Permit -- 3 C IT OF TIGARD MECHANICAL PERMIT
'I : COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00242
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 5/14/2008
PARCEL: 2S 111 AC -05400
SITE ADDRESS: 14880 SW 92ND AVE ZONING: R - 4.5
SUBDIVISION: LAUNALYNDA PARK LOT: 022 JURISDICTION: TIG
PROJECT: BARTLETT
Project Description: Install gas line and logs.
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:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
JOHN BARTLETT Description Date Amount
14880 SW 92ND
TIGARD, OR 97224 [MECH] Permit Fee 5/14/200E $72.50
[TAX] 12% State Surchai 5/14/200E $8.70
Total $81.20
Phone: 503 620 - 0579 .
Contractor:
FIRESIDE DISTRIBUTORS
18389 SW BOON ES 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 Muniapal 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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
Issued B
•
/1/ / Permittee Si � ' 1
Call 503.639.4175 by 7:00 a.m. for inspections th .. •usiness day.
This permit card shall be kept in a conspicuous place on the • • site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
05/13/2008 09:55 5036205699 FIRESIDE DISTRIBUTOR PAGE 02
; Mechanical Pe-mit Application
City of Tigard FOR c>�'1'Ic:E tasE �avl,1
l Received „. 13125 5W Hall �Ivd„ Tigard, patclg s fel (16 /9 Permit No,; , rib �� 2,
Phone: 503,639.4171 .Fax: 03.598.1 3 1' :�� 1t'` r y'
1 I. vI R CV i eN •
Ts G A R D inspection line: 503.[,39,4[ 75 BY; Other Permit!
Internet: w.yly.t;gard- or.gov Date Re,d B
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MAY 13 2 , ti ,•ic tI1 d. —
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[] New construction �'�� � .�'� „, :;ell ��'� t;: ,,y,..1,1)..1,11:,1,.),);.,:.1, �nl��� q s . p !: �,,,. ill a ��' e. ' �� � pi "' , , � t, I nl , dd, [] Addition /altcratiion /r Mechanical permit fees* are based on the i v al ue o f t �rk
performed. Indicate the value (rounded to the `e lil
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Other; C crest dollar)
` iR ^,�) , �', 1 ` , !r •�1Fiil 'i!; i its fEllll ?I �{ l 1 '�'i� l i I I r mechanical materials er ea profit,
, 111
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a ',)45V 13 0 ui meat, tabor, overhead, and refit,
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e� I- anrl2 - familydwclfin i�d1�gL1J • . 1 ( . a l a �, fb ! {III'+�Iu „illllqu Value: $
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Multi- fRmify ' �,., . VIII {
0 M aster builder 0 Other:
For special information use
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Job site address: ...,� , • • lnR/eooUn
" =j r Air conditioning or heat pump _ '
City /State /ZIP: p l_I� ��,�J I _ • (requires site plan showin .'seamen[ 14.00
Pc, Ti l.} Furnace 100.000 BTU ducts /vents} 14.00
Suite/bidg. /apt, no ": Project name: Furnace 100,000 ✓ >3TU (ducrstuente) 17.90
0
Cross street/directions to job site; — Gasheatpunip 14,00
Duct work ~ ~_ 10.00
1[ dronie hot water s stein 14,00
Residential boiler (radiator or —
_ hydronic ) 14,00
_
Unit heaters (fuel -type, not electric),
in -wall, in -due suspendcd, etc. 14,00
