Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT Permit#: MEC2016-00025
13125 SW Hall Blvtl.,Tigard OR 97223 503.718.2439 Date Issued: 01/12/2016Parcel: 13135CD10000
Jurisdiction: Tigard
Site address: 9811 SW PIHAS CT
Project: Poe Subdivision: 1999-073 PARTITION PLAT Lot: 2
Project Description: Replace vent-less gas fireplace with direct vent fireplace with direct vent Flue.
Contractor: NW GAS LINES Owner: POE, RONALD L& KATHY M POE RLT
16731 NE WASCO ST 13025 PRINCETON CT
PORTLAND, OR 97230 LAKE OSWEGO, OR 97035
PHONE: 503-256-2436 PHONE: 503-636-7242
FAX: 503-256-2245
FEES
Specifics: Description Date Amount
Gas Fireplace 01/12/2016 $33.39
Type of Use: SF 12%Slate Surcharge-Mechanical 01/12/2016 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 01/12/2016 $56.61
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, Stale of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility No Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or tlir questions to UNC b Uing 503.232.1987 or 1.800.332.2344.
Is ued By: � Permittee Signature:
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicohom I �j/ r
City of Tigard E I v E a 1 777,7
e mit No13125 SW Hall Blvd.,Tigard.OR 97223 I'(f_L' �o't!Lb.�Phone: 503.718.2439 Fax: 503.598.49 ther Penn t.I3! 1t Inspection Line: 503.6394175 1 �i - r�. ® See Page2 for
Interne[: www.ligard-oGgnv Supplemental information
WIINEINEININIM�l;lf Y UY �fl,r$ttu
= 4s.�«v t:.
aj, : : x
Mechanical permit fLvs*arc based on the value of the work
;E00
New construction ❑ Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
Demolition ❑Other: mechanical materials,equipment,labor,overhead,and prof-it.
_ a•... -:::�0 R110; .i Value:$
°: NEW4. i. .z v.2.�5: T.i 6 wt-and 2-familydwelling ❑Commercial/industrial ❑ Accessory building For special information use checklist.
Multi-family ❑ Master builder ❑Other: Description Qty. Ea. Total
.9 Heatin coolin :
Air ace 100,00 46.75
Job site address:
a C Furnace 100,000 BTU(ducts'vems) 46.75
Cityi StaterZlP: / D Furnace 100.000+BTU 0.0, cat,) 54.91
Heat pump 61.(16
Suite/bldg./apt.no.: Project name: Fre /99c, Duct work 23.32
Cross street/ch recti ons to job site: C Hvdronic hot waters stem 23.32
Residential boiler(radiator or
h dronic) 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 33.39
Flue vent for water healer or gas
tine lace 23.32
r
Log lighter(gas) 23.32
01-04 19A Ii
Wood/ filet stove 33.39
1AJ ' 0411e Wood fire lace/inser 23.32
Chimnev/liner/Bue/vent 23.32 .� .
l! Other: 23.32
TMANT
Environmental exhaust and ventilation:
Name: PC Range hood other kitchen
.Address: S,. \ t L 1. e ui men( 33.39
Clothes d ger exhaust 33.39
City/State/ZIP: �Z Single-duct exhaust(bathrmans.
toilet compartments,utility rooms) 23.32
Phone: r q Z Fax:( ) Altic/crawls ace fans 23.32
a L+pNtA• 't' Other: 23.32
Business name: Fuel piping:
C $14,15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
i L x �. Gas heat um
Address:
-1 e
� Wall suspended unit healer
City/State/ZIP: LakcSye, -b ll L tz Water heater
Phone:(�g)) Fax: :( ) Fire lace
Ran e
E-mail: Barbecue
rx CONTRACTOR . .. .. t, t *j, `` .'dv'+A=G xW". '" Clothes'd er(r(gas)
Business name:
er
Oth
Z ."o
W731(<
Address: 73( F_ t0aA d 0 L dT Subtotal
City/Stale/ZIP: 11X� d ?7;�L:j0 M inimum permit fec(S90.00)
Plan review(25%of permit fee)
Phone:(SO ) [f3 Fax:( 2
s zs G
G
�k State,urcharge I L./o of permit feel
TOTAL PERMIT FEE"
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-('ounty Building Industry Service Board
Prim name: , l./ L o C_ Date' (—(7-- /C
1 11 Idea.Penne.vFrPlrr i.APP am l I.d. 440-461-101 02 Cmc"I III
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial & Multi-F mily Fee Schedule:
TOM v
$0.00 to$500.00 Minimum fee$69.06
$500.01 to$5,000.00 $69.06 for the first$500.00 and
$3.07 for each additional $100.00 or
fraction thereof, to and including
$5,000.00.
$5,000.01 to$10,000.00 $207.21 for the first$5,000.00 and
$2.81 for each additional $100.00 or
fraction thereof,to and including
$10,000.00.
$10,000.01 to$50,000.00 $347.71 for the first $10,000.00 and
$2.54 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,000.01 to$100,000.00 $1,363.71 for the first$50,000.00 and
$2.49 for each additional $100.00 or
fraction thereof,to and including
$100,000.00.
$100,000.01 and up $2,608.71 for the first$100,000.00 and
$2.92 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I: Building Permits MEC PennitApp_I40113.doc 2
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
9811 SW PIHAS CT, TIGARD, OR, 97223
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2016-00025
David Young
Gas line existing.
Draft stopping at ceiling done.
Owner finishing non combustible facing finishes.
Violation Summary:
Inspector Contractor