Permit CITY OF TIGARD
N WT MECHANICAL PERMIT
�' COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00137
'' DATE ISSUED: 3/18/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S102AB -00912
SITE ADDRESS: 12125 SW 92ND AVE ZONING: R -7
SUBDIVISION: KIMBERLY ADDITION LOT: 012 JURISDICTION: TIG
PROJECT: LAWSON
Project Description: Installing fireplace and gas line to fireplace.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
RICK LAWSON Description Date Amount
12125 SW 92ND AVE
TIGARD, OR 97223 [MECH] Permit Fee 31181200E $72.50
[TAX] 12% State Surch 3/18/200E $8.70
Total $81.20
Phone: 503 -968 -9048
Contractor:
FIRESIDE DISTRIBUTORS
18389 SW BOONES FERRY RD
PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 595 -3726
FAX 503 -620 -5699
Reg #: LIC 40979
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. 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 than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: � " � Permittee Signature: / U)01/l./
Call 503.639.4175 by 7:00 a.m. for inspections that business ay.
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.
• 03/17/2008 10:42 5036205699 FIRESIDE DISTRIBUTOR PAGE 02
Mechanical Permit A li cEivED �eC FOR OFFICE USE ONI,y
Dodgy: • it No.: 1/11,C . ,(j $ r•-. 00 r 3 7
City of Tigard Rec . a yl�l
I . 13125 SW Mall Blvd., Tigard, OR 9722iA A 1 7 1 008 Plan Review Other Permit:
Phone: 503.639.4171 Fax: 503.598,1 Date/By:
Inspection Line: 503,639.4175 CITY OF T OA?D Date Ready/By; tuna: ® See Page 2 for
T t C; A R D NotWiiod/Mcihod: Supplemental information
Internet: www,ti);ard- or,gov BUILDINGiDIVISION
.. 4,, cr , .....�Irip r 11 � ... .. 1 ,r... p .,.,� :, nl,g w 19iirill I ltl' ,,,,,, 111 ') ' {iIiliJl !lfllii' ��? I B11 nr , L 1 1 I b l ' W u s +, mr „ V IINO U i!..w' }y��l
' I ,lUl . lll , 11111 1 ,, litllll r i 1t31�11 1 pr WY V I ,.. �11�,1iiiIIiIIUifdlll �,,,, I..,tll'' < ,Il r,hll., ,, ,f . � . t .i ..,, tl ,,, „ „„ I „ ri l �llu W ,r . .,„n, >�
e 1 ;,L�. I�,i,l, � . LLI 1111un „ , , r,illL , . Mechanical permit fees* arc based on the value o t he work
❑ Now construction 0 Addition /alteration /replacement performed, Indicate the value (rounded to the nearest dollar) of all
❑ Other; mechanical materials, h overhead, p profit.
DemoDemolition mec 1 equipment labor, and r
ue.
� t , , „, I p °IO n r ' 1;. Val $ ) j q
W a I I' II Ifl,Ir• „u, i s ii Ili
i, ¢iy6 141 I it {11+ .ifp I iN ' ' w . i �I W,. 4 ., ��I�i�II�IIII I I I�II�I) Ei r { I I I iI f Illllll I .I i r ..
