Permit • CITY OF TIGARD MECHANICAL PERMIT
• • a ,. -. COMMUNITY DEVELOPMENT Permit #: MEC2012 -00618
T f G R R D 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/06/2012
Parcel: 2S103DC00810
Jurisdiction: Tigard
• Site address: 13670 SW 114TH AVE
Project: Bonn - Savage Subdivision: VIRGINIA ACRES Lot: 8
Project Description: (1) wood insert and (1) vent installation
•
Contractor: CUSTOME STOVE INSTALLATIONS, LLC Owner: BONN-SAVAGE, NATHAN
21707 NE 159TH ST. 13670 SW 114TH AVE
BRUSH PRAIRIE, WA 98606 TIGARD, OR 97223
PHONE: 360 - 254 -3866 PHONE: 971- 506 -5067
FAX: 360- 254 -3866
FEES
Specifics: Description Date Amount
Wood Fireplace /Insert 12/03/2012 $23.32
Type of Use: SF Chimney /Liner /FlueNent 12/03/2012 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge- Mechanical 12/03/2012 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 12/03/2012 $43.36
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.
NNN
Issued By: ,O / rrr� " Judi , Permittee Signature: 6k, A ?Po e 4�D A,(.,
ii' VVV Calll 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 Applicatio FOR OFFICF 11SF ()NIA 1
City of Tigard ! ; ; ■ , _ permit No EC� -DV6r
a 13125 SW Hall Blvd., Tigard, OR 97223 A--�"
' I : Phone: 503.711 2439 Fax: 503.598.1960 4/P ( E r O c FSillMIIIIIIIII other Pamir:
l' t i ; n ti n Inspection Linc: 503.639.4175 Date Roady/By: ruA&: to See Page 2 for
Internet: www.tigard - or.gov _ . /Method: 'Tic" supplemental information
CITY OFT _ •`
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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
Value; $ $550.00
fa I- and 2 family dwelling ❑ Commercial /industrial ❑ Accessory building Far special Information use checklist
❑ Multi ❑ Master builder ID Other: Description Qty. I Ea. ( Total
, ki MMr''� dux`` v s ;. Inp/nR
w•r '' ' �j r '�< '` e�`'' ��1'1l''�,�1V'l1l";`ti�'.�'�1V :::;,i :':':. °:, � ; .
� ,t<. .r.�•....,,o, .. .- ,; , ., -.,.. , .� ".. �� ... : , Air colieatinditioning COOII: ,
Job site address: 13670 SW 114 Ave. (requires site plan showing placement) 46.75
Furnace 100,000 BTU ducia/vcros) 46.75
City /State/ZIP: Tigard, OR 97223 Pumace 100,000+ BTU (ducts/vet 54.91
Suite/bldg. /apt no.: I Project name: Heat pump
`regains site plan showing placement) 61.06
Cross street/directions to job site: Duct work 23.32
• I II• ydronie hot water system 2132
Residential boiler (radiator or
hydronic) 23.32
- Unit heaters (filet-type, not electric),
in-wall, in -duct, suspended, oft, - 46.75
Subdivision: FLol no.: Flue/vent for any of above 23.32
Other: 23.32
Tax map /parcel no.: _ Other fuel appliances:
:�` ^i4 �;: >C. c f; i • t -_ ;, - - i• Water healer 23.32
• •.. �;• ' .�:�w:. , �- cr ,: ,. • 33.39
Install wood insert and vent Gas fireplace/insert
Flue vent nt ffor r water heater or gas
fire lace 23.32
- Log lighter (gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert I 23.32 23.32
4t , , •; t ' o :r. , . F r t1'�1N I�l'1 ; Chimn /liner/flue/vent I 23.32 23.32
_ . �a. ,1_� r.�c, � Other; 23.32
Name: Nathan Boon- Savage Environmental exhaust and ventilation:
Address: 13670 SW 114 Ave. - Range hood /other kitchen
equipment 33.39 _
City/State/ZIP: Tigard, OR 97223 Clothes dryer exhaust - 33.39
• Single -duct exhaust (bathrooms,
Phone: (971)506 -5067 Fax: ( ) toilet compartments, utility rooms) 23.32
4'. a' �',�: -,� ;'�..r CO A 1
• .��; ��k, t�l�''�f'�� y�'�i •% •, :' Anic/crawlspace Elms 23.32
" Business name: Custom Stove Installations, LI.0 ^ Other: 23.32
Fuel piping:
Contact name: John Romanchock 514.15 for first four: $4.03 for each additional
Addre s: 21707 NE 159 St. Furnace, etc.
Gas heat pump •
City/State/ZIP: Brush Prairie, WA 98606 Wall/suspended/unit heater
Phone: (360) 254 -3866 I Fax: : (360) 254 - 3866 Water heater
Fire lacace
E- mail: sales@e ustomstoveinsta y�y, Range
r . '1�'^/A };• ' '` i ce .. { �Y9:.5''roVVl\;r, 5'. 1.'.. . • ..... . Barbecue
Business name: Custom Stove Installations, LIC
Clothes dry er (gas)_
Other: _
Address: 21707 NE 159 Rt. • -" a k .i
.,,, t 6;;
9 � ' - ,�.; ; �1�1VI7�� ?�',1��ibrlfk;�I�'xl�,} ,.w,:�:��'i1�� =F'
City/State/ZIP: Brash Prairie, WA 98606 Subtotal 46.64
of permit fcc ($90.00)
Phone: (360) 254-3866 Fax: (360 -) 254 ,3866
Plan review (25% of permit mit
fee)
CCI3 lie,: 189206 State surcharge (12% of permit fee) 10.80
TOTAL PERMIT FEE 100.80
This permit npplientina expires If a permit Is not obtn within ISO
Authorized 9i8tlatu /4f_,, �' .�1`' / days after it ha maple s been accepted amaple Print name: Debora Rom nehnek Date: 11/29/12 Pee methodology act byTri•Cotmty !lidding Intl,4vry Service ir
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