L';t WCIQ.k - - rtc•laee _ W _ 11 p tar : s — MI� / '� Wood /pellet stove Wood fi .1sec/insert _1M Chimney/liner /flue/vent _� ; x r ., r• . ; ;;1 23.32 t d•t ' . e 55��:jj'4 *;:'�x� °t.� OW >:,s`• -•' - -• Other. �. Y<'; ;,b :k. : ; : d ventilation ` •: {r'�•. .. . � +: '� • .�� Environmental exhonetan Name: • Lam' M ']TT 0v 6 --^ Range hood/other Idtchcn . , - vi • meat • Address: ' Clothes d er exhaust Mill 33.39 • City/State/ZIP: Single -duct exhaust (bathrooms, Fi � ' ,, ( ( ) toilet coin • srtmettt4 Mill Mill room Phone: ( ) � Fax: _ �.- � .: �d „ 4 AB T'•' 4'; . ;;: : •, �= 3.32 . ? -+ d, f x,, �e.1- k P 1 ti :.'.•.. is a;:. � , ! � ,. ''' f X' ,M1 �!'� ; %• � LY � an'r t i1.C:�.Ra. t t L.. Qther `; L Business name: . Fuel .i in: $14.15 for first four S4.03 for each additional Contact name: Ftur etc. Address: _ — Gas heat e n v Wall /suspended�it heater - z: _ ; _ • aFes : ( ) — Fireplace . Range E- mail: . ;;,�. , ,. � f,.: e :. a q .Asrbee„ ✓.a "'; ; h � A'7Tp�l^ { 'Sk.: *t ___ C`a d;S �i: !�i =:t;` z' 4,,; ,T ^ ff,:i . e: :;: ;,•l .x. ;� _., , :.. . Business name: SILYi Se . e it S Clothes d er :a9 LEV 1115 �.—.._ Other. Address: Ot Gr1 50 I doh 0 I '`' . subtotal ' �'f: , City /State/ZR :i . p ��� . ' .11' 239 M initnumycrmlt fce ($90.00) 0 r eV • Phone (TO) tl'-Glrr i;l I . (' () " _ Plan review (25% of permit fee) �" State surcharge (12% of permit fee) , /U. — CCB lie.: 1.144 O g'5'• � ' , . - TOTAL. PERMIT FEE 6Q /��, r This permit application expires if a permk is not obtained within 180 Authorized signature: days after it has been accepted as complete o n Print name: rL , Date: `Ts��r/ - - - I • Pea mmbodology set by Tri -County Building Industry Service Board ,. r:1AuhTinnV•.nn0e1MPP.A.wn:rs.w .w tnm ...... —, _ II CITY OF TIGARD 1 i1 MECHANICAL PERMIT t3 COMMUNITY DEVELOPMENT IU®® Permit #: MEC2012 -00285 T LGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/04/2012 Parcel: 2S102CA00205 Jurisdiction: Tigard Site address: 13285 SW ASH DR Project: Miner Subdivision: VIEWCREST TERRACE Lot: 3 Project Description: Duct work. 8/1/12: Add gas fireplace, range hood, (3) exhaust fans and fuel piping for fire damage repair; additional investigation fees charged for work without permit for these items. Note: Does not include furnace installation. 8/9/12: Add (1) clothes dryer exhaust, investigation fees for work without permit and reinspection fees. Contractor: SUNSET HEATING & COOLING Owner: MINER, EDGAR W & LUCINDA L 0607 SW IDAHO ST PO BOX 264 PORTLAND, OR 97239 LINCOLN CITY, OR 97367 PHONE: 503 - 234 -0611 PHONE: FAX: 503 - 234 -0439 FEES Specifics: Description Date Amount Type of Use: SF Gas Fireplace 06/04/2012 $33.39 Class of Work: ALT Type of Const: Flue Vent for Water Heater or Gas 06/04/2012 $23.32 Fireplace Occupancy Grp: Occupancy Load: Range Hood /Other Kitchen 08/02/2012 $33.39 Stories: Single Duct Exhaust (Bathrooms, Toilet, 08/02/2012 $69.96 Project Valuation: $0.00 Utility Rooms) Fuel Piping 06/04/2012 $14.15 Fuel Air Handlers 12% State Surcharge - Mechanical 08/02/2012 $20.91 Fuel Types: Units < 10000 cfm: Investigation Fee (equals Mechanical 08/_02/2012 $84.21 Gas Pressure: Units > 10000 cfm: Permit) Investigation Mechanical 12% State 08/02/2012 $10.11 Furnaces Boilers & Compressors Surcharge Furnaces < 100K BTU: 0 -3 HP: Clothes Dryer Exhaust 08/13/2012 $33.39 Furnaces >= 100K BTU: 3 -15 HP: 12% State Surcharge - Mechanical 08/13/2012 $4.00 Floor Furnaces: 15 -30 HP: Investigation Fee (equals Mechanical 08/13/2012 $33.39 Permit) Unit Heaters: 30 -50 HP: Investigation Mechanical 12% State 08/13/2012 $4.00 Vents w/o Appliances: 50 or Greater HP: Surcharge Air Conditioning: Reinspection -Mech. 08/13/2012 $90.00 Heat Pump: Reinspection -Mech 12% Surcharge 08/13/2012 $10.80 Appliances Vent Fans: Vent Systems: Total $465.02 Hoods: Comm Incinerators: Woodstoves: Gas Fireplaces: Required Items and Reports (Conditions) Clothes Dryers: Other Mech Units: Gas Outlets: Other Desc: Duct Work: Fire /Smoke Dampers: 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 Notif ion Ce r. 