' ,I II „ lU,+. l„ . l
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E i- and 2- family dwelling ❑ Commercial /industrial El Accessory building For .special information use checklist,
❑ Multi {amity
Master builder ❑ Other: Description Qty. Ea. Total
1717.77W' ,1 r ;I I' ° "'ilp I {u�tt� yI II I I i L Il, :,ilf 1,,i. i,j0J„,�..,, ll0illi Iieatin• /coolin
l lit II' I fi iIV�W I 1 „ol m Lrr lu,:r n11., Irp'=,• .r„ ti jWd yd+ „ d +,
,ti... I Ill.,
� I II I �; ,, +,� � + � J Air conditioning ” ng or heat pump
Job site address: * r 5•u) 1 � A u - re aired i t i nin o 14.00
City/State/ZIP:
�- 1 Q l DR Q 9 3 Fumace 100,000 BTU dncts /vcnt,$) 14.00
Furnace 100.000 ETU (dads/vents) 17.90
Suite/bldg. /apt. no.: Project name:
G d t t /SUt(. — Gas heat pump 14,00
Duct work 10.00
Cross strect/directions to job site: I1 dronic hot waters stem — 14.00
Residential boiler (radiator or
hydronic) _ 14.00
Unit heaters (fuel -type, not electric)
in -wall, in -duct, suspended, etc. 14.00
Flue/vent for any of above 6.80
Subdivision: l Lot no.: Other; _ 10.00
Tax map /pared no Other fud a ..ltances
IIII :t,. r 1 10.00
m ' Ir ur u +r Ilii 1.101 r 1 m I I 1 � '.Igl{I
,ill11 llil jllll l {�I llli I1' Waterheator
” , ::�,'ll III lit V 11'il:r /�i i'h,in � 1111 �!1j 1'0001i `1Ni�t9!d, iJ„>,t 'I ,0f l I�I� 1!II?Ilill{ . �4irui :, II I cos 'ere a taco 10.00 lLck)
�� U J P _ Fluc vent for water heater or gas
fire. lacc 10.00
- Log litter (Ras) 10.00
Wood/ ellet stove 10.00
Wood fire lace/insert 10.00
• Chimney/liner/flue/vent 10,00
+' lil i 1 lI I i ti ',j V `I1 d�t , lJrl'1 1 �i i : l.liwi lf k st { l� i piii 1 ;i llt jl � ll igi ; jt Other; 10.00
Name: [l,K _ Environmental exhaust. and ventilation
1_ ���1 /� — Range hood/other kitchen
Address: - r rj , .4 a.� k , 1 equipment II t0.00
Clothes d er exhaust 10.00
City /State /ZTP:7C\cJ'�1 .0 ! • r Cl -duct exhaust (bolhrooms.
Phone (512 ) • ► rik 1 j Fax: ( )
toilet com artments, utili rooms 6.80
, � , y � i � 1 p tl , I \ 1 flh iltiw a p1: n I •' 1•dylal:gf' ; Atticicrewlspaccfons 10.00
iisrrif I II 1111 r,q j;tvisto k 1 ;`i�li 1 I. �., i t j ;- I °r di., .j ,.I). 1,.
I� 1.,1 J r {I : •
,' : �I'' ,rda,rn „udwo,,, lIl J ii,ll, r I • Iii „,rvp,ii,i1.1))it i � t Nu1'.:li : 10 00
O
Business name: 1'�1 re, is Th bki n _ Fuel ' .in.
Contact name: Arn >, A $5.40 for first four; $1.00 for each addhlonat
"1 Furnace, etc.
Address: If ,-C d n t • ( • pi Gas heat .um.
City /State/ZIP: P • . R ' 2. Wal isus •cnded/unit heater M Mill
r� rr ^� n Water heater
Phone: (C3 Cr ✓ 1-0.4 Fax: 5 ` , .�• .. • t Fireplace S y v
E -mail: _Range .
1 r t u u 1 r j ` i 1, l
1 I I tiyt� p ��y r j. jtj .�,/ 11 f. I!IiH,!1 ,, .. 11 q il, ,,__ ih1hL'Ill Rarbccue � �MI
I,. E l { { G 11,11 1 '.. “ 41 l ll�l`'1 t ''-, �
. IiI VYW 1LIASJ?'� 11.1 i�lllll,IiEli.lr a )rt11+, t lk„ ; I .a
411j ,:.,, , r , i � r f {11it. -,. �.,„ , �. , Clothes d er • as
Business name: r l fp S I ci,e "D Q - 0ope�Q 0 Other:
n p 1f1111r1. iIIIII�il1G`' 0� `�•, I t# M i,t l`sl��jlll�liililioii +li+l'0 i
Address: u �. _V $6 i,i hll a Uttu .�t+
— Subtotal
City/State/ZIP: Minimum permit fee ($72.50)
!Pill
Phone, ( ) Fax: ( ) _ Plan review (25% of permit fee)
Staac surcharge (12% of permit fee)
CCB tic,: �� .r- -- TOTAL PERMIT PEE - J -
This permit application cnpirer if a permit is not obtained within 1841
Authorized signature: ` lb 0.01 r .. days after if hn been accepted no complete.
