Permit CITY OF TIGARD MECHANICAL PERMIT
tlI COMMUNITY DEVELOPMENT Permit #: MEC2012 -00647
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 12/10!2012
Parcel: 1 S135CD00100
Jurisdiction: Tigard
Site address: 11525 SW 95TH AVE
Project: Wilker Subdivision: 2008 - 018 PARTITION PLAT Lot: 2
Project Description: (1) install of morso wood stove and (1) vent pipe in location of existing pad
Contractor: ADVANTAGE CONSTRUCTION & MAINTENANCE INC Owner: WILKER, GWYNETH E
PO BOX 756 11525 SW 95TH AVE
BEND, OR 97709 TIGARD, OR 97223
PHONE: 541 - 318 -7809 PHONE 971- 645 -8275
FAX: 503 - 674 -9424
FEES
Specifics: Description Date Amount
Wood /Pellet Stove 12/10/2012 $33.39
Type of Use: SF Chimney /Liner /FlueNent 12/10/2012 $23.32
Class of Work: ALT Type of Const: 12% State Surcharge - Mechanical 12/10/2012 $10.80
Occupancy Grp: Minimum Fee Adjustment - Mechanical 12/10/2012 $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. �t
Issued By: �t / I l; . ( � Permittee Signature: Q j `4- PP�-i C l�+ (.21,1 �C! •t/1J�xC- 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.
Dec 10 12 08:55a Advantage Construction 541- 318 -7809 p.1
Mechanical Permit ApplicaR C I1 D
roll cl
y/ l l:
i lc 1;sr: ("IA of Tigard Received � j
lig
13125 SW Hall Blvd., Tigard, OR 97223 DatrJlly: /off, I Q i �. Cr Permit Noes a2f>47- _ CV&
0 Phone: 503,718 _2439 Fax: 503.598.1960D E C 10 2012 Plan Review
T I C; A It 0
Line: 50.3.639.4175
Date/By. Other Permit:
Internet: www.iigard pr.gov Date Ready,By: tuns: 0 See Page 2 for
CITY OF TIGARD Nctified/Method: Supplemental Information
TYPE of ING DIVISION COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction Addition /alteration/replacement Mechanical permit fees* are based on the value of the work
Performed. Indicate the value (rounded to the nearest dollar) of all
11 Demolition [*1 Other. k)000 c 1 -'l'v i 1 mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL IAL EQUIPMENT / SYSTEMS FEES*
1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For sped& Information use dieeklisz
Multi- family 0 Master builder ❑ Other: Description Qty. 1 Ea. Total
JOB SITE INFORMATION AND LOCATION Ilesting/coollog:
kb site address: � _ ,', I Air conditioning
5 , 5 6 � ! 5 114 r -- (requires site plan showing placement) 46.75
City /State/ZIP: —T (51 • 9 Furnace 100,000 BTU (dudslvents) 46.75
Furnace 100,000+ BTU (ducts/vents) 54.91
Suite/bldg. /apt. no.: 1 Project name: Heat pump ,
Cross street/directions to job site: (requires site plan showing placement) 61.06
Duct work 23.32
Hydronic hot water system 23.32
Residential boiler (radiator or
hydronic) 23.32
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 46.75
Subdivision: Lot no.: Flue/vent for any of above 23.32
Tax map /parcel no.: Other: 23.32
Other fuel appliances:
DESCRIPTION OF WORK • Water heater 23.32
i i 1 Ynb Gas fireplace /insert 33.39
1 ti 2 eSC 1 •�.Dezt . - f / j Flue vent for water heater or gas
e-4,1-1-- n [ e_ (_. ' L 1 1 fireplace 23.32
•
I 1 "" I ' J n Log lighter (gas) 23.32
r/s� C A p eti f e ? t (/ 'j-J i6 !—jam Wood/pellet stove 1 33.392
Wood fireplace/insert 23.32
(IPROPERTti' OWNER F ❑ TENANT Chimney/liner /flue/vent j 23.32
6,,.. 1 Other. 23.32
Name: V�,3i L
Environmental exhaust and ventilation:
Address: Range hood/other kitchen
equipment 33.39
City /State/ZIP: Clothes dryer exhaust 33.39
S
Phone: `-� 7 1 ) ( , �- J c ) '75 Fax: ( ) Single-duct exhaust (bathrooms,
P ❑ APPLICANT ❑ CONTACT PER toilet compartments, utility rooms) 23.32 _
PER4ON Atticicrawispace fans 1 23.32
Business name: Other: 23 32
Contact name: Fuel piping:
514.15 for first four; S4.03 for each additional
Address: Furnace. etc.
-
City/State/ZIP: Gas heat pump
Wall/suspendedlunit heater
Phone: ( ) Fax: : ( ) Water heater
E -mail: Fireplace
Range
CONTRACTOR I Barbecue
Business name:A 1. FIE_ 1Clothes dryer (gas)
Address: P. 0 � / ` > ltil Other:
• ( - 0 b -75 4 MECHANICAL PERMIT FEES*
�� 4 n /)
City/State/ZIP: 0 err 0? Subtotal
Phone. (f+it) (0/0 (23 Re) 1 Fax: (60 3 ( 0 1 Li _ q a L.� Minimum(esmit fee permit fee)
CCB lie.: 1 7 L, T l / Plan review (25% of permit feel
- I 0 Li —7 i f,?-(e (13 i State surcharge (I2 %of permit feel
Authorized si afar . I The TOTAL PERMIT FEE 1 eO • N2
gn permit appli expires if a permit is not obtained within 1m
. _.._. _ _... _. days after it has been accepted as complete
^ , . / QI i 0 , • Fin mMlinelnIntw art by Tri- ('nimty Rniidine Inriiwtry Gnrir• Rnant