Permit CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00490
D DATE ISSUED: 9/30/2008
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13125 SW Hall Blvd., Tigard, OR 97223.503.639.4171 PARCEL: 2S104CA - 07900
SITE ADDRESS: 13231 SW HILLSHIRE DR ZONING: R -
SUBDIVISION: HILLSHIRE • LOT: 079 JURISDICTION: TIG
PROJECT: RANDALL
Project Description: Install gas insert.
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: •
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: • <= 10000 cfm:
• > 10000 cfm: GAS OUTLETS:
Owner: FEES
MARSHA RANDALL Description Date Amount
13231 SW HILLSHIRE DR
PORTLAND, OR 97223 [MECH] Permit Fee 9/30/200€ $72.50
[TAX] 12% State Surchar 9/30/200E $8.70
Phone: 503 - 336 -0807
Total $81.20
Contractor: •
LUDEMAN'S FIREPLACE & PATIO
12675 SW BEAVERDAM RD
BEAVERTON, OR 97005 - 2129 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 646 -6409
FAX 503 -646 -8034
Reg #: LIC 51469
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 B jf ._..r.Py2.✓K 1 D Permittee Signature: tv--_ —
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
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.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: )-( 1-00g -CO 40 REQUIRED ON GREEN INSPECTION CARD.
•
✓. . Code I Inspection Description I PASS Date I By ✓ Code I Inspection Description • I PASS Date I By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure. grading /footing 125 Wall cover
210 Foundation walls • 130 Ceiling cover
215 Footing drain 135 Low voltage
- 220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural ❑ 150 Hot tub /spa /pool
230 Underfloor insulation • 195 Misc. inspection: •
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up - MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
/><"" 699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbing underslab
915 Fire alarm rough -in 310 Crawl drain
920 Suppression trip test 315 Post /beam plumbing
995 Misc. inspection:
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I: \Building \Forms \InspCard- AOP- Blank.doc 02/02/07
SEP.29.2008 3:45PM 101 0.091 .2/3
Mechanical Fer Mit Application
p..ci„d
-. City of TiJY,.ard DateBy, ot 4 PCMIII NO.7 ete ...a) V ..
' .
' 1 13125 SW I-Eall r, lvd., Tigard, OR 97RE CEIVED
ap Pim] Rcvi ®w Other Permit:
Phone! 503.63 Fax: 5n3.59X.1960 Daccay;
T1GA RD Inspection Line 503.6394175 `. - i 2 9 2008 Date Reititlyiy! Anis 0 Re Page 2 for ------
interim: worw. igard-or.gov Natificd/Methed: .---.6 Supplemental Informatton
6, a ARD _
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y ■ .. .;, 77.031-v , , ,,, ( l',,V
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raw ,, , i f - , 4100 lYi L F', q' • ' A , 14. ; 1 1 , , ., 6 4....w •
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41. .4141 B, ,Pq1 ' , ' 4 f
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Meehanieal permit fees" are based on the value of the work
0 New construction ' Kl Addition/alteration/replacement performed, Indicate the veld ,1 < I 1
c ,, roun_c_ .0 the neaest dear) of all
0 Demolition '. El Other: mechanical materials, equipment, labor, overheacl„and pro CI t.
I '41. ''', A "r' - V - AkiNIM $4 14flf,`1'.,Y7lti,"..051rrli Value: S
:,• tt. il:iiii:,,/,:.. ,,, 77,7 ..3 4 .,;; ;:A fra„ r; ygo,40,1,.4,,vtaA , 4 •4 i i,:,.•74,..4;i14■4,i,V,4 ., ' . , , '
ni ..41. A.L'Ai,,,J.7 , •
r4 1- and 2-family dwell g 0 Commercial/industrial 0 Accessory building
For special information use checklist.
Ej Multi-family 0 Master builder 0 Other: Description Qty Ea, I Total
•,
1 1-.:,
:;101K'011I*0414.iklig1,-)•--,-, n- -, i . 7 I F.14 ;1 ` , ,!,V , )6 !, ; . P, T`I T I' ' ...