: �M � DntC:
Print name _- 0 5 - Fa methodology set by Tri County Bedding Industry Service Board
• � , f w , rt
4: 1IIuildinq \Permlta \MEC.PermilAap.dne 01/19/07 440.4617T(11M2/C0M/WER)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: IVIEC2008.00137
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3,
Phone: (503) 639 - 4171 Al l t
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 4/11/2008 TIME: 7.01AM PAGE: 22
SITE ADDRESS: 12125 SW 92ND AVE CLASS OF WORK:
SUBDIVISION: KIMF3EF LY ADDITION LOT #: 012 TYPE OF USE:
PROJECT NAME: L.•Ai'YSON
DESCRIPTION: Installing fireplace and gas line to fireplace.
OWNER: LAWSON, RICK PHONE #: 5039 €&9Ck18
CONTRACTOR: FIRESIDE DIS:TRIB(JTOR ; PHONE #: f 03',f3( 3716
Inspection Request Scheduled For: Date: .1/11/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
659 Meclhanical find 068230 -01 971 -235- 0489 Y
Corrections /Comments /Instructions:
TH-s pi PARTIAL APPROVAL ❑ CANCEL I I NO ACCESS
FAIL ri CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: 4 —6 8 Phone #: (503) 718- 2
d
CITY Of T,IGI RD
BUILDING DIVISION PERMIT #: MMMEC2008.00137
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/18/2008
Phone: (503) 639 -4171 , , P I C I
Inspection Requests (24 Hrs.): (503) 639 -4175 . °_ _
INSPECTION WORKSHEET FOR DATE: 3/21/2008 TIME: 7:01AM PAGE: 45
SITE ADDRESS: 12125 SW 92ND AVE CLASS OF WORK:
SUBDIVISION: KIMBERLY ADDITION LOT #: 012 TYPE OF USE:
PROJECT NAME: LAWSON
DESCRIPTION: Installing fireplace and cgas lime to fireplace.
OWNER: LAWSON, RICK PHONE #: 503 368 - 9048
CONTRACTOR: FIRESIDE DISTRIBUTORS PHONE #: 'w03- 59x..:~3726
Inspection Request Scheduled For: Date: 3/21/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
099 Mechanical final 067068 01 503.595 -3726 Y
corrections/Comments/Instructions:
- 4a ---- ,Otr i
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
J FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: g— 21 —",g Phone #: (503) 718-
CITY-VF TIGARD
BUILDING DIVISION PERMIT #: MEC;2002- 00137
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/11Y2008
Phone: (503) 639 -4171 kl
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/19/2008 TIME: 7:01AM PAGE: 18
SITE ADDRESS: 11125 SW 92ND AVE CLASS OF WORK:
SUBDIVISION: KIMBERLY ADDITION LOT #: 012 TYPE OF USE:
PROJECT NAME: I. AW3ON
DESCRIPTION: Installing fireplace and gas line to fireplace.
OWNER: LAM ON, RICK PHONE #: 603
CONTRACTOR: FIRESIDE DISTRIBUTORS PHONE #: ';03
Inspection Request Scheduled For: Date: 3/19 /2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 066960-01 197-1235048
5048 N
Corrections /Comments/ Instructions:
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL O ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: Phone #: (503) 718- Z /