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Permit
CITY OF TIGARD MECHANICAL PERMIT R I C COMMUNITY DEVELOPMENT Permit #: MEC2013 -00350 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 06/26/2013 Parcel: 2S 103DD00425 Jurisdiction: Tigard Site address: 10950 SW FAIRHAVEN WAY Project: Wittkop Subdivision: FAIRHAVEN COURT Lot: 13 Project Description: Gas fireplace insert and gas piping. Contractor: T & K MECHANICAL Owner: WITfKOP, LARRY PO BOX 116 10950 SW FAIRHAVEN WAY FOREST GROVE, OR 97116 TIGARD, OR 97223 PHONE: 503 - 844 -9173 PHONE: FAX 503 - 846 -0195 FEES Specifics: Description Date Amount Wood Fireplace /Insert 06/26/2013 $23.32 Type of Use: SF Fuel Piping 06/26/2013 $14.15 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 06/26/2013 $10.80 Occupancy Grp: Minimum Fee Adjustment - Mechanical 06/26/2013 $52 53 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 que = • OUNC by calling 503.232 1987 or 1.800 332 2344. Issued c y: • / 01444 Permittee Signat 411111W i � J/� 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. 06/25/2013 10:50 5036269138 HOT SPOT FIREPLACE PAGE 02/02 � � t A i� •L. Mechanical Pe t o it �:L!'L i! LIVED I r l l; i 1 l l I( r l•s a ir■ l City of Hall • 5 A A �IFCaoi3.00350 13125 SW Hall : . Ti OR s N 2 5 f ^ , 3 • Phone. 503.713 + : 39 Fax 503398.1960 Dote/By: >ew ghee Permit - ; \ , , 1 , Inspection Line: - 03.639A175 CITY OF TIGARD Date Ready/By: J� 6 ® See Page 1 for Its , , BUILDING DIVISION Nom: S°pp " ' "�" 'a'°°n • 1 TYPE OF WORK con tci » SCHEDULE — USE ' , • ❑ New construction ► AdditioaJeltelatiodrepleceAOent Mechanical permit fee me based en the value of the work performed Indicate the value (rounded to the neatest dollar) of all ❑ Demolition ❑ Other: mechanical malarial:, equitmletu, labor, oycrhead, and pmht TECORY OF CONSTRUCTION Value: E RESIDENITAL EQUIPME ' /SYSTEMS • g - and 2- family dwell'' _ 0 Commercial industrial 0 Accessory building For sp tat bcfamwtion use medals: I Multi -amity ❑ Master builder ❑ Other. Description I Qty- I Ea. l Total JOB :i INFORMATION AND LOCATION - Heatlog/cooUng: - / . i Air aoadittoning Job site address: I / C) ? Std 3C4—.) R k' ked- L1e-h(l/ SCR rite otoe sae vtng ate) ! 46-75 City/State/HP: r r� furnace 100000 BTUJd�mlvents) 46.75 t • th ✓ I• t' - r�l Furnace 100.000+ BTU (d hems) 5491 Suite/tsldg/apt. no.: Project name: Heat pump (requires she plan showing plaeemsnt) 61.06 Cross street/directions tole : Re: Duct work 2332 Hydronic hot water snstem 23.32 • Residential boiler (radiator or hydronic) 2332 - Unit hogs (fuel-type, not electric), • in-wall, in-duct, susseudcd etc. . 4635 Subdivision: Lot no.; Flue/vent for any of above 23,32 Other Z3.32 Tax map/parcel no.: I Other Reel appliances: DESCRIPTION OF WORK Weser heater 23.32 Gas Ore,lace/insert . / 33.39 SCSI' SI' Q S i It 4 S 511 3 e . Flue vent for water beater or gay fireplace 23.32 •01liehter (gas) 2332 - Wood/pellet stove 3339 Woodlacermsett 2332 PROPERTY OWNER i © TENANT . ChimstcyiliocrIeuriveot 1 23 _ Name: Ack r r ) Nkc El0;11011meiltal exhaust any veotil n: Address: /45 54 i r h a re v, Oal Rmrge hood/other kitchen e iPmmt 33.39 City /Starer/IP: 71 e a d f 0 I q ' mum dryer exhaust 33.39 7 Sintilathict exhaust (bathrooms, Phone: ( ) Fax: ( ) _ toilet compartrnourrs. utility rooms) 2332 X MVO 0 CONTACT PERSON Anicicrawlspacc fans _ 23.32 Other 2332 Business name: 11 . 4 ,d 5 la 1 - • l Fuctpip+ug: Contact name: 11, „ , . . a i „AA Z 514.15 for rust four - S4.03 for each additional Address: l*■:_5 t- i 2L) tic 2 vp. 14:/ Furnace„ etc City /Sta�fLIP:e =i ,. r • yd ✓N ,() .- '77065 walvs� unit Phone: ( ` -- � -- j Fe+3c : (S.s.5 Yam g « water -- � n Fireplace / � EL IS E-mail: a • C,� v2 • +[4it i� . .l.( Range • CONTRACTOR _ Barbecue Business name: •� r - .0 / e , / Clothes dryer Other Address: p) 1. y 8 ro MECHANICAL PER11>FI' FEES` City/State/ZIP: �v e g J- ‘104.4.. Q ,f' ]/ I/0 Subtotal Minimum permit tba ($90 -00) D..64:5 • ng: (.Q?) 3 S 7 , (Di Fax: ( ) Plan review (25% of permit fee) 1 State surcharge (12% of permit fee) t,,, _Ay ' , TOTAL PERMIT FEE Tonto prink applientson expires ifs wank is Prot obtained within 180 Authorized signature: ff� . �� y 1ha days after h 6a been aergrmd as comp Print name: ' a- 1h • itn. X Date• 4 as- a Fee methodology met by Tri -Comfy 90Udiag Industry Service board tic rean:tatq n2 440- 4617r(11r47xOMFWE5)