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Permit 1111 CITY OF TIGARD MECHANICAL PERMIT 8 • -_ COMMUNITY DEVELOPMENT Permit#: MEC201300042 Date Issued: 01/23/2013 TIGARD 13125 SW Hall Blvd,Tigard OR 97223 503 718.2439 Parcel: 2S114BD02100 Jurisdiction: Tigard Site address: 9740 SW RIVERWOOD LN Project: Reed Subdivision: COPPER CREEK STAGE 2 Lot: 38 Project Description: (1)gas insert Contractor: GASPRO INC Owner: REED, DENNIS 7603 SE LOUNSBERRY LN 9740 SW RIVERWOOD LN PORTLAND, OR 972056 TIGARD,OR 97224 PHONE. 503-775-7020 PHONE' 503-670-7132 r FAX 503-775-7019 FEES Specifics: Description Date Amount Gas Fireplace 01/23/2013 $33.39 Type of Use: SF 12%State Surcharge-Mechanical 01/23/2013 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 01/23/2013 $56.61 Occupancy Grp: 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 1.800.332.234.4. / , /► �/ / I Issued By: CyI �-C�I Permittee Signature: ©u APP/ i l- ! 70J_I 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. Metirlanital Permit Application. ECEIVE' Clay of Tigard nc�By: i r- / 3 4.•:'Pannttxa7 ( e7-Diu.' :~ '� 13125 SW Ball Blvd.,Tigard,OR 9777 k JAN 2 2 2013 Flan , ' Phone: 503.639.4171 Fax: 503.598.1960 j : • Othax Permit• 1 ,. , I Inspection Ling: 503.639.4175 ,o'T/'J -° r5 r''''' Dte e4/ B o ,<: Jw: ' 441'49:40.1!r;1. .Internet: www:tigard-or gov t.i l 1 1 I t N M*bd. �, f . LONG t . 11:1 New construction W ddjtion/alttrntiam/rcplacement haniciapermit'fees*'are based on the value ofthework. . 0 Demolition 1:1 Other: pesfonnedAndicatethavaluC(rounded to the nearest dollar)of all .mechanical ,-.-.-..-,uii. . labor overh .s and. •t_ _—_--. _ .. ... . .,......y '....A'...**,.',..',.)..:..:',:',.'::: . .,;..4..'.: _ - �...•=any-7�j'1. g.,. 1-and 2-family dwelling 0 Commetcial/industial ❑Accessory building \l',!:-:,1—L.• -,:"..•_•,_cai:::' Multi'ftamily ❑Master builder Other: 'F'orspecialWaring:kvl use checklist _ __ _ ❑ : Description. t--,' Qty. Be. Total• Job site address: 9 7i._ ` .• - .. r„ : . � -� tt ��1 Cdr . •� � .; _: City/State/ZIP: / /4'Av L.�4 f .2 . 100 000 r[r 46.75 Suite/bldg./apt.no_: , Pro Project / '- • Pwnace 1001•■a. BTU.(dacta/veam _ 54.91 3 _ _ .6'1.06. Cross street/directions to job site Duct woe .- , . . 23.32 Mil Xibsldtarlia!,'.Situ(tndldr.br dE vie' • ' 23.32 MI Unitheatexi".(fact=type.not olocttic), 11111M3111111 ' In-wall,in-du s =.erri-. etc. Subdivision Lot Flue/vent for an of above. _UM Other . •'2332 Tax map/pare4 no.: Other fuel a.I liaaces �'r':' Cater• �'i1?:'. '23:32 • :'rte f� A ,• _ [ _ : Flue Vent for water heaoor or gas fire!law 23.32 En 1-o:ii:+tor :as . • _ 2332 Wood/.ellet stove INN 33.39 Wood •.lace/insert • _® ; �'_`` ' ' -- _- - -- _ . ,. 1 r:, _ 23.32 Name: • . f . E ronmental exhaust and ventilation 4 7 Range hood/other kitchen Address: q I VO .J W R t i/eA (,i/0Di/ ,L iv e,u ,ment III 3339 City/State/ZJP:T i il 61 /r1/. (i 9 #1.2,t f Clothes, er exhaust _ 33.39 Mille Phone:( l )?ax single-duct exhaust(bathrooms, • :( ) toilet cam.attmcnts.utili t rooms 2332 :.4y , MI ;u �;.%n. ;, :,,t, __ ti ..� °' AUnnc/c aw.�ace:fans 2332 Business name: �_ M ` ~ t7fber 23.32 Mil Fuel .•`'a Contact name: !j y I $14.15 for first four;$4.03 for each additional Fume,' etc_ Address; , .� S- • r h- : , _ :_ n Gas heat.um. City/State/ZIP: ,'�/L '2 q 7, i Wall/sus,cudedhmit heater 1111-- Phone:( ) — r, r 'Fax::( .I ) - • Water heater E-mail: * 4 zM t - GCS i I, �'lti MIIIIIIMMIIIMIll Business name: Clothes. er ;as r AI Other _ , _ ∎.:'•{. City/State/ZIP: Subtotal EMU Phone;( ) Fax:( ) Minimum permit fee($90.00) Plan review(25%of permit fee) CCB lie_: 9 Staff surcharge(12%of permit feu) • jrAir: TOTAL,PERMIT FEE 117,M061 Authorized ai � i This permit applieaden aspires if a permit is not obtained within 180 B /./ •takes after:411%.s bean accepted is eowp►ek°, Print name: a_I Jdili Date: / / • rot methodology sot by'Fri-County Building Industry Servioc Board I1BOldbutWermits1Ml'G-Pemaitarisdot 10/01109 esa4serr ri i rnam ikownrn