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Permit
CITY OF TIGARD MECHANICAL PERMIT 3 • �� COMMUNITY DEVELOPMENT Permit #: MEC2013 -00087 T IGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/12/2013 Parcel: 2S104DC06900 Jurisdiction: Tigard Site address: 13757 SW FERNRIDGE TER Project: Simpson Subdivision: MORNINGSTAR Lot: 10 Project Description: Replace gas fireplace Contractor: GASPRO INC Owner: SIMPSON, GEORGE W & JANIE M 7603 SE LOUNSBERRY LN 13757 SW FERNRIDGE TERR PORTLAND, OR 97206 TIGARD, OR 97223 PHONE: 503 - 775 -7020 PHONE: FAX: 503 - 775 -7019 FEES Specifics: Description Date Amount Gas Fireplace 02/12/2013 $33.39 Type of Use: SF 12% State Surcharge - Mechanical 02/12/2013 $10.80 Class of Work: ALT Type of Const: Minimum Fee Adjustment - Mechanical 02/12/2013 $56.61 Occupancy Grp: Stories: Fuel Fuel Types: Natural Gas 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 quest' • - • t NC by calling 503.232.1987 or 1.800.332.2344. J, 4f Issued By. / / liiej Permittee Signature: 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. . pcEivED . ,..„,.., . . : Meeliiiitchisi-Terniit Ann lica on !()1; 01-! l( ! ! ,I t r \ i \ ',V10,9f Tjgard Received . .., . Daten ot I 1 Irriliril erf6114° ,, o / - -40040g ,11 '4/ ' Tigard, OR FEB 1 1 2013 P FEB Phm Review • " k. ' 4hail OF TIGA111) DanIty: Other Permit BUILDING DIVISION Dstalbsady/By: ' i ",' I ig see Pees ? for - .Interne wwwigard-or.gov hicatfled(Method Sopplemental Lakormation . , '''' '' — 7:7;1.: -..i ..-----7- --‘? — ;--7... _ - - :i -_ : 7 -' .-,.. - .;;;. - .7:77- - 7." .,'.- .• ' '''..7: 7 " '''.-- " ' .- ----- ---, ' '.- :::, - . "-----7-- • , , . " -."-f:-.:::::". %." , . " iriohinical peimit ie;siare based on tie Value o El New construction L • . tiition/alteration/replacement • performedAndir,ate the vale (rounded to the nearest dollar) ( El Demolition . 0 other : . mechanical materials, equipment, labor, overhead, and profit. 7 :- - , . - 77 - ; _ • : - .7 - 1" . s.' :::.7 7_77.7 . ,..,, ,'-: "t• ,-;-. -77 • ' • • %WC. $ •_, 2.. ,;:•:.'. ..1 , .2:7; • . .L ••,- • • • ,.,:',' 2 i-: .:'.. •- • -f• ...-`;`; ',• \.•, .; - -C •' .112 • -- -- • - •s - 7 — 7 - . ' - ^77-7-7 '-• — 7.7.-.'7" ,■‘-• : . •.." - ,•'.. .;' 7 ..:-- :•• • .',t_•,.. - ,t - T • T ' ' ,•,... ; If _ ; .:::.,.1;.7 ‘, : ,L I- and 2- family dwelling 0 CornmercialfindusIrial 0 Accessory building • .-- For special hrfonnatioto use checklist El Mult III Master builder 0 Other • DesCriAtiOn. • ; I Qty. I Ea_ J To ...- -, ,- -,. : -,..... --,- 1-, ..,.., -:, ., -, ,, _ , ,;-,..-,-, , - ,- , .-.. ,- - -: -. \ i",-- 4, -- ;- . :,_ -,,.._ ...-„-...,..:. -.,..-: ,-,,-;‘, , • 1 3 • '_: ; , - . ...'-12 ..,........: '• ''. 7' 7 ;,.- . %* --, -'' t ..,• . l• ■-• ,.,'• • ' 4. -'..-•'- '-''' ' ,9 , ,' ...•,,,,' . V ','" ., - ..e , - .A, Heating/cooling . • Air conditioning Job si a divss: 13 7572 54/ ._.Atu g TeAA01( -.