Permit _ CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2013-00598
Date Issued: 10/09/2013
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 2S111BD01601
Jurisdiction: Tigard
Site address: 14815 SW 98TH AVE
Project: Rogers Subdivision: ALDERBROOK FARM Lot: 5
Project Description: Install new pellet stove.
Contractor: HAVEN SPA POOL& HEARTH Owner: ROGERS, MICHAEL R&ELIZABETH A
10560 SE HWY 212 14815 SW 98TH AVE
CLACKAMAS, OR 97015 TIGARD, OR 97224
PHONE: 503-655-9440 PHONE: 503-267-1979
FAX: 503-655-9514
FEES
Specifics: Description Date Amount
Wood/Pellet Stove 10/09/2013 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 10/09/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 10/09/2013 $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 1.800.332.2344.
Issued By: Permittee Signature: IN 1-d:/o 770,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.
Mechanical Permit Applicat'I i I- - FOR OH:10E US�I ONI 'i
City of Tigard 1°'k,i tr II-/) Received Permit No t/ .^f�q -600.59,
�' g I 1 A,". DateBy: �� �� �7Y y%��o�ri�3
el 13125 SW Hall Blvd.,Tigard,OR 97 3 q Plan Review
Phone: 503.639.4171 Fax: 503.598.19600 e T 0 2013 Date/By: Other Permit:
Inspection Line: 503.639.4175 ® See Page 2 for
.r I v��^�O Pe Date Ready/By: g
Internet: www.tigard-or.gov Notified/Method: ' , 000000000y00OUDElor
WY OF TIGARD
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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
1
• ' lV t r
� .F.. ; .max . . > x L : n . '' a.. 1:v " -' , Tl�� ;•p,r+``1hkkirdoy1 ..kka4rvo
,�.�n
.2 '-and 2-family dwellin g ❑Commercial/industrial ❑Accessory building
For special information use checklist.
❑ Multi-family D Master builder ❑Other: Description I Qty. I Ea. I Total
'`` - r ': ' i' ii 'u?t1 ;>I , 1.03..J '" Heating/cooling
*
Job site address: ‘4.451 e.. Air conditioning or heat pump
'S N �,�� q e ��I\> (requires site plan showing placement) 14.00
City/State/ZIP; - \ ) _.Q . Q1aam Furnace 100,000 BTU(ducts/vents)
14.00
CS��� Furnace 100,000+BTU(ducts/vents) 17.90
Suite/bldg./apt.no.: Project name: Gas heat pump 14.00 •
Cross saeet/directions to job site: • Duct work 10.00
Hydronic hot water system 14.00 ,
Residential boiler(radiator or
hydronic) 14.00
Unit heaters(fuel-type,not electric),
in-wall,in-duct,suspended,etc. 14.00
Subdivision: I Lot no.: Flue/vent for any of above 6.80.
Other: _ 10.00
Tax map/parcel no.: Other fuel appliances
_-�: •-'.°"7:`,1 Water heater 0.00
s 1 P9,,.c: - P, ,4-f',,..: le y ,...1:-':G .
-1n�STO�.I 1 new �el 1 3 l t.Jt.J v Gas fireplace 10.00
Flue vent for water heater or gas
fireplace 10.00
Log lighter(gas) 10.00
Wood/pellet stove / 10.00
Wood fireplace/insert 10.00
�, ;tom; ,� n.- Chimney/liner/flue/vent 10.00
.-. �. ,. ..- ,-.� . ....., .. �'T Other. 10.00
Name: \K£ fef, Environmental exhaust and ventilation _
Address: \4C \i3 S`� 1 v 1 r, � Be hood/other kitchen
1 equipment 10.00
•City/State/ZIP:'1-1.(�� q-j c� Clothes dryer Exhaust 10.00
JSingle-duct exhaust(bathrooms,
Phone:( t • .f1 -,q,q Fax:( ) toilet compartments,utility rooms) 6.80
MR''° Attic/crawlspace fans 10.00
�pf ' Other: 10.00
Business name: �QkJ�,.l 1 '� ��t �I ��n Fuel piping
Contact name: n(] t Gx $5.40 for first four;$1.00 for each additional
Address: 10a(c)c)��"� J H �� 1 Furnace,etc.
) �� /� �� y Gas heat pump
City/State/ZIP: CALC .1 t{ 1 b u 1 01 S Wall/suspended/unit heater
a a
Phone:55b (055`►'t 4 0 I Fax..aS jl 55 q5 1 c4, Water heater
p e ,.��y (` � Fireplace
r) E-mail: S.2-\1 C.-E.& t�-� ctL P6bb'-�1.1 -at 1•`sal ' 1 Range
rtaUf tAti: 'r,P :.:_ Barbecue
Business name: k..1 ctLe1\ 0301 k �l_J.A..�..tl , !. Clothes dryer(gas)
�-'■ ■ Other
Address: 10 ,417) 7C� T"l�� O[.‘ i 1a 0;i-'?4 Itc = a 1:a
City/State/ZIP: el ibis__. Subtotal
one:{.�/� 11__ �,}�� Fax:,„),),arc,..,,,, Minimum permit fee($72.50)
..a.�i W "�1'T-� Plan review(25%of permit fee)
CCB lic.: b/ Ic -5a,G 1 13 State surcharge(12%of permit fee)
1 I TOTAL PERMIT FEE /DO t I()
Authorizign This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: • Fee methodology set by Tri-County Building Industry Service Board
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