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Permit II N CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT Permit #: MEC2011 -00058 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/08/2011 Parcel: 2S 1148808300 Jurisdiction: Tigard Site address: 16358 SW 104TH AVE Project: Lampkin Subdivision: SWANSONS GLEN Lot: 24 Project Description: Install wood stove insert and chimney liner. Contractor: TOM BISHOP CONSTRUCTION Owner: LAMPKIN, DOUGLAS G 4578 SE 103RD AVE 16358 SW 104TH AVE BEAVERTON, OR 97005 TIGARD, OR 97224 PHONE: 503 - 644 -7868 PHONE: 503 - 349 -8910 FAX: 503 - 626 -9138 FEES Specifics: Description Date Amount Wood Fireplace /Insert 02/08/2011 $23.32 Type of Use: SF Chimney /Liner /Flue/Vent 02/08/2011 $33.39 Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 02/08/2011 $10.80 Occupancy Grp: Minimum Fee Adjustment - Mechanical 02/08/2011 $33.29 Stories: Fuel Fuel Types: Gas Pressure: Total $100.80 Required Items and Reports (Conditions) This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. ' Issued 1 A i.. . Permittee Signet `'� l rstler' Call 503.639.4175 by 7:00 a.m. for the next available inspection date. This permit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 02/08/2011 14 :37 5036269139 HOT SPOT FIREPLACE PAGE 01/04 rc \ \ � J � I t)4t (), l R t 1 tie l ?\I 1 Mechanical Permit Application NNN Received City of Tigard • li d i Permit No -: -.0 -G+C2/ S$ 13125 SW Hall Blvd., Tigard, OR 97223 - EB 8 20 flan ttavieW Omar Permit - Phone: 503.639.4171 Fat: 503.598.1960 DaterBy- t ®gex Page 2 fir • I. Inspection Line: 503 - 639,4175 �, a� ��r, ��� AateleeaelY/BY Pl sat"11°1i °'matP6a • f . f f , e ? Internet: www.tigterd -or.�v a Notihcd/Method_ COMMERCIAL SCHEDULE - USE CHECKLIST — TYPE ttilr . WORK MexhanMechanical pa'r it fixs• are based on the value of the work 1t ❑ New construction Ditt Addition/alteration/replacement performed_ Indicate the value (rounded to the nearest dollar) of all E.1 Demolition 171 Other: mechanical materials, equipment. labor, overhead and . • fit. Value: $ CATEGORY OF coNSTItucnoN RESIDENTIAL EQUIPMENT / SYSTEMS FEES` ^� 1- and 2- family dwelling ❑ Commereial/indushittl ❑ Accessory building For ial information use checklist. (ylaster builder 0 Other: Dacri,tion Qty. Ea_ Total © Multi -family 0 SOB SITE INFORMATION AND LOCATION . • Heating/cacti � H p ' r Air conditioning site address: f IF 3 s8 l o `! .1 site .tan showia: , cut x6.75 Furnace 100 000 BTU (ducts/ veers �- . 54.91 MIMI City/State/ZIP: I l .•r � ` T 7 Ftrmace loo 000 BTU ( duavlve:nes_ Suite/bldgiapt no.: Project name: Heat pump — 61.06 III Ductwork 23.32 Cross street/directions to jab site- ----- Hyd onic hot water gstem 2132 Residential boiler (radiator or _ 2332 vdronic) Unit heaters (fuel•ype, not electric), 46 75 in -wall, in-duct, suspended, etc. — _ Flue/vent for any of above 23.32 EMI Subdivision: Lot no.: Other: 2332 Tax map/parcel no.: Other fuel appliances • Water heater 2332 DESCRIPTION OF WORK Gas fireplace f 33-39 I. „Alto , 0 • Y ■ avid l d It 41— Flue vent fbr water heater or gas IIII .111 fire .lace Log inter (Ras) Wood/, llet stove IIIII 33.39 MI Wood 11 = 111111FEEKIM Chinni Hiner /flue/vent FilEP PROPERTY OWNER • D .TENANT eater 23.32 Eavironmeatal exhaust end ventilation Ntrrne: 3 L� ifl " . "'r •• Range hoed/other 1dicben Address: Ur, 5 . SI-3 JO t _ y A t 3339 Clothes . exhaust .1111 3339 MIN City/State/ZIP: %i Chi Q y q`7 _ Y Single -duct exhaust (bps. l toilet commitments, utility rooms 23.32 a Phone= () 3t1/9 - . �O Fax: ( ) ptdc/orawlspace (sus 2332 APPLICANT ❑ CON T�#C"T PERSOfv Other 23.32 Business name: f-b , J • k .--" • i e Fuel piping _. Contact name: 514.15 for first four $4.03 for each additional a . z Fenrtaee etc_ �� Address: 115.15 SLJ C . e5 . AMINE etas heat pump City /State/ZIP: 3 e. • r'' le a r q 7o uS' AWY - , . • unit heater Phene: &O.-aiL - e ^ 9/3 f Fi :, lace �� E -mail: b Q - k pi" -c 4.".e It / - 4) O1 iii c i /• fp J41 CONTRACTOR Barbecue MIEN — r Clothes dryer Business name: r Q m • i S) a 41 Le' .a Other. Mil Address: 4/577 S /6 3 r% IECI AN1CAL PERMIT )BEES" City /State/ZIP:" / /t 970 r5 Subtotal `, i 1 Q .- Fo►rl C ✓ _ Minim um► permit The (690.00) a, CD Phone: 603) 6. / 7 ff Flax: ( ) Plan review (25% of h ermit fee) 1 State suicharge (12% of permit the) /O • Fs dv cCB lie.: 1.� �d� e► 'TOTAL PERMIT FEE f rn� • . • )1 his app atioa expires if a permit b not obtaiet within 180 • days Ater it ban bees emoted es enmplete. Print a Authorized Si . : j fi S ervice aoan / J, methodology set by Tri Coan4' >hnldiag lwdusar f Print netelte: � r 1 � �' I ate: aR. • Fee ma 44o461Tr(I1 OMvia)