Permit ,� CITY OF TIGARD MECHANICAL PERMIT
111 COMMUNITY DEVELOPMENT Permit#: MEC2013-00501
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 09/03/2013
Parcel: 2S 103DD00432
Jurisdiction: Tigard
Site address: 10740 SW FAIRHAVEN WAY
Project: Hammes Subdivision: FAIRHAVEN COURT Lot: 6
Project Description: Install freestanding gas fireplace and tie into existing gas line.
Contractor: EVERGREEN GAS INC. Owner: HAMMES, DAVID A&VICKE S
PO BOX 388 10740 SW FAIRHAVEN WAY
WEST LINN, OR 97068 TIGARD,OR 97223
PHONE: 503-407-9542 PHONE: 503-320-0077
FAX: 503-344-6345
FEES
Specifics: Description Date Amount
Gas Fireplace 09/03/2013 $33.39
Type of Use: SF Flue Vent for Water Heater or Gas 09/03/2013 $23.32
Class of Work: ALT Type of Const: Fireplace
Occupancy Grp: 12%State Surcharge-Mechanical 09/03/2013 $10.80
Stories: Minimum Fee Adjustment-Mechanical 09/03/2013 $33.29
Fuel
Fuel Types: Natural Gas
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct• - ions to :. C b -- ing 503.232.1987 or 1.800.332.2344.
Issue. By: � O _/ / Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the Job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Application :TOR OFFICE USE ONLY .
Received Q 111 City of Tigard DateBy 7 /2 ala Permit No.: ��/0-00 50�
° 13125 SW Hall Blvd.,Tigard,OR 97 B.ECEIVED J
Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 Other Permit:
3 2013 Date/Ry.
T l'GARD Inspection Line: 503.639.4175 S L I Date Ready/By. Juris: ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: Supplemental Information
CITY OFTIGn►ARD
TYPE OF.B l l G DIVISION IJION COMMERCIAL FEE*-SCHEDULE — USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ®Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
. . Value:$
CATEGORY OF CONSTRUCTION .,RESIDENTIAL EQUIPMENT/SYSTEMS FEES* : .
® 1-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑ Master builder ❑Other: Description Qty. Ea. Total
•
JOB SITE,INFORMATION AND LOCATION Heating cooling:
Air conditioning 46.75
Job site address: 10740 SW Fairhaven Way Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard Or 97223 Fumace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:
Duct work 23.32
Cross street/directions to job site: 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
_ Flue/vent for any of above 23.32
Subdivision: Lot no.:
Other: 23.32
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
- .DESCRIPTION OF WORK Gas fireplace/insert I 33.39
Flue vent for water heater or gas
fireplace I 23.32
Install a Freestanding gas fireplace and tie into the old gas line Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
- ® PROPERTY OWNER ❑ TENANT Other: 23.32
' - Environmental exhaust and ventilation:
Name: David Hammes Range hood/other kitchen
equipment 33.39
• Address: 10740 SW Fairhaven Way Clothes dryer exhaust 33.39
City/State/ZIP:Tigard Or 97223 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)3200077 Fax:( ) Attic/crawlspace fans 23.32
- ❑ APPLICANT - - , .0 CONTACT PERSON,' Other: 23.32
Business name: Fuel piping:
S14.IS for first four;S4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace
Range
E-mail: Barbecue
CO_NTRACTOR .. Clothes dryer(gas)
Business name: Evergreen Gas Inc Other:
MECHANICALPERMIT FEES*
Address: Po Box 388 -
Subtotal
Minimum permit fee($90.00)
90 .°°
City/State/ZIP:West lion Oregon 97068 Plan review(25%of permit fee) -----'
Phone:(503)4079542 Fax:(503)3446345 State surcharge(12%of permit fee) /0•00
CCB lic.: 158031
TOTAL PERMIT FEE /00• t)
This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: / * Fee methodology set by Tri-County Building Industry Service Board
Print name: Date:
I:\Building\Permits\MEC_PermitApp_0401 13 doe 440-4617T(I 1/02/COM/WEB)