Permit III 41 CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00533
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/6/2007
PARCEL: 1 S135AA -90010
SITE ADDRESS: 10319 SW 87TH AVE ZONING: R -12
SUBDIVISION: THE DEODAR CONDOMINIUMS LOT: 010 JURISDICTION: TIG
PROJECT: FLETCHER
Project Description: Install pellet stove.
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: 1
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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS:
Owner: FEES
FLETCHER, MARY K Description Date Amount
16388 SW ESTURARY #101
BEAVERTON, OR 97006 [MECH] Permit Fee 9/6/2007 $72.50
[TAX] 8% State Surcha 9/6/2007 $5.80
Phone: Total $78.30
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.
Issu = / Permittee Si nature: „i_ c
Call 503.639.4175 by 7:00 a.m. for inspections that business day I
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.
SEP. 5.2007 5 :02PM 0.107 - .2/B
iv ehanical Permit Applica h 1O►. 011 t(i t ,1. u l_1
City of Tigard le '
Received /f 0 Ida
13125 SW Hall Blvd., Tigard, OR 97223 REt I ► l Ai • Date/Br la i _ 1 .'� Plea Review other permit: v Phone: 503,639.4171 Fax: 503.598.1960 � �1 ■ •.,.a. Dete/0y:
inspection Line: 503.639.4175 SE ' I 1 6 Z 0. ,� 1 J. I I , Date Ready/By. � Ea See Page 2 for
Internet www.ei.dgerd.or.us Notified/MeMod. Snpplemfu „I information
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'
:Y4'1142 " :' ll�.RSlt. i` COM MERCIAL FEE* SCHEDULE - USE CHECKLIST replacement Mceiha pe rmit fees" are based on the value of the work
❑ New construction Add itional • i performed, Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: 1 mechanical materials, equipment, tabor, overhead, and profit.
Value: $
CATEGORY OF Mg: UCTION RESIDENTIAL EQUIPMENT / SYSTEMS EMS FEES*
- an d 2- family dwelling [] Cnmtnetc': . , 'al ❑ Accessory building
For special information use checklist.
0 Multi- family 0 Master buil , ❑ Other. Description — I Qty. J Es. I Total
JOB SITE 11YFORMATI i r LOCATION Hcatia' coonn:
Air conditioning or heat pump
Job site address: /0 3 / 9 _` 7 7 t. /5 t _ Lreyui,e site pins showing placement) 14.00
City/Statc/ZIP: /�ns�� � i ` G 7 a Furnace 100.000 BTU (duets/vents) 14.00
! Furnace 100,000+ BTU (duets/ventsl 17 -90
Suite/bldg. /apt. no.: I. j • et name: // e. 7eC f j e / l _ Gas heat pump 14.00 ,
Cross street/directions to job site: Duct work _ 14.00
Hydronic hot water system _ 14.00
Residential boiler (radiator or
hydronic) L4.00
. Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
"— Flue/vent far any of above 10,00
Subdivision: ° Other: _ 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTIO • I ORK Water heater 10.00
Gas fireplace 10,00
^ -- /) P J/ 7 4 �, 7t v e Flue vent for water heater or gal
fireplace 10.00
_ - Log lighter (gassy _ 10.00
Wood/pellet stove / 10.00 , /e7.60
Wood fireplace/insert 10.00
Chimney/linarlflueMmt T 10:00 /Q. o O
PROPERTY OWNER I ❑ TENANT _ Other: 10.00
-- ) - near. _
Name: / 1 �� ' .1 r C. Environmental exhaust and ventilation
1 Rnnge hood /other kitchen
Address: - _ ' ` equipment 10.00
Ciry /SteteiZ P: /� Q ir 9 7 a a '3 Clothes dryer exhaust L 0.00
Single-duct exhaust (bathrooms,
Phone: (503 «5a- Q 90 ( ) toilet compartments, utility rooms) 1
q APPLICANT ❑ CONTACT PERSON Anicicrawlspacc fans 10.00
Other. 10,00
Business name: go.r.Pc ,»o n . III _, Fuel .i , iu:
Contact name: e , c N_� JC - S5,40 for Brat four: 51,00 for each additiona
Furnace, etc.
Address: / 7 0 +5e ( ) 43 : , „A R...12 _ Gas Ilea[ pump —
City /State/Zl33 e rlt r 71p/) / a, I' 7C14:74.5" Wall/suspended/unit heater Water Phone: (�C 3) 6 V6, - 605 ' : ( 43) C0- - ,C=1.3 Fireplace a
-mail: Range _
CONTRA 1 < Barbecue _
Clothes dryer/gas)
Business name: Q5",:9, 1r1 42_ Other:
Address: MECIIANICAL PERMIT FEES* _
I Subtotal , cal 0 , 0 G
Phone tate/ZIP: _ Minimum permit tee ($72.50) 7 , 2,
Phone: ( ) I I • ( ) _ Plan review (25% of permit fee) ■
CCB lie.: iy ?+ O � �� j 'er i _ State surcharge (8% of permit fcc) ,5"
TOTAL PERMIT FEE 7� 30
`
J Th is pe rmit appttcation expires if a permit is net ermined within ISO
Authorized signature: doya after it ha', been accepted ee eomptete•
Print name,..., 9V j c. Al` , l , I elate: 91 . 6". Q 7 ` s Pee methodology set by aunty Building lnduetry Service Board
I
CITY OF TIGARD
BUILDING DIVISION 44 PERMIT #: EC2007 -00 3
13125 SW Hall Blvd., Tigard, OR 97223 (L DATE ISSUED:
91:x91E12001 9 ,
Phone: (503) 639 -4171 . � r /ei T
i�'>
Inspection Requests (24 Hrs.): (503) 639 -4175 __
INSPECTION WORKSHEET FOR DATE: 10/5007 TIME: 7:01AM PAGE: 54
SITE ADDRESS: 10319 SW 87TH AVE CLASS OF WORK:
SUBDIVISION: THE DEODAR CONDOMINIUMS LOT #: 010 TYPE OF USE:
PROJECT NAME: FLETCHER
DESCRIPTION: Install pellet stove.
OWNER: FLETCHER, MARY K, PHONE #:
CONTRACTOR: LUDEMAN'S FIREPLACE & PATIO PHONE #: 503
Inspection Request Scheduled For: Date: 10/512007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 05700301 5031152 -2590 N
Corrections /Comments /Instructions:
, C
U )—ji iii
1 )-3.---)/ 1'
SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: V< -- Date: 1 A/0---7
0---7 Phone #: (503) 718- ___