Permit ,111 C
ITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00066
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/6/2008
PARCEL: 1 S125DA -08000
SITE ADDRESS: 09115 SW 69TH AVE ZONING: R-4.5
SUBDIVISION: KINGS VIEW LOT: 073 JURISDICTION: TIG
PROJECT: KELLY
Project Description: installing pellet insert in 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:
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
KELLY KELLAY Description Date Amount
BARBARA D
9115 SW 69TH [MECH] Permit Fee 2/6/2008 $72.50
TIGARD, OR 97223 [TAX] 12% State Surch 2/6/2008 $8.70
Total $81.20
Phone: 503- 245 -3945
Contractor:
•
PELLET STOVES SOUTH
21553 S HWY 213
PO BOX 1717 REQUIRED ITEMS AND REPORTS
OREGON CITY, OR 97045
Contact #: PRI 503- 252 -9606
FAX 503- 252 -3987
Reg #: LIC 46433
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:
Call 503.63 . 175 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.
Feb 05 08 Pellet Stoves 5032523987 p.1
Mechanical Permit Apo - (.,.,, EJED , R2 ( (, : , ,r 1_,
City of Tigard DriEl Received P ermit r o.:
d, Tigard, OR 97�B 6 t U� t>at 71� /' C , - • ,,
• 13125 SW Hall Blvd.,
503.639.4171 Fax: 503.598.1 faro Bavicw
- : ; taspectionline: 503.639.4175 CI X r I Date Ready/By: Antic lif See owl ;c
moot: d.e 2 for
www.tigargw. BUILDINGDI�fISION Notified/Method: nt atInformation
TYPE OF WOI1K : COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
0 New construction XAddition/aR ation/repEeement Mechanical permit fees* are based on me value of the work
Demolition ❑ Other: per. Indicate the value (rounded to the nearest dollar) ofsQ
medonicat materials, equipment, labor, overhead, card profit
CATEGORY OF CONS1RUC11ON t g Gq o
Ue '
41 and 2 - family dwelling ❑ Commercial industrial ❑ Accessory building BF.9>D10V71A[ EQUIPMENT /SYSTEMS FEES
❑ Multi - family ❑ Master builder ❑ Other: For special ` Q use cheddia
Description j Qty. 1 Ea. I Total
JOE'SrIE
DEFORMATION AND I;ocArttox . 'leafing/thaw
kb site address: cZt , ` C (k) k4 R
„A Air condition,* or heat pomp
Graces site plan stamina Mammon) 14.00
City/State/ZFP: '2 Furnace 100,000 BTU (docts/veob) 14.00
ct�A 9,./C) X12 � �� Furnace 100,00(+ BTU(dactr/yews) 17.90
SoitelbldgJapt. no.: I Project name: Kia__A 1 i
Gas heat pomp 14.00
Cross street/directions to job site: Duct work _ 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (&nl -type, not electric),
in -wall, in-dud, suspended, etc. 10.00
Fluelvent for any of above 10.00
Subdivision: I Lot Other. 10.00
Tax map/parcel no.: Other fad appliances
DESCRIPTION OF WORK
�-A.� ater heater 10.00
9 , ��� s)ak .‘,...„ , .14N - t'.►. r ' 2 Fire vent for water heater or gas 10.00
fireplace 10.00 _
Log lighter (gas) 10.00
Wood/pellet stove 10.00 /C.0(0
Wood fireplace/insert 10.00 . :,,,
HOPERTY.'OWNER :..: 0 TENANT . ...
C>
lliner/flue/vent 1000
Other: 10.00
Name: ( S 4 4 ,1l Enviloomeatal exhaust and ventilation
Address - k t S W in -13- equ hood/other u:rohm 10.00
City/State/ZIP: 7 t ��.� Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms, P� ( ./ 0. a 4 — 39 (J Fax ( ) toils campattments, utility rooms) _ 6.80
ta APPLICANT : ' 0 CONTACT PERSOT1 Atticklawlspae fans 10.00
Outer 10.00
Business name: ? A 5 7 6 4 / a SIAS Feel Wiring
Contact name: t 4a 4u, O re._ N 0 (x_. mein $5.40 for Brat four, SS1.00 for each additional
Address: �; -- Po r T il lA 111 � `t pump
City/StardZ1P: a--) RA (i U N c.. - t -- u (2-- C ( -- 7 Q cF j Wan/suspended/unit heater
Phone' .(56 ) P — 9 I O , e 7 I F 643) a 'q$ r`j W ataheater
E - mail:
Winne
CONPRACPOR . Barbeate
Busing name: , Clothes dryer (Ras)
other:
Address: � � - MECHANICAL PF.ltitOT FEES*
City /State/ZIP: Subtotal /6.0 (}
Phone: ( ) I Fax ( ) Merimura permit fee (57250) r14 57)
l � � - Plan review (25%ofpermit fee)
CCB Zia: '- L l 3 g Stare surcharge (12% ofpetmit fee) Q. 9 (
-,_ L TOTAL PERMIT FEE R a
'� -- - -� --- , This permit apptleatioo expires R per
a mit's not obtained vriftm 180.
Authorized • • ' - ;N___._- - h drys atter it ms been accepted as complete
I Print name: N P`m i-� - ' -� 1 a_ -o g • Fee adh odobgy set by Tft•Coumy Banding Industry Semin Hoard
k O4 6N6 4404617f (IUO2/001411/WE8)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008 -00066
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 216/2008
Phone: (503) 639 -4171 I
7�� pfjlj' 'i
Inspection Requests (24 Hrs.): (503) 639 -4175 "'I�� iC /
INSPECTION WORKSHEET FOR DATE: 6/17/2008 TIME: 7:OOAM PAGE: 44
SITE ADDRESS: 09115 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: KINGS VIEW LOT #: 073 TYPE OF USE:
PROJECT NAME: KELLAY
DESCRIPTION: installing pellet insert in fireplace
OWNER: KEI..LAY, KELLY PHONE #: 503 - 245 -3945
CONTRACTOR: PELLET STOVES SOUTH PHONE #: 503- 252 -9606
Inspection Request Scheduled For: Date: 6/17/2000 Pour Time:
Code # pection Description Confirm # Contact # Message
.699 Mechanical final . 071447 -01 503-245 -3945 N
Correctionsrentsiinstruct ions 1 �/0 r /
-rte � , ) ..
1
....,
_ _ _
/ , „--
•
[ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: k � i� G / � _ Date: `" /� / 4 Phone #: (503) Z-'9 Insp ( ) 718 -
111111111GARD -
• ::'__ . D IVISION PERMIT #: MFC20O8-Of 066
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/6/20013 --
Phone: (503) 639 -4171 to
Inspection Requests (24 Hrs.): (503) 639 -4175 „_,1511- °'! �
INSPECTION WORKSHEET FOR DATE: 2/14 /20013 TIME: 7:01AM PAGE: 22
SITE ADDRESS: 091 SW 69TH AVE CLASS OF WORK:
SUBDIVISION: KINGS VIEW LOT #: 073 TYPE OF USE:
PROJECT NAME: KELLY
DESCRIPTION: installing pellet insert in fireplace
OWNER: KEI..I.AY, KELLY PHONE #: 503-245.3945
CONTRACTOR: PELLET STOVES SOUTH PHONE #: 503- 252 -9606
Inspection Request Scheduled For: Date: ?/14/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 065027 -01 503245 -3945 Y
Corrections/Comments/Instructions:
07 i Al f .i 1 . au. - /icy -.. —.es . i/ ,! A4.. 'i i - ..
❑ PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: -2 --64 o sr Phone #: (503) 718- 244-0