Permit CITY OF TIGARD MECHANICAL PERMIT
11_ '. COMMUNITY DEVELOPMENT Permit#: MEC2013-00714
T[GAR.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/27/2013
Parcel: 2S114BA16200
Jurisdiction: Tigard
Site address: 16225 SW COPPER CREEK DR
Project: MARTIN Subdivision: COPPER CREEK STAGE 4 Lot: 127
Project Description: Gas fireplace with fuel piping.
Contractor: FIRESIDE DISTRIBUTORS Owner: MARTIN,JOHN R JR&JEAN C
18389 SW BOONES FERRY RD 16225 SW COPPER CREEK DR
PORTLAND, OR 97224 TIGARD, OR 97224
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 Fuel Piping 11/27/2013 $14.15
Class of Work: ALT Type of Const: 12%State Surcharge-Mechanical 11/27/2013 $10.80
Occupancy Grp: Minimum Fee Adjustment-Mechanical 11/27/2013 $42.46
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
1 1/22/201 3 10:21 5036205699 FIRESID PAGE 04/06
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• • • ... "
Wleehanicit•Permit- Applicatim,'; CE EIVED fORD1ITICE1.1SEi.O.ININ '
• City of Tigard Reoaived" /.., / il.NO.: ^- "
i i 0171 43 873. - P'5ren /)/ '•"-C- ao 11-00-7,/if
• :• ...4i.J. 13125 SW Hall Blvd.,Tigard.OR 97223 ian Review
• •• : • Phone: 503.639.4171 Fax: 503.598.1960 NOV NO V 2 5 2013
14
./13y; Other Pamir:
... . • , ,
inspection Line: 503,639.4175 •
TIGARD : • Da,ta.Rekly/l3y; lulls: ' Ea sce page 2.for
lute:rue; www.tigard-or.gov CITY OF PIGA R D 14§iified/M4th°d: Tyc, Stippitirieltai tnitormation
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Michatt IOU Perinit fees*are based on the value of th *one
. . 0 I:iew construction 0 Add iti on/alterati on/rej3lacement p.erfarmid.•Indicate the value(rounded to thp nearest Ctojig)of all
0 Demolition 0 Other! • mechanical materials,equiptent,labOr,oirethead,and prat,
'6;41•41•0;10144.U4Kkori•4;.:;:,;,,i:1•..:•.xi.~i,o4...r.i7,,,';;:„A••':. . Vititi6:$ . : . . . , ,
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sr:fr'' 'Cis.' LataLZO .i.S .,W,I.'',-:-.34:E,.7,..-ona-aGA.,:.Y.5.7afaiii-.7,=.if,At l•I
12 I-and 2-family dwelling 0 Cornmercialrindustritil 0 Accessory building .
Fo..•jrpecial leorioariciti:irk 6lieeklisi. • •
0 Multi-family' . 0 Master builder . 0 Other: 15ripion ----- -Fy. F7i---:. Total
- • vc•-••••,•-: '‘'0"..k:rr!pr,.,,--,,,,,s',e,:•:
.ge i,keidgeMMilt-FistinUiii 1 Mrvt_fridai a rizAn,,,,,,I,-; z0,J1 Heating/cooling
Air cOnditicining
Job s'i !L.cYres .- )ton,D.5 5 IA/ 0.-Opp e,r- (!M PM 1=1 r (reguiy.site elan slowing placental* .. .46.15
City/State/ZIP: ' ' ‘
1 0■D. a 1 l: IP - Furnace 100,000 BTU(duets/vents) 46.75.
Furni00,606+57-ifothicisivento .54.91
Suite/bldg./apt.no.: Project name: pekor4,14 iiest piimp .• -• .-
61:06
Cross street/directions to job she: Dim work, . • 23.32
Hydrpnie hot wate.r.wtem 23.32 . .
., . .
• Residential boiler(radiator or
•
hydronic) 73.32
Unit heaters(fitel-tYPe not electric).
