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Permit CITY OF TIGARD MECHANICAL PERMIT s . COMMUNITY DEVELOPMENT Permit #: MEC2012 -00306 T t GA R. D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/07/2012 Parcel: 25111 DC06000 Jurisdiction: Tigard Site address: 9475 SW BRENTWOOD PL Project: Snell , Subdivision: SUMMERFIELD NO.9 Lot: 534 Project Description: (1) fireplace gas insert, venting and gas piping Contractor: FIRESIDE DISTRIBUTORS Owner: SNELL, MIKKE 18389 SW BOONES FERRY RD 9475 SW BRENTWOOD PL PORTLAND, OR 97224 TIGARD, OR 97224 PHONE: 503 - 641 -1919 PHONE: 971- 235 -0521 FAX: 503 - 620 -5699 FEES Specifics: Description Date Amount Wood Fireplace /Insert 06/07/2012 $23.32 Type of Use: SF Chimney /Liner/FlueNent 06/07/2012 $23.32 Class of Work: ALT Type of Const: Fuel Piping 06/07/2012 $14.15 Occupancy Grp: 12% State Surcharge - Mechanical 06/07/2012 $10.80 Stories: Minimum Fee Adjustment - Mechanical 06/07/2012 $29.21 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. /1 Issued By: O� j� Permittee Signature: ©1U / - PLI c �.► �/) J( /// ��� ---JJJ 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. 06/05/2012 14:38 5036707905 WIDDOWS PAGE 01/02 S / Mechanical Permit Application , , ...:Filth 1)1.1.1(i.: usl-: O)N1.1' City of Tigard .f EView Z / C Permit Y • 1315 SW Hall lvd, Tigard, OR 97223 JUN 0h 5 � I [� �7 t a d Phone: 503.639.4171 Fax: 503.598.1960 V 2 2 D Other Permit: Date/By: T I G A R I) Inspection Line: 503.639 L� OF -- w ADD Date Ready/By: Y See Page 2 for it Internet: www.tigard- or.gov t Notified/Method: Supplemental Information BUILDING DIVISION II INiill 4! : i , II II!`.,., •,!ia1 : il'p�i ��},,�,,}}i+.�I(�I�g� i A l j I 'l lji;i' ;,i' fK 1 ,r,;, . i! 91 gg nnlnm n u Im n s n �u�ru " .lL,4,l ' t ;tli. i i ,:, I, . ' 1 a„ Il Yl'joil W, . .' i - ., •,I •. �tl ,� it ,.,11 I 1 j q.,. r'I I• " t a' ti, :1 ; I 1 io', n I' d . a ,,,IIU +'Ib', '�'P,I,•ui:• � ,';� ...- !?�i. .;,I,I. .. A! ..���u; h'G�Y I� d UI i D fl0 f ���i I , ,yiG t..•6' -I' a.„ ,x•. . liu, Ii`,. 'I l i�, :� :,ll• II,.,,,•.. �ldmttianm�lltltminnA�iRlnlii +�InnIhif�rtdnmtulnllmNtrtni �i IL'. ^.V I•�,r�;... ,I•a: I 1, ,, �..t „�. I � n., �I Mechanicti permit fees* are based on the value of the work ❑ New construction igi Addition/alteration/replacement performed Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑Other: mechanical materials, equipment, labor, overhead, and profit 1 !!! I' , ( 1�i ?ti'1 Ijl!Ii1il ; ro I I :I; n :'+ ' i I I!I• , : ' I l 1'Hu.: i , I I , • j� I ;, �u +` = i�',r' � I I,��N,�,� ' , �W i i! I li I!tn!.,.. ; r'i� , �I;;�_, ;!I I'.!' : . Value: $ ;� '.II , 1,,• , Ill, In ,Ill'•lrl;i� � - ;., ., 'f- 1,;(1 :. !I,;M1+i�,, ,1� .".i; ?I'I IIL; I 1 I .. l I r . < , , •,;..,..„ •: . : .I , I I il�al.lic '4:n,nl; Ir,. :;iil;ill.n.l' i. ,'ill��}.�� m upIV I ylum il , ��'IprcOlnl n 10� .. gia 1- and2 -famil dwelling ! ''!i !!:t"'` il?rio d .hirhL !1a e; 11i lu 2-family g ❑ Commercial /industrial ❑ Accessory building ❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist Description I Qty. 1 Ea. 1 Total ,� %i: � :ali'llI•, { ,Ifllil lll; : q. ii'lli I •'' "'' II ' °” Illlllil :' :i :r,,i '1 {1j pili li 1 1111,1.. . , ., : 1 . -. 1 ,1.,000.# , I ' t�4 ,11r, c .� :, •I ,.I!i,i :.� �,,,�.�.�))�itik'�I ��yy ,l. , I;b d�ii : .