Permit CITY OF TIGARD MECHANICAL PERMIT
III 2 , COMMUNITY DEVELOPMENT Permit#: MEC2013-00716
T I GAJ D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/27/2013
Parcel: 2S104CC00900
Jurisdiction: Tigard
Site address: 14301 SW MISTLETOE DR
Project: PINN Subdivision: HILLSHIRE ESTATES NO.2 Lot: 114
Project Description: Gas fireplace installation.
Contractor: FIRESIDE DISTRIBUTORS Owner: PINN, MICHAEL&CHARLENE
18389 SW BOONES FERRY RD 14301 SW MISTLETOE DR
PORTLAND, OR 97224 TIGARD, OR 97223
PHONE: 503-641-1919 PHONE:
FAX: 503-620-5699
FEES
Specifics: Description Date Amount
Gas Fireplace 11/27/2013 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 11/27/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 11/27/2013 $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: 0, 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.
11/22/2013 10:21 503625 •" FIRESID PAGE 02/06
1VMec.1a encsE P'er'mit A phae
A' ,a, ����,� a,;on o r1C7:115L.1).N.Ll'
Received ., permit!o,:•
City of Tigard nn Dsie/By:. , 7 13 •.�/ Ii.G.44, _ i .
13125 SW.Hall Blvd.,Tigard,OR 971/0 V 2 5 2013 Plan'Revii w Other Permit,:
Phone: 503.639.4171 Fax: 503.598.1960 pates y;
,,/,f GART7 lnspccr on Line: 503.639-4175 CITY®F. p RD Dade-Ready/Hy: I see P{ii'i'.,iPr
Internet: www.tigard-or.gov p�mNgG� yp�t� Notifed/Nfethod u� y RS $uppk'nenmt 1olortinaftan
l"�''�jji '+1r` :.p'3YS'x'"1yf7�1r gli�, ,,1ye�:��l: q,- ,y BUILDI _�,A +.a .',+ ;lY�r „'S t'd �rN'�r�� Ru;+ �p�.5t.: c 6�{i.i � t f;„""t�l A �l'lrl it 9 t 7Jr 1'kY(9 F.', ,
.'T 'eta r+ r;yG 6 `,m,§a, � ..: g �'l n - } „.,,, !.s:7.:,. 1 .hu: .WM..N:..,,,a,),.K'ri •,..;R�EY:Y: i)�4iLY
S 4Ve C4,,.,.-.�,.•,,,,, .G jr:.., x ∎• ' -a..a-ca a •a-._'.tn• i ,`�' ' . . .!.
Ei New construction Addition/alteration/re lacement I`'1ec11aoid..indmitfthe are bused on.ttothe.wane arest woar
p performed.indicate the value(rounded to the.nearest dollar)of all
• ❑ Derriolition ❑Other: . mechanical materials,eguiprnent,labor,overhead,and profit.
r 4� 4 'r n .„ ^ �• r.• `+ •, sxN jt` ti.• c..q.. Value:S•
?,'•. �,„,:li/ !a� ` �`' Ury ��LY t A.,• .e @Le �'ay.3;t"�40 . .e '' ..,
.ts rf. h S 7c t.'rbr, ' • 1 ,uY,6.-'''„< r r •-'':..'n`. 2 ') * (4(1. .01), r r tcfasay ci c ,p1 1,
,.,r' 4''i •!kilo,
L•'t1 / 31 ''.?Yti%,--.,a l LS.:F :4:71(.5,v, �i'tiW:'.t;l02.y t
.0-1-and 2-family dwelling 0 Commerhial/iridustrial u Accessory building Forspeciallylbrinarton'usechecklisr,
0 Multi
-family' 0 Master builder L Other:
Description ( Qty. Ea:, Total
•
,3 -fl',ti 4EML i�z iMaMo' W y 't. F”P'' i; ' .A
HeStin_/coblin:
Job site,address: Air cotidittonitig
Li 3 o l 5,\ . t eZ�, 11,3-t-t'e._rftrt__- (requiressiteplen ehowingpiseetnent) 46x75
Piunacc 106,000 Es. TU(duois/vents) 46.75
City/State/2iP: "T=1. 4 r, i I
Fumaee.100 000+1370 duets/vents 54.91
Suite/bldg./apt.no Project name: P;,iy,/ ' , . ' Heat pomp 61:06
Cross street/directions to job site: Duct work 23.32 .
