Permit %-ft-o4rCITY OF TIGARD MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT Permit#: MEC2015-00810
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 12/02/2015
A Parcel: 2S111BC01700
Jurisdiction: Tigard
Site address: 10265 SW VIEW TER
Project: Stack Subdivision: GREENBRIER Lot: 1
Project Description: Replace wood stove insert with gas fireplace insert,including chimney liner and vent.
Contractor: RICK STICKA LLC Owner: STACK REVOCABLE TRUST
686 S 25TH CT BY STACK, RICHARD W& JUDITH C
CORNELIUS, OR 97113 10265 SW VIEW TER
TIGARD, OR 97224
PHONE: 503-680-1046 PHONE:
FAX:
FEES
Specifics: Description Date Amount
Gas Fireplace 12/02/2015 $33.39
Type of Use: SF Chimney/Liner/Flue/Vent 12/02/2015 $23.32
Class of Work: ALT Type of Const: Fuel Piping 12/02/2015 $14.15
Occupancy Grp: 12%State Surcharge-Mechanical 12/02/2015 $10.80
Stories: Minimum Fee Adjustment-Mechanical 12/02/2015 $19.14
Fuel
Fuel Types
Gas Pressure:
Total $100.80
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain a copy of the rules
or direct qu- ..es to OUNC by calling 503.232.1987 or 1.800.332.2344.
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Issued By: diro Permittee Signature: -
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applicata i, 4VE FOR OFFICE USE ONLY
City of Tigardii t, `IL
�""� � Received ,��tw
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`f g Date/By: I �5 j Permit No.:MrLWv/Sy� 9td
13125 SW Hall Blvd.,Tigard,OR 97223 Plan Review
Phone: 503.718.2439 Fax: 503.598.1960 D F r O)5 Date/By: Other Permit:
TIGARD Inspection Line: 503.639.4175 Date Ready/By: Juris I ® See Page 2 for
Internet: www.tigard-or.gov Notified/Method: I Supplemental Information
CITY Of A HggtAKggD 1
TYPE,OFlalI�t�v�Ip���9�)` COMMERCIAL FEE* SCHEDULE USE CHECKLIST
Mechanical permit fees*are based on the value of the work
❑New construction ❑Addition/alteration/replacement performed.Indicate the value(rounded to the nearest dollar)of all
❑ Demolition ❑Other: mechanical materials,equipment,labor,overhead,and profit.
Value:$
CATEGORY OF CONSTRUCTION RESIDENTIAL EQUIPMENT/SYSTEMS FEES*
❑ I-and 2-family dwelling ❑Commercial/industrial ❑Accessory building For special information use checklist.
❑ Multi-family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB SITE--INFORMATION AND LOCATION • Heating/cooling:
Air conditioning 46.75
Job site address: 10265 SW View Terrace Furnace 100,000 BTU(ducts/vents) 46.75
City/State/ZIP:Tigard,OR 97224 Furnace 100,000+BTU(ducts/vents) 54.91
Heat pump 61.06
Suite/bldg./apt.no.: Project name:Gas Fireplace Insert Duct work 23.32
Cross street/directions to job site:103rd 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
Flue/vent for any of above 23.32
Subdivision:Greenbrier Lot no.: I Other: 23.32
Other fuel appliances:
Tax map/parcel no.:2S111BC Water heater 23.32
DESCRIPTION OF WORK Gas fireplace/insert I 33.39 33.39
Flue vent for water heater or gas
Replace wood stove insert with Gas fireplace insert fireplace 23.32
including chimney liner and vent. Log lighter(gas) 23.32
Wood/pellet stove 33.39
Wood fireplace/insert 23.32
Chimney/liner/flue/vent I 23.32 23.32
® PROPERTY-OWNER ' 0 TENANT Other: 23.32
Environmental exhaust and ventilation:
Name: Richard Stack Range hood/other kitchen
equipment 33.39
Address: 10265 SW View Terrace Clothes dryer exhaust 33.39
City/State/ZIP:Tigard,OR 97224 Single-duct exhaust(bathrooms,
toilet compartments,utility rooms) 23.32
Phone:(503)639-4537 Fax:( ) Attic/crawlspace fans 23.32
0 APPLICANT- 0 CONTACT PERSON Other: 23.32
Fuel piping:
Business name:
$14.15 for first four;$4.03 for each additional
Contact name: Furnace,etc.
Address: Gas heat pump
Wall/suspended/unit heater
City/State/ZIP: Water heater
Phone:( ) Fax: :( ) Fireplace I 14.15 14.15
Range
E-mail:
Barbecue
. . CONTRACTOR. . • Clothes dryer(gas)
Business name �rl e �ft L�C Other.
C
' MECHANICAL_PERMIT FEES*
Address: Subtotal 70.86
City/State/ZIP: Minimum permit fee($90.00) 90.00
Plan review(25%of permit fee) 43:59•
Phone:( ) Fax:( ) State surcharge(12%of permit fee) 10.80
CCB lie.: L o 4245-9 TOTAL PERMIT FEE 14 r
.� This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Authorized signature: x 1 * Fee methodology set by Tri-County Building Industry Service Board
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Print name: ti /a�,( p S' A Date: le /217/,/t' /� ,te
1:\Buildingwermits C_PermitApp_040113.doc 440-4617T(111/02/COM/WEB)
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
10265 SW VIEW TER, TIGARD, OR, 97224
Residential - Mechanical
699 Mechanical final
PASS - No C of O
MEC2015-00810
David Young
Violation Summary:
Inspector Contractor