Permit CITY OF TIGARD MECHANICAL PERMIT
i �.: COMMUNITY DEVELOPMENT Permit#: MEC2013 00712
T IAAD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 11/26/2013
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Parcel: 2S 104AB 11000
Jurisdiction: Tigard
Site address: 12330 SW MORNING HILL DR
Project: TAYLOR Subdivision: MORNING HILL NO.6 Lot: 139
Project Description: Gas fireplace with fuel piping.
Contractor: FIRESIDE DISTRIBUTORS Owner: CLAVIJO-SUERO, SEBASTIAN
18389 SW BOONES FERRY RD TAYLOR, KELLY S
PORTLAND, OR 97224 12330 SW MORNING HILL DR
TIGARD, OR 97223
PHONE: 503-641-1919 PHONE:
FAX: 503-620-5699
FEES
Specifics: Description Date Amount
Gas Fireplace 11/26/2013 $33.39
Type of Use: SF 12%State Surcharge-Mechanical 11/26/2013 $10.80
Class of Work: ALT Type of Const: Minimum Fee Adjustment-Mechanical 11/26/2013 $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:
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.
11/22/2013 10:21 5036205699 �+T� �,1 FIRESID PAGE 06/06
Mechanical Permit Ap1 l9ca ,CXGI`�E' r;:,c:i OTFICE.US O L�.
IN City o£Tigard Rece vcd
• u (3125 SW Hai(Blvd.,Tigard,OR 97323AI q r Date/By' f �f < V ,� �'rC 7L
Phone; 503.639.4171 Fax: 503.598.191 OV 2 5 213 Plan Review
Date/13y; Other Permit:
T I(:AItD Inspection Line: 503.639,4175 Data Ready/By: 611 Sec Page 2 for
. • Internet: www.tigard-or.gov MART)
�`� OF�g��1N® Notified/Method: I Supplemental information
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Mechanical permit fees`art based on the value of the work
❑New construct ion ZrAddit on/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
0 Demolition ❑Other: • mechanical materials,equipment,labor,overhead,and profit.
„a.p
yaert r,1I IYi,N y mm �e i1t(•ttc} ed f, Y Value $
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�,+ y v a , ow ,•.h�,.- .J, ,I. ,.' , J T"'-nry. L twc7} te+rOa.'
J ..and 2-family dwelling ❑Accessory building '
y g ❑Commercial/industrial
❑Multi-family' ❑Master builder For special Information use checklist.
❑Other Description ] Qty.T Ea. I Total
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Job site address: 1 X3'3 0 3V) 1\1\w-el; t 1 i•11 viz
Air conditioning
C? 1 (requires site plan showing placement) _ 46.75 _
City/State/ZIP: •• 1±AQrd • OR q 11^�LI Furnace 100 000 BTU(duots/vonts) 46.75
tc 4'o'-t Furnace 100,000+BTU(ducts/vents) 54,91
Suite/bldg./apt.no.: Project name: 1-In pump 61.06
Cross street/directions to job site: rDuct 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: Flue/vent for any of above 23.32.
Lot no.:
Other: • 23.32
Tax map/parcel no.: Other fuel appliances
'�,es• 1!T z:�' ��ye, ��r �.7 ,..1-,.-,, A ti•'.:��
Water heAter+ e ti: " ,1t, . P r .*.':. :.;,l� !tgi n %nr � ;.�:: 3as firoplace
23.32
33.39 •3e1
_ II AO. . . 0 P 1 ' 1... i ..P. .. • t .. Flue vent for wafer heater or gas
• fireplace 23.32
Log lightergas) 23.32
wood/pellet stove 33.39
Wood fireplace/insert 23.32
` y„ .,Lr,,; ,.';P3 iaf.�'.7,�U7 1$�„ i' i,fatr,+,,i:r s .y,:r,�/(1' r.;:y.v:.,., Chimney/liner/flue/vent 23.32
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�/ "<<� .- Other: _ 23.32
Nye' K Q\) 1 ;p 1 , Environmental exhaust and ventilation
Address: TI ' Range hood/other kitchen
r. r V i t e xi . I ,esuipment 33.39
City/State/ZIP: ` `{ 0 12 0 7 Clothes dryer exhaust 3339
Single-duct exhaust(bathrooms,
Phone: + Fax:
( ) toilet companments,utility rooms) 23,32
N, i, �,,`ty1,1 yir� . lr°O: 'r: ',?1}.yi,„�/g t�v'S`r fis t 5;;;',I,;.'14(.47:9.g; iS 1N4yiw *s iy ' Attic/crawlspace fans 23.32
Business name: L .N Other; 23.32
�1 ��'�!(�Q ��5[ Fuel piping
Contact name: poi,h 51415 for first four;54.03 for each additional
-
Address: • • S . A 1,00 r , /
Furnace,etc.
• i 0i Gas heat pump
City/State/ZIP: / • 7 Wall/suspended/unit heater•
Phone:J 2) a tJ ' Fax:: Water heater•.� CJ UJ mu .r r Its) • - r
\Q� E-mail: „ l Fireplace I 1N,15'
RanZe
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ittl;.,,t,,V:'.Yi'•,�_. :,l(F`i'A,� s ':a,t9.::1':tzrr,_,74,,1,:': ,,: .'.1'� ,..,;. );;1., ;i:,. "rot hi!• ,. ,,-"...r:: - Barbecue
Business name: Clothes dryer(gas)
Address: Other
5 CSQ Q S Q 11 'gA9[E (',;M04ai'•°1•s:. ?,.
City/State/ZIP: �t ;�;�
_ Subtotal
Phone:( ) Fax ( ) minimum permit fee($90.00) 10-cam
Plan review(25%of permit fee)
CCB tic.; 4,I Q State surcharge(12%of permit fee) 040
l 1 'T'OT'AL PERMIT FEE. 104-so
This rmita application ex p
Authorized signature: plugs"
Oe Pp Aires If a permit i,not obtained within 180
` 'f days after it has been accepted NS complete.
Print name: 1 ii i ._ Far t Y. Date: I t Ally ' l ee methodology set by Tn-County Building Industry Service Board
I:1 Buitdinglpermit9lMaC-PernitApp.doc 1W01109 4404617T(11,03/CO1,41WE6)