Permit CITY OF TIGARD MECHANICAL PERMIT
111 . COMMUNITY DEVELOPMENT Permit #: MEC2009 -00125
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Date Issued: 03/25/2009
Parcel: 2S110DB90991
Jurisdiction: Tigard
Site address: 15435 SW 114TH CT 99
Subdivision: FOUNTAINS AT SUMMERFIELD CONDO Lot: 99
Project: Kessler
Project Description: Install fireplace insert.
Owner: FEES
KESSLER, LORRAINE REVOCABLE TRUS Description Date Amount
15435 SW 114TH CT #99 Permit Fee 03/25/2009 $72.50
TIGARD, OR 97224 12% State Surcharge 03/25/2009 $8.70
PHONE: 503 - 624 -1938
Contractor:
FIRESIDE DISTRIBUTORS
18389 SW BOONES FERRY RD
PORTLAND, OR 97224
PHONE: 503 - 595 -3738
FAX: 503- 670 -7285
Type of Use: MF
Class of Work: ALT Type of Const:
Occupancy Grp: Occupancy Load:
Stories:
Fuel Air Handlers
Fuel Types: Natural Gas Units < 10000 cfm:
Gas Pressue Units > 10000 cfm:
Furnaces Boilers & Compressors
Furnaces < 100K BTU: 0 -3 HP:
Furnaces >= 100K BTU: 3 -15 HP:
Floor Furnaces: 15 -30 HP:
Unit Heaters: 30 -50 HP:
Vents w/o Appliances: 50 or Greater HP:
Air Conditioning:
Heat Pump:
Appliances
Vent Fans: Vent Systems: Total $81.20
Hoods: Comm Incinerators:
Woodstoves: Gas Fireplaces: 1
Required Items and Reports (Conditions)
Clothes Dryers: Other Mech Units:
Gas Outlets: Other Desc:
Duct Work:
Fire /Smoke Dampers:
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 uspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. T ge rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001- 0100�y obtain a copy of the rules
/ f
Issued By: k I "�� Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for an inspection that 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.
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,. C3/24/2009 08:56 5036707905 WIDDOWS PAGE 01
Mechanica 1'C':)`)i3S h 1 }l 6�ae1.1J;b. 1'( :OI11(1 t al:OM A
• City g
Ci of Tigard � DBtisy: j a d Permit No,: 9 /)-,� t e,Rop l -60/g5
RE C E VED
13125 SW Hall Blvd., Tigard, OR Plan Review
Phone: 503.639.4171 Fax: 503,598. g
1960 Date/By: Other Permit:
TIG.ARD Inspection Line: 503.639.4175 MAR 2 4 L Date Ready /By: 19 fa See Page 2 for
Internet: www.tigard -or gov Notified/Method: ' re. Supplemental Information
•FTIGARD
a i:,.... 0 . _, a.i"Yr 4t': W,.i .,.O§W. ,.. s..,9, �'�k tfx 'r'�'r r,,�j . :*I
Mechanics permit fees* are based on the value of the work
❑ New construction ddition/alteration/replacernent
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
e <t t � }}�
' ee _ 'i a , 6 y r } . , tsar ""'• 4 lf , lYn ;i 599 Vg I I , e. �. '! 1 y ,.,, , ; , ,`e R Value
a - !k• ) , 0'& 1 ,110, E i _ { . ar t.
and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building " ' ed t
For special information use checklist.
El Multi -family ❑ Master builder ❑ Other:
Description Qty. i Ea Total
r . +f.: 4 Jt•)B S) '. t *14L'T1O!'4 AND `00. * 1 + ` , ' i i ' Heating/co iling
Job site address: `S y3S Su... I -I 1 t.}'L},s Cowl Air fires ite Wing o ing pump
(requires site plan showing placement) 14.00
City / State/ZIP: - V -
- - _, ` Cr, (11.17-4 Furnace 101;000 BTU (ducts/vents) 14.00
Furnace 10(,000+ BTU ( ducts/vents) 17.90
Suite/bldg. /apt no.: �3 Project name: Gas heat pu rip 14.00
Cross streetldirecti . I si te: Duct work 10.00
Hydronic In t water system 14.00
Residential toiler (radiator or
hydronic) 14,00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.:
Flue/vent fo • any of above 6.80
Other: 10.00
Tax map/parcel no.: �gy Other fuel t ppliances
t ZS r }r )1 '' I r "'1NO i ';` }�J s`� �„ � ... � i iu�l " (t l �� heate 10.00
, I.. . 1,i � . ..a: h, , } . i 43 e 4 : ,n�'..! .'
+ ' w Gas Water fireplace: 4 ref" L 10.00
1 .1c t�C 'e l 8 � Flue vent foe water heater or gas
fireplace 10.00
- -- Log lighter ( pas) 10.00
I Wood/pellet stove 10.00
Wood firepli ce/insert 10.00
:w O'g t ,i �.. �a : 1 .I 4 IN 44 1b . : fie i fi ; Chimney/lin�r /flue/vent 10,fl0
V m ,, , 7 , - . -f ,.0: 4V,::; ,`' ,:! ' ' ` ... ,ti , .;t\, . vs y4''' Other: 10.00
Name: LG t. Irp .r e- tc s'S (er Environmen tal exhaust and ventilation
Address: is tv,35- 1 4.-Crt% Ctdt,,.t r Range hood/ ether kitchen
equipment 10.00
City / State/ZIP: ci p Clothes dryei exhaust ' 10.00
Single -duct exhaust (bathrooms,
Phone: (5 z4.# g 3 Fax: i ( ) toilet compat;ments, utility rooms) 6.80
t , '! t, 4iit�4T � �.. , t a 445 �.,t,=, ,c +,t r : i1 a itrti #4 a . , Attic/crawisl ace fans 10.00
Other:
10.00
Business name: Ages I :rt Ii
J Fuel piping
Contact name: Ly , - (a..1 ,„,e P.✓'irGW 1 ' $5.40 for first four; $1.00 for each additional
Address: /8329 /11
Sw �r,es e
lim ettJq(,1 Gas heat un
p P
cam
City /State/ZIP: J' �,„� / ' ,, . 972.2-4t Wall/suspend sd/unit heater
Phone: (S 3 )5 , . 3 - ?3 g / C Fax: : (5 670 -7 . 2..3 .--
7 Z3.-- Water heater
E -mail: Fireplace
}y��, j� Range
s , ,1:�', . � a r �.3 ���> .t : + ..t,h � , s ., utr, s1, , +, . �.; ���� ,� Barbecue
Business name: Clothes dryer (gas) •
Address: 7 _ / -_ Sr` a r i Y w {0 � ; ' 4 11 !. 1LF„h y S k �! sf
t:, .,
City /State/ZIP: Subtotal
Phone: ( ) G F ax: ( -) Minimum permit fee ($72.50) - 1'Z „ ,
CCB tic.: Q I - Plan review (25% of permit fee)
State surcharge (12% of permit fee) e _
• TOTAL PERMIT FEE. Ili 7 °
Authorized signature: \ ; This permit at piiration expires if a permit is not obtained within 180
1 d: ys after it has been accepted as complete.
Print name: try �tl►.uy.0 a y'„at,11- ` Date: 3 -2* 09 - 1 * Fee methodo ogy set by Tri-County Building Industry Service Board
1:\ Building 'Permits\MEC- PermitApp.doc 01/19/07 440- 4917r(iI /02/COM/WEB)
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