Permit CITY O F TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00694
TIGARD; DATE ISSUED: 11/28/2007
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S133DC -05300
SITE ADDRESS: 13335 SW BRITTANY DR ZONING: R -12
SUBDIVISION: BRITTANY SQUARE NO. 1 LOT: 011 JURISDICTION: TIG
PROJECT: QUINCY
Project Description: Install gas fireplace and gas piping.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CU) DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
TIFFANY QUINCY Description Date Amount
13335 SW BRITTANY DR
TIGARD, OR 97224 [MECH] Permit Fee 11/28/20C $72.50
[TAX] 8% State Surchar€ 11/28/20C $5.80
Total $78.30
Phone: 503 -310 -5222
Contractor:
FIRESIDE DISTRIBUTORS
18389 SW BOON ES FERRY RD
PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -595 -3738
FAX 503- 670 -7285
Reg #: LIC 40979
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans, This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Not cation Center.
Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OU NC by
calling 503.246.6699 or 1.800.332.2344.
Iss ed By: ■ 6ZAAAALLY Permittee Sig , • -, r e ,
Cali 503.639.4175 by 7:00 a.m. for inspections t Business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
w 11/ 16:05 503620 l I DISTRIBUTOR PAGE 02
O le itailiical Permit: A�rj�lica cr t. r
J 1 OFFICE 1.;$t Gr(�it.l
City of Tigard Received` / �
Pc G c, ,
w ? Date/B t rmil No.; / _ GU O • 4
111
•
i 3125 S W Hall Blvd., Tigard, OR 97223 NOV �D0
1 : Phone: 503,639,417] Fax: 503.598.1960 • Other Permit;
Inspection Line: 503.6394175 4' �'�:
Ins
TCC:,4K.C► p 1 I � TiT'T., tut
Internet! www.tigard -or.go ' Cr' St See Page I for
} y� P � t > UIL fT' TG DIV ` !J ; f1 C� itt y� . r� Supplemental information
, r l : n i•'�1 E : ' V �'7 V ( !,v T ' I5' I' � � / y . i ? 1t�-W t'16� 6 � r.,s � 1 1 .. 1,1 e ,,
Y :. - . 1 •.., _ ., , i..� _ S " .�,., 4 ...� a . �L. .7„ JWt7�rCiLL71� - i i
❑ New construction a Addition /alteration /replacement Mechanical permit tbes° arc based on the valuo of the work
0 Demolition performed. indicate the value (rounded to the nearest dollar) of all
❑ Other mechanical materials, equipment, labor, overhead, and profit
Ys ` ° t� i'tdkit'doik iiOF Maf '? . i I ii ''lilt ' ry
I , t: 'I � ; � -, .. • , C�rVS�R1`7��Y`b '
4 t � � ?/t �` s, Value: $
,ihi I'"".1"'' , 1 I' :.r� yiN per ,, "1 ;'T i N
.2 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building '" "'lit II ^' � �' "' ' ,'° ,,, „m Y� � {F,
❑. Multi -famil For special Information arse checklist,
Y 0 Master builder ❑ Other:
Description
F t ; ` u, , 1 '!" 1 T (if3 del T1� i\1Wu' I Gkii 'i",a i�", {r s D ii Qty. i Ea. ( Total
' - ,t .. . . . . i . QN i S .�14 ; il ti ,„ Heatind/eooling
Job site address; t `.� - l Air conditioning or heat pump
1 � ' w ' 93 � re aims site plan showing placement) 14.00
City /State /ZiP: -'' 0 ,..x..a . u ,Q Furnace 100,000 BTU(ducts/vents) 14,00 •
Suite/bldg. /apt. no.: -' Project name: Furnace 100,000+ BTU (due, /vents) 17.90
. Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
— Hydronic hot water system 14.00
Residential boiler (radiator or
jydronic) 14.00
—
Unit heaters (fuel -type, not electric).