� 1�,•;Li Heatinpfctaling q q 1 Air conditi ming Job site address: �l 't 7 3IA.) E� rt� pi O �l (requires sits plan showing placement) 46.75 City/State/ZIP: T °,r b. Furnace IC 0,000 BTU (duets/vents) 46.75 f�n�l II t � 4 ��a�, Furnace IC 0,000+ BTU (ducts/vents) 54.91 Suite/bldg. /apt. no.: Project name: 1 y Heat pump 61.06 Cross street/directions to job site: Duct work 23.32 Hydronic bot water system 23.32 Residential boiler (radiator or hydronic) 23.32 Unit heaters (fuel -type, not electric), in -wall, in -lust, suspended, etc. 46.75 Subdivision: I Lot no.: • Flue/vent f any of above 23.32 Other: 23.32 Tax map /parcel no.: Other fuel appliances ;i.i''!i '! l;!l,p Ii ' ' : :'il1!!ll!ii;,4 5j,i.,., .'I, ITil " '}y r n l+il'lf l... -.l i! l lia; , ,•u', , ,!Ufb , Friel" ,1114!1= i :l!jlla� -.'� 1tr;i :,lpl.,:):„.r li" !I•I' !�,. , ;.;� :,L . t ' n f:, ;:i' lr 'I�.,. 11iq ,V,i Water heat 3. 23.32 +�I ,� Y' � � , �I'riill4lici :Al iL d � �,e.., :Ii: aIIIIIy i I • Gas firepla,e 33.39 a _ / I ' . �, Flue vent f 1r water heater or gas - fireplace 23.32 I II. ! MIL , - ; Log lighter (gas) 23.32 Wood/pellet stove 33.39 Wood fireplace/insert I 23.32 23 .52 ' •`YI : :;;,!.1fil `Il fitt4�1�1��,�0ts 0,; ;;i ,, ,' - , i4i ,.05.P' {!R!!Igliik5". " ?rlll� 7:: „ it i; ;,,1,,,.,1 I Chimne /liie ueven IIII!lS.114 411i`!KC./.C<Nilf•• ;;I,,IM . :! ) 1 :I,ll,� ;!;;, , . :' + . ?cl ;l � ; �! ,`'!' - 011l�l, Other: /fl/ t 23,32 - 2- �✓ Name: ,• 23.32 m► KK L!I Environmental exhaust and ventilation Address: C 7 S- 3(.0 ”" -r��, .nL , . , , 0 f Range boaUother kitchen ` l EJ i�'W C:JCJr f)/2 , equipment 33.39 City/ State/ZIP: '7 n L q--207, "' rot i D / -„ 1 �� Clothes dry er exhaust 33.39 C Single -duct exhaust (bathrooms, Phone: ( - I s. t _ A • • Fax: ( ) toilet com � � p;utments, utility rooms) 23.32 .I :r;I ati, , ry;m. li. I `ij '. v. t �{ ;r,rt; hqk ''. •, III4iiil" c : !n•• r I IN iIt''' . ! , r I ll I , '' p S ri/ t � 1 _ ,1- ;il!il ,:,; ; i,, , -P, , i Attic/crawl a i; it 11'' �:nal `B•',„ „ - �. ': . r �"1 �i�� I .' al , P ce fans 23.32 Business name: _ - Other 23.32 _ 1 wl ` I Al . „1/ilm. Fuel piping; Contact name: J/4 r J/(3 IA ) „�,,,., V/ $1.1.15 for first four; $4.03 for each additional Address: 18 gg4 nn J- - , � d - Gas heat pump ^! P P City/State/ZIP: �r l n) (1 , / ne Q�* `7 � /- /� Wall /suspe:tded/unit heater Phone: (qv) ry 3l — Qs 1 I Fax: F : - (5 /,916 " X/AGi . Water heater E -mail: 1 e Fireplace l 1N,1 S /4/ j • I � I . • . • ea • a .1 • ) • • Range P %j. I'` , ll ,, '1l ,'' I ''i;'li , lll ; :; ' , y' ; �Iili! v Ilit.•';IIP; •1 .i, , ii •;,:•;.•,„!.'.'.'.;;;',. 1,1' li 4 +ilil •. •e,,, , "h•„ ,.L lil ,,,i1;11Iltt :,1111!1 : - .. 14 :L.., I' �`, , 1'1 l; ; -. ai I,'' B ar b ecue Business name: j - r , al � ,�� .` S Clothes dry :r (gas) Addreess: ( �xy �� /�,�/] (((/// % % %��� //''�� , Other: J � J j. J 1�� {��f�� �11r �n77��n]}}�'1Iq�7'II'��� }� (g 1'1I� ' Add resale✓ l l] 3 lea t ).�2cli Ir' _ 4 �c) i INliv' i 11 I . IIl1 # i0 7 1,#;�'. T ., li f1JIIIIP ". ,11lLIl111!11 1!I �or'��Lnl C� D 7 4 Subtotal l de-74 - Phone: (09)) aq5 D .-- + Fax: (.. 3 / .,�, 6/ Minimum petrnit fee ($90.00) •no Q lU t `+/"'� Plan review (25% of permit fee) �CB lic.: V ! e ra State surcharge (12% of permit fee) f 0.1312!, TOTAL PERMIT FEE it)p'•Sta ✓ Authorized signature: 1.L0 . / / This permit application expires if a permit is oot obtained within 180 days after It has been accepted as complete. Print name: !t . —, —AO ` • Date: , — -- • Fee methodology set by Tri -County Building Industry Service Board a - I:\BuItding\Penniu PermitApp.doc 10/01/09 440- 46171(11/02/COM/VEB)