. . in-will,indict,suspended,etc. .46.75 .
• ,
' . Flue/Vent fUr any of above 23.52
Subdivision: • i Lot no.: &Mei: . . . .
23.32
..-
.
Taxrnap/parocl no.; . Other fuel appliances . .
•
z',,', ,7,',,•-..?-‘,..-,,,p42zeixF.N_"- ,,,.Th,.,04riFilifirqr,1,-131MIX,i'MU„;.,--Y;-;-,,,', ./,;.',;k3 tv,,,,..7,.v.i,t;,,,t Water beater 23,32
,4 _..A*.%..A• . ,---:-..2.77.r,,, ,,..1-,,,41..k.e.karaa.ixdomed.siAt -watie•,,• •Avay,Z.,. „si■, I.Lic, lip-?;''
.--9Ef2SEYLet ------i--- .1-3ge
Tre+clAk 9(6 hint • (U'w laS Lit5c,e4 Flue vent for water heater or gas
fireplace 23.32
-
• .
Log lighter(gas) 23.32
. . Wood/pellet stove 33.39
• ,Wood fireplace/insert 23,32
• .
4 Chimney/liner/flue/vent .. 23.32
lairniZAR'U -4..:V.V4
.i .i'• .:MI trAfirarrg IFF: r5i.. :.k.V. . ,t. • . ,,,v,1, .....,- .
Name. 0 h n f J Os) MarAi "
n tnv ,,
i,, ,,•ent.al exhaust and ventilation
Ringe hOti/otber.kitchen. .
Adcliess:. 1 41 22.6 . n im 0.,0 ppr vire c_k_ r- .. e.iliCrhent
City/State/ZIP: ---ctIcurck 0 g. c Y"V-P-1-1 Clothes dryer exhaust 33,39'
, Single-duet exhaust(bathroom%
Phone: •7)) aq
PO ill i) Fax:C. ) toilet compartments,Utility rooms) : 23.32
t Attie/0-4ms pace fans 2332
Oth . 23'.32 .
BusineSS name; •-•/.-psici,,Q 7--)ts.t.- - er:.
Fuel
Contact name: pi. . $14.1.5 fOr first four;$4.03 for ezeh 0.iiditiontil
Furnaceer
, c. . .
pct.ri A Rjj.
Gas heat pump . . .. ,
.. '
City/State/ZIP: p 13 p 1-1 ir J' CA. i .OR Cr 7 g1/4731-1. , Well/suspended/unit heater .
.
phorLe:1512LieS4535 I Fax; :so koD,5i,,eick Water heater
Fireplace .
S-rnail: .
1 . ..,....r • Range
1:`"-•.1:',',4,Y.:','.5K.-...1`2,1' 41''''.4.4',4',.'"7:3--':'1541'ittaiib 1,-4',v)1, ;:i:-:,;..,,.. •,,,,,,..,y-'0,, -:,,.`:,,,: Barbecue . •
Clothes dryer(gas)
Business name: i.ce.%tak. -ii .t.'s , Other;
Address: SadiA9 al. 'ale,vi :"i•,, .i':;.'‘''PV'InTiirML
City/State/ZIP: Spot
Phone . Minimum permit fee($90,00)• 10..00
:( ) Fax:( )
Plan review(25%of permit fee)
CCB lie.: ki 0(17 9 / . Scarp surcharp(1 %of pennit,ftti) /0•5-o
.„ Tarifa,potivutfu. zoo 4:13
, .
,.._.. . / / This permit aPplictition expires It a Perialt is naibbtilded within'180
Authorized signature: / ' 4 iiiik • IF,
days after it bas'been'accepted as c-omplete.
Print name:44 IL, to , ii, Date: it Ele 1 ' * fee methodology set by Tri-Coenv Buildmg Industry Service Board
[Anuadavo,ermitAmEwenn.App.doo two]too 4404617T(1 Ino2JC0tvvv/E3)