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 estions to OU C al' g 503.232.1987 or 1.800.332.2344. Issue By: Permittee Signatu j 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. 08/10/2012 13:08 5032340439 SUNSET HEATING PAGE 02/02 . .: • . Mechanical Permit A 1 I licati JAI, EivED : 1 1 FOlt OFFICE USE ONLY City .ot Tigird ....-.------ -' Resseived lighrritil=111 ig -Oo , ; 5" • ... : :, • r a 11125 SW Hall Blvd., Tigard,: OR 97223 A , , „ 9 ,) n 0 Plnn Review : • .. :' a 4, Phone: 503.639.4171. FAX 503.598.1960AU 13 1 0 Lu I L Dateff3y. Other Penult: . il 4-4,.6, Inspection Line: 103.639.4175.. Duo ReadyfEly: larill: 121 See Page 2 Dar •': ...* ...* Internet: wonv,tigard-or.gov - c1 OF 6A NaiirtoWellteci: . • , Supplemental Information m ilDlIVI: V !SION . ... .. . 77 ...P.:" . ..:iv.... 'inyWomr kiti:1 '1/1.4j.t141145UHLUIMIW";:aiSVPIEClailgr • Mechanical permit fees* are based on the value of the work El Ncw construction V Add ition/alteration/replacestnent performed. Indicate the value (rounded to the nearest dollar) of all 0 Demolition • 0 Other: . • . mechanical, material e ui houlat!L..---t--.—E.----or overhead and rofit. *.e.6.6,-ole 1. ogowtfetytc*:,,reiA.044154,1.5•:?. . . ,.,. A7 .„.. .... .,. - 4 .- ., ----- TZ:V;diatkiknialtbifni104:40sTESSTEEr . . • I. and 2-family dwelling 0 ComMercird/industriai 0 Accessory building .. Multi-family D 0 Master builder I=1 Other: Description For spedal information use checklist. I Qty. j Ea. I Total .. JO* silt: INORIvtATO1W1045,6,0,07, 41;1.:;'(44=I'A',-, Muting/cooling Air condition mg -;12:1T272i±.1tnia2151fi'!62_k__6____ ,(rcanires she plan showing placement) 46.75 City/State/ZIP: — 1 - Li ard . .., CyL_ rn ci, 1 )23______________ FurnFme 100 0jc)2(thi)U eta/vents 46.15 Fuace 100,000+ BTU ( &fa/vents) 54.91 Suite/bldg./opt. no.: . rro"ject name: Heat pump 61.06 Cross street/directions to Joh site: buet vimic;___-_L- H dronle hot water a tam 23.32 Residential boiler (radiator or , ^ , hydronic) 23.32 -- Unit heaters (fuel-type, not electric), in-wall. in-duct, suspended, Me. 46.75 — . v — Flue/vent for any of above 2332 • - Subdivision: • i Lot no.: • v _ Other: 23.32 .. Tax map/partel no.: . Other fuel appliances , ;•!;••..;:.:;.,:l...:::,:.i`....Z....:.';';'..0.;',....e,Aliiitit8ditiiiWfil4i1/4010:133;i4:v:V1/4,W. Water h eater 2332 v • .• • • Tr.)Lke tita4P IrJOR-A-- Flue vent for water heater or gas . jut lace ' • Log Rohm (gas) 23.32',,,„ .P 011042•,- 0-144k1.4 A) , f_ ,_ ___, . Wood/pellet stove 33.39 Ls) Co 4 . 1 4 "k s ' 4 4 • _........,... . . ' S ' Wood fireplace/insert 2332 -- .. E ..-,■i ; ;,v1:1:110pitro^: T I, ': ii; '{;., n iT.:70fiko4 1.A P. . -.„,-.... ' : Chimney/liner/flue/vent 23,32 2332 , -- Nartlet&i,'LL. 06). .16 , Environmental exhaust and ventilation _ - Range hood/other kitchen Address: 1 - . • 4L 4 - . - - - EA City/State/ZIP: . ' . ' . , , • Clothes d er exhaust 33.39 Phone:( ) .• Fax: ( 23.52 ) V614 toilet compartments, utility rooms) , g• T,I.-r, ' .."..'. , " :: !•'•:•."' I tift: 1 0i i 4 , ..'17:7: .c?,'■:%■}i3t.41.1;:nr:NiStrilkeeditintpiksokgaii .Atticktawlspace fans 23.32 ... 23.32 — , BusinesS name: Fuel Other rini51 Contact name: 514.15 for first four 84.03 for each additional Furnace, etc. Address: • • • ---- . --- — Gas heat pinup • — City/State/Zip: walikaspended/unit heater Phone: ( ) • Fax: : ( ) Water heater • - • • Fireplace L fl-mail: • • • Range '.!'1,''.7'.'.::':.:'.1:;■;:r:,'r.Alarli,.W...",lf.:67;4 titbiii7A:;-.04iVE:l.):5iMlielgic..; Barbecue • • 1 Clothes dryer (gas) _ Business name: Stilt) se,-1- g-leia,_+11 % crt) i ■145 _ . Other: Address: 01001 5W . I abliic - hut • ..:;1';i''.:1 .: .: •,. City/State/ZIP: P wHillatil. VIZ: Cat-39 . subtarat 10,50. , . — Retie: (G ) 234-06, t.) 7(1". I • 1 ) Z 34. -D Lfyi Minimum permit fee ($90.06) ei C o v 00 Plan review (25% of permit fee) CO3 lie.: Il, 0 sis, .. • .., ' State surcharge (12% of pcmtit fee) la PO . — .. TOTAL PERMIT FEE /DD. ?O . -. Authorized signature: . - , . • 1 This permit appUentien expires if a permit is not obtained within 180 A A days alter it has been accepted as complete. LLiat name: , ._ Ny 0 - Date:15306 * Fee methodology set by Tri-Ccainty Building Industry Service Board . - ... ......_ ... ...........—