■41i Avvii 1:1147/s' tW'1**,1:,.. ,,,,,, ,.„ ilutirwcooling
Air conditioning or heat pump
Job site address: /3,.. '; / ...„...5v rib 1 A/f 4 0 g , (tt plan show:unlace/mot) 14.00
City/State/ZIP: 1 •
T -- cl o X. 9_2&; 2) Furnace 100,000 BTU (duets/vents) 14.00 _
Furnace 100,000.1 BTU (chicts/v.nts) 17.90
Suitebldg./apti 110.: Project name: "eqeil,t • „.. / Gas heat pump 14.00
Cross streel/direetions 10 j0 site; Duet WOrk 10.00
L Hydrotne hot water system l q 00
Residential boiler (radiator or
z‘;L-oLli) 14.00
- Unit heaters (fue(-we, not electric),
-
in-wall, in•duct, supendcd, etc.' 7 1 4.00
Flue/vein for any of above IS,E0
Subdivision: I Lot no..
Other: L 10,00
Tax map/parcel no.: I Oilier fuel apeptnces 4
..` :. d, - ,i;' :a.,.. .1, 0 :14_2,":"2..1 . I: LI' ..k.' i'.1 1-1.!•■• Jk.,,. 11',1:7,.•g;;34n1:,,,,!'vi,77,77 Water heami. 10.00
, , "., 1 101.; '',i1 ',00 fa' 's .1 , 0 / 1 ' )41 !,4*M`ti..".‘ , !'!Pr''
(... P
... .. '-' ,,,' .. l'' '"- ' . "- " " '' ' ' - ''''' • . . ' Gas fireplace ..z/23,-re / 10,00 /0,40
- 22 6 --Z ..Se ' L-_,_,__ Flue vent fir water heater or gas
fireplace
- - Log lighter as 10.00
1 1
- WoOd/pellet stove III 10.00
Wood Fire )lace/Insert 10.00
'• •;.,,4i SIllitney/liner/flueivent / 10.00 /0.0
111111M0000t i!' .°.( ' 1 , 0, ' , ' 1,,,liii . '' s 1 : ■..N:All'i,:!11 , .0*,4707.RYi''. . 'ot Other; 10 00 ,
. j..., Ar Environmentri1 exhaust and ventilation
Name; id r At 63 • a _
Range hood/other kitchen
Address: /3 „p / , a el, ,p cd De esp..ipinent 10.00
1132:211MIL., Clothes Etter exhaust 10.00 -
Single-duct exhaust (bathrooms,
Phone: (545 . ' ad 0 Fax: ( ) toilet compartments, utili rooms) 6.80
/ •, , ,,/,:•r t . , •,,i , , t, :,;..;ii for4i ,itt, 04
„:, E t60,Ato, Attickraw1s•ace fens
1 ",' ;11 ', f;:,,..,. ,, , ,, ,,,, ,,, , , , . .. ,
i. N. , IC Nt f . .• 1 r ... , , 1 \ •...■, ../ '; N.. r . (0.00
(Dther: 10.00
13usiness
name: , ir) 0 ______ Fuel piping
Contact naine: * 1. 4, c jec Alli? S5.40 for first four; $1-00 for oath additional
Furnace, etc. i
Adci : - LS e • 0 R . Gas heat purnp -. -
City/State/ZIP; p, a :..ijer__61_1_, 9' 7oc15 wol/sysperidcdiunit heater _
Phone:454.$) a v4, eovo ? Fax; ; (so 6, ye, . eptL.37' Water heater
-
Fireplace
---
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Z-Illail: I o ni A d oi , emdm $ . • Ad ,, ,,„,„:, ,, Range
`1 .•'l, c ',",. ',.'i l;' 1;: .: , :l' I /: , [ , iill r ;:: 1 1:fi'ci;;:ti Barbecue
. -
-
Clothes dryer (as)
Business na•Jtc: '_____
Other: I
Address: L . Sig,ratt ' L '' ' .1 : '
ti:• ,i , .•,I• .i.,,._
Ci iyiState/ZIP: 1
, Subtotal i261, er, .1
Phone: ( ) Minimum permit fee (S72.50) '75 I
I Fax: ( ) _
Plan review (25% of permit fee)
-
LCCB lie.: .5 . State surcharge (12% of permit fee) "3-176c
TOTAL PERMIT FEE
prmit no
e plention i expire mit 9 if a per is not obtatnwithin ed wi 180
Authorized signature. Th13 na3,•.9 Ow it hue been accepted ar en m p it le •
Print nainC * ' $44 e.ire #( i IP / Date4' ,- OF w f iteutcdoiogy set by 'NA:0111;v DI/ging Industry Service Bo '
om
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