-' (requires siteylansliMALW placement) 46_75 City/StatearP: 7360)12 _ Cft 4 1 46.75 -..D 3 . Furnace 100,000 EtTU(dUcre/verm_.) Furnace 100,000+ BTU (ducts/vents) 54.91 Stirte/bidgiapt. no.: I Pr°ject Efunc; A 1 t-i 1,010 • Heat Pimp 61.06 Cross slreet/direotions to fob site: Duct work 23.32 • HYdronic lid water system 2132 Residentiarbeilei (radiator or hydronic) . 23 32 ihl Unit hettosrs.(e 4type, not electric), in-Wall, in-duct, susptuded, etc. 46_75 • Flue/volt for any of above 2332 • Subdivis' ion: I Lot no.: Other: 2332 Tax map/parcel no.: Other ftrel appliances . ..7 E-- " .. --- -.. -- - : - .r . -• - - - .- - - • -.,--- .‘ • .77. -:- - .- . - - -,! Wafer heater • ;;,"-- '''"i' .. •.:- -,--z - --..? - ,..-:--•,'-', .- - -L ......- .. = -,- -.•: • .: . _-__. -, --,-;:., , . , . .. . , 2332 ' • , . • renim5rmanougmgPININIIIIINIIII Plea v e nt . . . / . 39 water heater or gas Szeplace 2332 I lighter (PTO . 23.32 • Wood/pellet stave 3339 ... Wood fireplacclimert 23.32 7 ":::: : :: - .. , ..7,7 7 2;, , _, • ..-:-..,--,:-, ., ,-,----:—..= .--.,--_-_-,.---- :' : - 7777 - 72:- ,"•.',.ff.,—,77,7, ChlameYililleriflucinnt 23.32 -f— _.;..._.',..L„s. -.._•-•-,, 7!...7±...::—.1!...'`.. '''..,=:_.._-'-' '_ _,_ ,. 1 L:,..-... - 2_,. .. i— - . , :,...z.,.1',: 7 1.- .. .zz !.. . - . = - E -__ <,,! , ., , other 23.32 Environmental ahaust and ventilation _ Range hood/Mho Idtchen Address: / 3 7 i7 50 i-- 12.'zif g T a g I 1 Or L equipment 3339 City/StatrJZIP: ; , 40 7 .7 3 Clothes dryer exhaust 3339 Single-duct exhaust (bathrooms, Phone: (503 -h A - - a Fate ility romns) 23.32 .-...-:-.-_:. 7:71' • .::-; 7. - '• 7; 1 7 , -- -7•7 • „ r'. - - ,,L-;T.--,7F.;--- :1,.7 AtticlormvisPece limas • 2332 ".'-'r:• - 7 '' '- " :'': - ' - -- ."=.:' ' -'' ..2.='' ' :--- _:' .:'' 2, .--': ':'''''':',-:''' j .,.....L' *1 -' ‘ . 1",- - . 12 Other: 2332 Business name: ' 140 1 . Fuel dig!! Contact name: k ori pg,-11 $14,15 for Mir four; $403 for each additional 4 f Furnace, etc. .., - Address. . 25 tir_k ium i esditt j .4 4 - — ' -; . - Gas beat pump City/State/EP: P: / , l e_ 444 a t ..a 1 wawseepeadervanh hearer . Ph°nec ( 4) 7 - 7o • Fait: : (50) -202., 4/ Water healer _ Fireplace E -mail_ . 4 4 - ,gb . , a 7 . -1.-- Range ;.... 7' 1.. ' ' -. - -• ..-"-. • - •,: -_,:-.,...- - .. . 7- , • • - ... 7 1 , ,: 7----7: ' l' mow ' ;.,' f -_______.' ." __ ' ' : Clothes drirer(aa) Business mune: 0/9v5- Elliir Other; Address: 7( 03 ...5C; Z•41,1 5',6y2.441 j •-: • - . ,'" -- 7 ' - --' -.. ', - •‘, .-■:‘. --, -,-:- ,•'-; - .z City/State/ZIP: , 0, . „ , /1 " 9 — I - Subtend— " Minimum permit fee ($90.00) , 1111 (619 ) 7 — I_ i Fax (3 ( k.13 ) 795 '"" f • Plan ) —S - • CCII lie.; . / State surcharge (12% of permit fcc) /c). ge ././- Au .21P.--- TOTAL PERMIT FE_E_ ja0 . FO e This parmlt applieation myna if a permit ia oat obtained within I thorized signature gr „ -"" , days after b has been accepted as complete. i Print name: / j .„ ../, ta L %, Date:. .." / • Fee methodology set by Tri Building lachtsny Service Roan LABuildiag1PermiteNMEC-PenntAsadoe 10101/09 m.alfs a.% -.I. ••• • A•1014/./.. e pr. or....