in -wall, in -duct, suspended, etc: - 10,00
- —
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other, 10.00
Tax map /parcel no.: ��II t),I,W ll Other fuel a lianees
:'..: •� '" ,. " l''; ��i5t121piiiitN Ul1T k e( li ; % ��T i a1 ,� - , y ;F1 Water heater
u ..,c.r ,,.. 10.00
Gas fireplace 1 10.00
.._„, , A.1 • / _ I Flue vent for water heater or gas
fireplace • 10.00
--- — Lo: li:htcr ' ' 10.00
—
Woad /.e11et stove 10,00
Wood fire .lace/insert 10.00
' P!i bP R l,;OrV}iN �t 1' e 7 t .,: i i .' ( tJ v rvi ;t S ,l,ti i r q }: Chimney/liner /flue/vent 10.00
Other: 10,00
Name; `�bZ1 Environmental exhaust and ventilation
Address: t� T Range hood /other kitchen
gf 1 R equipment 10.00
City /State/2IP:, 1�.pt_A.x1k O e tD -i r -^ _Clothes dryer exhaust _ 10.00
Phone (5D) 3) 5a -� F ( ) tMlet compartments, utility exhaust (utility rooms) .
toilet compartments, ty oom s) 6.80
° ` = , + C('.AP,P1 f 1NT O � .d;� FlIERSbi P''i pace fans 10.00
I r
' r ` Attic /crawls
,
Business name: • A Other, 10.00
Fuel piping
Contact name: NI i C , 1Q 1�� _ $5.40 for first four: $1.00 for each additional
Address: 1 P 3 ?B S ( � � o 5 Pe. r 4 ,../ Oas hea pump
t�6� /�..�__.,. Gas heat pump
City /State/ZIP: p ' rr t. a r ■ ..L.-- Wall /suspended/unithcater
Phone: (j 5p11- �cr Fax: : ( Lo u ,. 7 D 5 Water heater
E-mail: Fireplace 1
_ Range •
p a, .r._ ( � , I , : , ;it ,F ;
. 4
Barbecue -
Business name: r o p j ST D} 'fEG Clothes dryer (gas)
Address: � f) Other
�,
City /State/ZXP: { „ {' l s)1f 'kx t l ;"
Snbttrrl
Phone: ( ) Fax: ( ) Minimum permit fee ($77
Plan review (25% of permit fat)
CC$ N "1 tic.: �j /a ter State surcharge (8% of permit
•
l � TOTAL FERMI ME / R ��
Authorized signature: l / / This pertalt Application mire:, tl mire:, iP a permit 4ibGn
iF nag within 180
iii, / i , � t � � � : , y . j • , .' dart after It has been accepted as eoelteu,
Print name: A ii 1 �!<7df�L% / Date: - ,, / ,1 ? • Feo methodology act by Td- County Building Winery Service Sonrd
r:tauildiosTermltelKEC -p itApp.doc 04/66/06 r�� 4404617T 1IJ
( tY71COM/W138)
CITY OF TIGARD ,
BUILDING' DIVISION PERMIT #: }�� ; 8t�7 -C)
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/2812007
Phone: (503) 639 -4171 li ma u�iisll v i , I
Inspection Requests (24 Hrs.): (503) 639 -4175. • '.. A % .2OO 7- DO 6 9Y
INSPECTION WORKSHEET FOR DATE: 12/19/2007 TIME: 7:80AM PAGE: 2.7
SITE ADDRESS: 13335 SW BRITTANY DR CLASS OF WORK:
SUBDIVISION: BRITTANY SQUARE NO. 1 LOT #: 011 TYPE OF USE:
PROJECT NAME: QUINCY
DESCRIPTION: Install gas fireplace and gas piping.
OWNER: QUINCY, TIFFANY PHONE #: 603-310-5222
CONTRACTOR: FIRESIDE DISTRIBUTORS PHONE #: 503- 585 -373t
Inspection Request Scheduled For: Date: 12/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 061835.01 503.68486635 Y
Corrections /Comments /Instructions:
0 aL L 1.4 /L 1 c_ / "LS i ' 0 - .v (r/ c 2z4 pow
ASS n PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL � CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: , s - Date: r- et- d Phone #: (503) 718-