Hydronie hot water system .23.32
Residential boiler(radiator or
.. h dronic 23.32
tJriit heaters(filel-type,not electric),
in•wall,its•duct,suspended,etc. 46.75 .
Subdivision; I Lot no.: Fluelven)forany.of above • 23,32.
ptjter 23.32
Tax map/parcel no.: . . Other fuel a r r fiances
g • (@ 1 R�1�w^�. .z_ c x e .- 'r"r 's. a: Water heater • 23-32
fjr ' '''a'.. }'?!i;?;'41*/.'Z.
.; '°a' N^ tie. A.�r.K� .i y %+g S.17),y' . ..
_ Gas fireplace I 33-39 13.34
[1 `4 fArl4 —c re place Flue vent for water heater or gas
fireplace 23.32 .
Log lightergas) 23.32
• Wood/pellet stove 33.39
' Wood fIreplace/insert 23.32
•
• Chimney/liner/flue/vent
23.32
• 4;:'• r t^ . r l t � .•_ .r' - ,,r;\ we ii•t>
fol . §1,. k R.r y F d •A. h. 3"..., .. . ,. 0th :• 23.32
Name: P`0 ri Environmental exhaust and ventilation . . .. . . .
ddress:, ` Range hood/other kitchen
A
143 a 1 Sw PI CstA-1-o Q, eyiiiprnent; 3339
City/State/Z113: L" CJL R c i' 3 Clothe&dryer exhiltst • 33.39. _ .
1 Single-duct exhaiust(bathrooms,
Phone:( ) Fax:( ) toilet corn•artments utflit rooms 23,32
•,a ��.}t, f,(:�y�ux17;t --;�'`i ?i A t gas.=n ''� yc: `}.',.,4 'AttwJcrawltpacefans 23:32
''., K? .g vt'u•^r t a s2'��'Gb•ti��3, q,t`.c- .P 1 2r9r 0.,t.ga'c,t'A„'yi.• 3�7C LtC-y ^� S Other 23.32
Business name: Fl-r is;thy s ST Fuel piping
Contact name: G v A •
n $14.15 for,rst foul 54.03 for each additional, .
1$3` 9 i 5v19 bon CS F`Exrui kQf ORShea,ere,
Address; ORS heat pump
Cityt tate/Z1P:')0�jv1 -1 a op a-7�� 4' n Wall/suspended/unit heater
Phone:6D- z1`L 43 5 35 j Fax::i5t�� ID ,O-5 u_1 ci F reel heater
E-mail:
�,� A�i ;'ii•¢+h`ie: -"t�,`- P).` CIfA 'l.`.,. .y S-a1¢ 04'M.;..,. 0.. ...,v^.,:'f Barbecue
Business name: p—irg s Di '�1�A- `- ,A Other:es dryer(gas) ■-
Address: f SfAji LD Igt&Lc rl90 v[" . c 1l-kli'. '-t a 1 t4•w. cr'ut ga4 4A .:` t ,n" : 4' 4 ''
City/State/ZIP: • Subtoiel 13.I'1
Minimum permit fee($90.00) q()-e4
Phone:( ) Fax:( ) Plan review(25%of.ermit fee)
CC$tic.: Li 0 q 7 ) State surcharge(12%of permit fee) 0', /
. .TOTAL P•ERN.LI'T FEE. V-fi-t)
Authorized si ature:A ,nr This permit appticatioo expires its permit is not Obtained Within 180
�/ / days after it has been'accepted as complete. .
Print name gall 1 , ,� , , l • Date: 1 * Pee methodology set by T1i-County Building Tndustry Ser"ice Board
t\auildIng'Permits1MEC-PermuApp.doc 10/01100 440446I7T(11/02/CoMAVEEI)