Permit CITY OF TIGARD MECHANICAL PERMIT
If 1111- g - COMMUNITY DEVELOPMENT Permit#: MEC2013 00451
13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 08/06/2013
TIGARD Parcel: 2S 103DA03290
Jurisdiction: Tigard
Site address: 10655 SW PARK ST
Project: Krager Subdivision: DERRY-DELL NO.2 Lot: 35&PT
Project Description: Install woodburning stove.
Contractor: FIRESIDE DISTRIBUTORS Owner: KRAGER, ROBERT WARREN
18389 SW BOONES FERRY RD 10655 SW PARK STREET
PORTLAND, OR 97224 TIGARD, OR 97223
PHONE: 503-641-1919 PHONE: 360-903-4861
FAX: 503-620-5699
FEES
Specifics: Description Date Amount
Wood/Pellet Stove 08/06/2013 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 08/06/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 08/06/2013 $56.61
Occupancy Grp:
Stories:
Fuel
Fuel Types:
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344. /
Issued By: �� Permittee Signature: a/o, t�°/0G/(?4- 0,
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
08/02/2013 10:54 5036205699 FIRESID PAGE 02/02
Mechanical Permit A FOR OFFICE USE ONLY
City of Tigard 'ITECEIVED .... , _
wenEly: a , :"..;111 P-tilvige- I 3 Y5/
IN . . 13125 SW Hall Blvd.,Tigard,OR 97 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960AuG Date/f3y: Glher iscnuilSre20 -0 0 05.
Inspection Line: 503.639.4175 5 2013 Date Ready/13y: June,: Ed See Page 2 for
TI-AK )
Internet vrww.tigard-or,gov Notified/Method: Supplemental Information
CITYOF TIGARD
0 New construction 0 Addition/alteration/replaceMent performed.Indicate the value(rounded to the nearest dollar)of all
mechanical materials,equipment,labor,overhead,and profit
0 Demolition 0 Other: - Value..$
... .15*
oiinoW ,,,,r----11.4",,,iieo-wkiliviiisggirmix,§Kviii
tz
I-and 2-family dwelling 0 Commercial/industrial 0 Accessory building - For special information use checklist
0 Multi-family 0 Master builder 0 Other Description QtY. I Ea. 1 Total
:11=1:'1241iP_X$4.1'1-1,11011:4M#0.01#.1r11-1.*-14. 111111111.14g11.1621As-' '21Y142,11.16....il.,..Fo-1.1V1,0"11:6111'1111;:7:::';111."f Head cu-*--( r2--11 conditioning 46.75
Job site address: 1i )
, A. • °It 1 • St- Furnace 100,000 BTU(ducts/yenta) 46.75
-
City/State/ZIP: 0 C
Furnace 109,000+BTU(doctslvents) 54.91
7V.rszur ii gp,3
Heat pump , 61.06 _
Suite/bldgJapt.no,: Project name: Duct work 23.32
Cross street/directions to job site: Hydronic hot water system 23,32
Residential boiler(radiator or
hydronie) 23.32
_
Unit heaters(fuel-typo,not electric),
in-wall,in-duct,suspended,etc. 46.75
Flue/vent for any of above 23.32 _
Other: 23.32
Subdivision: Lot no.:
Other fuel appliances:
Tax map/parcel no.: Water heater 23.32
"'-'riirkiiiieN-" i.: ;•144•47..:!::,:::IWZ,:.;.?".:. .::' Gas fireplace/insert 33.39
77.• "::.'.' ''''''t:- . .i'1"1-A:?*:1‘'3,21.::e*Ofti..fit§/!,/iP''''' - --4:''':'5'''' ''V'34.e!`1.-'''''.'" '.'.'''..:'...;.".'''''' Flue vent for water heater or gas
InliLtIt jg Dic.r1 6X/in l*Ii Mil it ti fireplace 23.32
• U Log lighter(gas) 23.32
.. Wood/pellet stove / 33.39
-Wood fireplace/insert 23.32
Chimney/liner/flue/vent 23.32
23.32
':',:;s1W:VE',OKOTAIIMigiPAM-1:74'..■,.`S. .?A:gq,',A4k.**YO.P ..:'..?-r7j,:;,n; '. Environmental exhaust and ventilation:
Name: Wet,ir(ill kratj42_,r- Range hood/other kitchen
equipment 33.39
Address: 1 01.116 c,4)„ park. S t Clothes dryer exhaust 33.39
City/State/ZIP: -Cc 1 cUra I OR. Cl 7)-)--6 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:Eux )3Loo-cto -4 Nil) Fax:( ) , , , . Atticicrawlspace fans 23.32
'''.:i'f:A.1 :'::':$0;*,titOA,Citt,V.R.I'M.e'` ;.,'....1.,: 01,00,4t10001t 'qn''." OFthul ..iping: 23.32
Business name: j rt_ i'd,9 -Di'st- ' $14.15 for first four;$4.03 for each additional
Contact name: pLn2.14 Furnace,etc. -
Oas heat purnp
Address: I c‘ c CI 5,W- F1)68116 - ,r(LI led_ . Wall/suspended/unit heater ,
City/State/ZIP: poi.1.1cond 6p. q 7)-.)-4 Water heater
Phme:603)ficia--.33 - Fax::SOF)) 0),r) -fitoq9, Fireplace
Rene
E-mail: Barbecue
' ;:;.tAri;,nfr, ,ir,; t!,7;44;,RkkWbOk:.B*.0f,Of.W,e!4iA::ZeNK::k.V.;.J, Clothes dryer(gas)
Business name: P(P 5 Cd-P b is 4:1,'j .&hrS D C-----6 Irlot^ : :::;:).errriAT:!'.74:**W„ fOrt1.**4440Agg',i*gi'W.'
Address: Cli1Mi a,S aLbood Subtotal 33301 ,
City/State/ZIP: Minimum permit fee($90.00) _
Plan review(25%of permit fee)
Phone:( ) Fax:( ) State surcharge(12%of permit fee)
CCB lic.: Lioq 7 Q //Ay/if TOTAL PERMIT FEE
IN's permit application expire;If a permit Is not obtained within ISO
days after it has been accepted as complete.
Authorized sipatare: ' Pee methodology set by Tr-County Building loclustry Service Board
141/44/1 , cbta717#111
Print name: Afoul -BEA,t-Hra a)0/ ' Date: gia)j3
MBuildingWormitAMEC_PeTmitApp_040113.doc 440-45171(11/02/CONf/WEB)