Permit n CITY OF TIGARD MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT Permit #: MEC2012 -00541
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 10/18/2012
Parcel: 2S110DD11900
• Jurisdiction: Tigard
Site address: 10725 SW HIGHLAND DR
Project: Denham Subdivision: SUMMERFIELD NO.13 Lot: 689
Project Description: (1) vent for gas stove; (1) chimney line /flue /vent and (1) fuel piping for fireplace
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Contractor: ALL FUEL INSTALLATION & SERVICE LLC Owner: DENHAM, PAUL
PO BOX 69 10725 SW HIGHLAND DR
TROUTDALE, OR 97060 TIGARD, OR 97224
- PHONE: 503 - 674 -2350 PHONE: 503 - 910 -4935
FAX: 503 - 674 -2693
FEES
Specifics: Description Date Amount
Flue Vent for,Water Heater or Gas • 10/18/2012 $23.32
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Type of Use: SF Fireplace
Class of Work: ALT Type of Const: Chimney /Liner /FlueNent 10/18/2012 $23.32
Occupancy Grp: Fuel Piping 10/18/2012 $14.15
Stories: 12% State Surcharge - Mechanical 10/18/2012 $10.80
Minimum Fee Adjustment - Mechanical 10/18/2012 • $29.21
Fuel
Fuel Types:
Gas Pressure:
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Total $100.80
Required Items and Reports (Conditions)
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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
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or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: /X 2 9021 JAI Permittee Signature: t'7 A f!^i / L
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.
Mechanical Permit Application FOR OFFICE uSE UNI '
,
r Received .
City o>FTigard OCT 18 201 DateB toy/ . /P-� Perm itNa.:/�GG �(�. O S4,I
• 13125 SW Hall Blvd., Tigard, OR 97223 M•� Plan Review
Phone: 503.7I8.2439 Fax 503.598.1960 CITY 1 O 1 rata/ e ; i
Inspection Line 503.639.4175 other Pemnc.�`(�e20�1'GOd
'1' 1 (; A R I.) �c ., r keadyBy. 7utlt: ® See Page 2 for
Internet: www.tigard- or'.gov BUILDI I. ' l i' , ' ,ufi Read ethod: .. p Supplemental Information
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Mechanical permit fees* are based on the value of the work • . • , '
❑ New construction ® Addition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment. labor, overhead, and profit.
n'.taa'rr .. i ..•, tj ''•....... ". in'cv,:_ -1•;.s t' ,•:i?� r r�l r..r Value: $ -'
f 1 J 711 �} „ •y:i:. 't' I:P: , [. .,..�'�. L •t
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® 1 - and 2-family dwelling -v 1 r- .... "� ,�6t.Y3...t1,: tn.!rcn'h:.Srr,:r ..r .. rrH uY• � i � 41 , r i �, � . �� . : ii ��; . r „ �n h�> 31 L���k ) t3
y g ❑ Commercial/industrial ❑ Accessory building For special WOrmation use checklist
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I El- I Total
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r ry 1.. � -CiC•� IJ /,,,f ,1 f f{ ti: .al . '� L u ��1� •ti u°,r: ..i ro k R• a M l I '� nr�• ��:�.i.i.t. '�
(i .t�.:.cW R:.'lrl G.rS•'' dCrJtt.__ � LwN.s,..:,..,tL...1.�f•t:" Y�u1�:ir.� Air conditioning
. Job site address: 10725 SW Highland Dr. (requires site plan showingplace'ment) 46.75 .
Furnace 100,000 BTU (ductstvents) 46.75
City/State/ZIP: Tigard, OR 97224 Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no,: I Project name: Heat pump
(requires site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) : "'- 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75 '
Subdivision: I Lot no.: Flue/vent for any of above 23.32
Other. 23.32
Tax map /parcel no.: Lr 4 Other fuel appliances:
!i v1. f ddt�394.0 rt lil.:b, y7} 1:P5, 4 " F " i A] i ,1�t IS i T {'
`{i:: ii � l v it l rr ti r e.? .ii,, ie t1} ?:d ice'„ i ii7 h tii. x : sx f ,azsa1*''`fi•'t {'� ' u't ff{�, h':', a;' 67( i, .. d : ) Water heater 23.32 •
Install gas stove, venting and gas piping Gas fireplace/insert 33.39
Flue vent for water heater or gas
fireplace 1 23.32. 23.32
Log lighter (gas) 23.32
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Wood/pellet stove 33.39
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Wood fireplace/insert 23.32
T
IIIT, } 1 t y 1 ,' ' r N K F? r u i
t i - t ilil ti . `IE hl( ' ( r�; r^(fi 4{ ! i . ty.,i -jj {P Chimney /lineriflue/vent . 1 23.32 23.32
I s.l.��1. .�1 . � ;
'' t uz �b I1?....,oil,, , , ,,1 L' a1.... ., ,,,,, r e L4�1e.,, + other; 23.32
Name: Paul Denham Environmental exhaust and ventilation:
Address: Same as above Range hood/other kitchen
equipment 33.39
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City /State/ZIP: Clothes dryer exhaust 33.39
Single•duct exhaust (bathrooms,
Phone: (503)910 -4935 Fax: ( ) toilet compartments, utility rooms) 23.32
r ' t.ie l Y 11a'1t v Ir I. +:T.'1_ 4 { 't'11 ! r .;? 1 t. TCIr'Ft .� 77- Y C . l" T•.c: .M ti S
= F"�
_• d'.A ettiiik5r-Y o- :o it ., ? - th�:ralk•Iftt.3111 .!��d. }'. tl -Liig� ?;,¢.-:'� i t:, ;aD.,ri ..!' Attic/crawlspaoe fans 2332
Business name: See Below Other: 23.32
Fuel piping:
Contact name: Eric Camp $14.15 for first four, $4.03 for each additional
Address: Furnace, etc.
Gas heat pump •
City/State/ZIP: Wal/suspended/unit heater
Phone: ( ) I Fax : ( ) Water heater
Fireplace 1 14.15
E-mail: allfael@comeast.net
� II Range
. ii, } ln,,�+ n, tl v ' t �r i+ a r�{I r . I T r.Ite: is s 1 GS �' l q � T iF, rt u i tC n Orf• rIRT,Ir'', c
r �E f11 �i.� II ' ly �.� 1 f � �, 6. 1 : 't t FS B arbecue
I11, L+)'hr. li 'r. 7r � a� .u..11 !:ftl r_ _ d. S? J' = '1'�t{iJ�.rr, � �i {�fr.. ,i 1 ? fvrlrv�l.. .,! " u
Business name: All Fuel Installation and Service, LLC. • Clothes dryer (gas)
Other: N " p .
Address: PO Box 69 ! Iii' r ill «h.r„WLa. lI;tl `r!!� +)�,'' 4_i�', n'�;'wk.liy uyr1 ;[ a +? do
City /State/ZIP: Troutdale, OR 97060 Subtotal 60.79
Phone: (503) 674 -2350 Fax: (503) 674 -2693 Minimum permit fee ($90.00) 90.00
Plan review (25% of permit fee)
CCB lie.: 169503 State surcharge (12% of permit fcc) 10.80
TOTAL PERMIT FEE 100.80
Authorized Signature: Z , This permit application expires if a permit is not obtained within 180
days after It has been accepted as complete.
Print name: Ar(, 1 . �� Date: 10/18/12 • Fee methodology set by Tr -County Building Industry Service Hoard
l: 1Buildin eermitskMEC- PermitApp.Ooe 03/07/12 440- 4617r(11/02/CAMIWEB)