Permit CITY OF TIGARD MECHANICAL PERMIT
74 COMMUNITY DEVELOPMENT Permit #: MEC2009-00103
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/16/2009
T I E R L� Parcel: 1S 125DA00900
Jurisdiction: Tigard
Site address: 9145 SW 66TH AVE
Subdivision: Lot: 0
Project: Soule
Project Description: Install pellet stove insert.
Owner: FEES
SOULE, ELLNORA M Description Date Amount
9145 SW 66TH AVE Wood /Pellet Stove 03/13/2009 $10.00
PORTLAND, OR 97223 12% State Surcharge - Mechanical 03/13/2009 $8.70
PHONE: Minimum Fee Adjustment - Mechanical 03/13/2009 $62.50
Contractor:
SPECIALIZED STOVE SERVICES LLC
21707 NE 159TH ST.
BRUSH PRAIRIE, WA 98606
PHONE: 360 - 254 -3866
FAX: 360- 254 -3866
Type of Use: SF
Class of Work: ALT Type of Const:
Occupancy Grp:
Stories:
Fuel
Fuel Types: Solid Fuel
Gas Pressue:
Total $81.20
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 -0100. You may obtain a copy of the rules
or dyr(ci questions to OU c - ',ng 503.246.6699 or 1.800.332.2344.
Is ued By: k. 4 '` .ii Permittee Sig ure: �� � ; N,.! /�
Call 503.639.4175 by 7:00 a.m. for an inspection tha • • smess day.
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.
RECEIVED
_ . i' iximIica 113erinitl 1 OFF1(1: t'si: ONLY
MAR 13 2 ocived
City of Tigard Dale/HY: . 1 Z• "CFI ‘ 44 1=Erl
" 1 4 13125 SW Hall Blvd„ Tigard, OR 97223
11 . . 9
1 'Ipiiiiii
il Phone; 503.639.4171 Fax: 503.598.1 Other Perrnit:
-; 1 A ' ;t1 Inspection Li IIIIIIM ne: 503.639.4175 ii‘ A Pf ' t . "
.; 1 .1 -' ' fr ' , cody/rty: NM HI See Page 2 fbr
Internet; www.tigard-or, • gov r A -' Illy Notiriod/method: Sapptementor information
: 1 ; :,;;, '-::: '!' ::: !„, ,,,tiittlitAitiblit:: ,H ' : ' ; ':':Cit O ittet etAit: 1, t0 100 ,J. 0 4; 1:1§t
Mechanical permit fees* arc based on the value of thc work
0 New construction IJ Addition/alteration/replacement
performed. Indicate thc value (rounded to the neorest dollar) of all
0 Demolition 0 Other: mcchrmical materials, equipment, labor, overhead, and profit.
,-,
21 1- and 2-family dwelling 0 Commercial/industrial 111 Accessory building
For special iriformation use checklist,
0 multi-thrnil 0 Master builder 0 Other
Description 1 Qty. T3a, f Total
:;.::;.'''',:',;: ',,•:'.:" ::;:;,-: ;'.'; 4 . 6104 ift: : t 4 titOMAtit0,14i*OtttiON'L.: .. ':.,. i , .i: ;..; . Heating/cooling
Atr conditioning or heat pump
Sob site address: 9145 SW (,6' Ave.
(requires site plan showing )looetnent) 14.00 -
City/State/ZIP: Portland, OR 97223 Furnace 100,000 .BTU (dooto/vents) 14.00
Furnace 100.000+ STU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name:
Gas he_aat 1 14.00
Cross street/directions to job site: Duet work 10.00
Hydmnie hot waterustern _ 14,00
Residential boiler (radiator or
hydmnis) 14,00
Unit heaters (fuel-type, not electric).
tn-wall. in-duct, suspended, etc. 14.00
Flue/vent for any of above 6.80
Subdivision: IAA no.:
Other: 10.00
__,_ ......,
Tax map/parcel no.: Other fuel appliances
10.00
10.00
Install pellet stove insert
Floc VC/It for water heater or gas
. .
fireplace 10.00 .
Log lighter (gas) 10.00
______ Woo 1 10.00 10.00
Wood fireplace/insert 10.00
Chimnsy/liner/flue/vent I 10.00 10.00
,..::;':'' 1::' •?;'' EY'llitOlIteKtY 'OWNtli;' :.' . ' ''::: ''.": ' ''3j . ' ' t.818A81 .: :: ' ;
10.00 ,
Name: Elinora Environmental exhaust and ventilation
Range hood/other kitchen
Address: 9145 SW 66 Ave.
equipment 10.00
-
City/State/ZIP: Portland, OR 97223 Clothes dryer exhaust . 10.00
Single-duct exhaust (bathrooms,
Phope: (503)244-9820 Fax: ( ) toilet compartments, ittV rooms) 6,80
777 7 , :481,A#ttlitk i it,!'i":: :: :;'''.'; : :: ' ,: : : ;:';'L;':';',:1",1:;'10,)14tACTA,titSof 4 ) . ' .T Auic ranS 10.00
10,00
Buiiness name: Specialized Stove Services, LLIC
. Fuel piping
-r -
Contact name: JP 55.40 for first four; S1.00 fbr each additional
--____.-
Address: 21701 NE 159 St. FUMICO, etc.
Gas heat pump
City/State/ZIP: Brush Prairie, WA 98606 _VkLalysysteiided/unit heater _
Phone: (360) 254-3866 Fax: ; (360) 254-3866 Water heater
Fircplacc
E-mail: diromanebock@msn.com
Range ,
j.,' ,, , ,
Clothes ci_._(ga.r s) .„.,_
Business name: Specialized Stove Services, LLC
_ Other:
Address; 21707 Nt 159 St.
City/State/ZIP: Brush Prairie, WA 98606 Subtotal 20 00
Phone: (360) 254-3866 Fax: (360) 254-3866 Minimum permit fcc ($72.50) 72.50
Plan review (25% of permit fee)
CCB lie.: 175302
State surcharge (12% of permit fee) 8.70
-
'
TOTAL PERMIT FEE 81.20
This permit implication expires if 0 permit Is not obtained within 1110
Authorized signature: g 4 / . days after It has heen accepted as complete.
Print name: .11P Romanehoek Wririt
Date: 3/12/09
• Fee methodology 3et by Tri-County Building Industry Serried flourri
mniInciing‘Permirain-rennitAnp.dna mil . /I17 440-4617T ( I I /02/C(71'1.4/WEB)