Subdivision: -" Flue/vent of above
{lot no.: any b.80
Tax map/parcel no.: Other; 10 00 -
i . , rrnglii!lilpl'I..qrl! , I ,., r r !!!u • pla't�yj Other fliel appliances j !1 ill I , ; ii�;�. , q � !lances
l�si r r „ I I,li II . �I!if!ill I ,,,f�i yyly�0y ( Y0 I ulnq,y :ii ,r I 1 I u r . PP
IfVlV�� �I�, yy�p� ! 11 il,l ! Eti.1�1. r7jl I 11: •� 1 -
, : 5 �il ,E11iid11111u ;i 1 ,", l ; Water heater
il M.... .► t ` , I. Gas fireplace — - � 10.00
Flue vent for ,eater heat ar gas 10,00
fireplace
10.00
- i,,og ligMe gas) ( 10.00
— stove 10,00
:, !;!,' ;' pp ll i �y�j�q� �,� Wood fire IACe /laser[ 10.00
�,,,• ?:4fu.;l , iq ��,cl[ �iec!'i�'Y 3fIlV,�, �I11!�!i`rlll
Pl(GI lu ' iq 1 ?'IU PI llL „ . , .. II
i 1 +: fl I t ! I ! II I : • , 1 ,(1 ;, !Ili l�iimi,i!l i ? I., I, dll� li`i'11! j ``,1ii N, III I',f'il, Chimn /liner/flue/vent
Name: !Ai
10.00
l' Oilier:
10.00
Address: ..__ �, � Environmental exhaust and ventilation
T`�_ �. n e Range hood /other kitchen
City /State %ZIP: k`1 n �� ��,. equipcnenl
, 1 0.00
Ul `" Cl otlres d er e xhaust
Ph - 0 �, b p--1 q
Fax ( ) Single duct exhaust (bathrooms, I O.00
„ i;(I'I(Iiil` i "w t I !I r „EII! !! (' � toilet coma room
, ,,., ,, ll il !f I I ,l i '.i.i,i iili..l �3 I I ;i ul compartments, s) 0. 0
it ,ll i ,i a . 1.. ,. . l ll --” g lii:frhlllii!! Attic /crawls ace fans 10.00
E r _Othe
n 1 0,00
Business name:
Contact name: Fuel piping
Adress: 4[ 2 �` $5.40 for first fear $1.09 for each additional rr'- .'���,� w 1•21 ' V , , Furnace, etc,
1 L �
City /State /ZIP: c _Gas heat um
b �') ' 4 D
Phon _ Wall /suspended /unit heater
Fax: : Br p, `Q n � (� Winer heater
E -mail: } s�LJ .F/ 4a - -
Fireplacc
ull!! i l , l; !`. fill fill !ll, Gt[� ! r;; tillll !III!!glglllu ,
Ran
l..f,,., JI I! 111 , dl'14 Ili ' i 4 il l
k ?!l Barbecue _
Business name: Clothes dryer (Ras)
Address: r
Other:
ss:
Addre tate/ZIP: - 60 V i1 iilil 1jiil!liuii' l ili I It�IIIi „ la rid 1. 1 " r 1: u I N!!IlII ' q
,� i.;l.,.. t a t il l •t;l,ll l(,tllll!Illal)lilll�lil
Phone: ( ) - --�� Subtotal
— Fax; ( ) Minimum permit fee ($72.50)
CCB ]ic.: L.1 Q /S -7 /� — Plan review (25% of permit fee)
_ f Slate surcharge (12% of permit fee)
—jam TOTAL PERMIT �y,[1
Authorized signature: _ mss. ", g t// f} ` has This permit eppn re9 eNtlon ezpi if a permit i� net ahtntn
L , t.{ c(1 withinAD
l rint name:
days after it been accepted nn cnmplete,
� I,� 1 � ! Date: . ,_ / w , • Fee methodology set by Tri- Cennty Building tnduatry Service nontd
P
440.46177 (I 1/02 COAQ WPR)
t •PCrn,BApp.dac 01 /191(17
CITY OF
BUILDING DI PERMIT #: MEC2008- 00262
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/14/2008
Phone: (503) 639 -4171 /6u� ".
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' " .
INSPECTION WORKSHEET FOR DATE: 5/21/2008 TIME:. 7 :00AM PAGE: 44
sA ►T1 9L
SITE ADDRESS: 14880 SW 92ND AVE CLASS OF WORK:
SUBDIVISION: LAUNALYtkIDA PARK LOT #: 022 TYPE OF USE:
PROJECT NAME: E3ARTLE I I
DESCRIPTION: Install gas line and logs.
OWNER: BARTLETT, JOHN PHONE #: 503620 -0579
CONTRACTOR: FIRESIDE DISTRIBUTORS PHONE #: 503.595 -3726
Inspection Request Scheduled For: Date: 5/21/2008 Pour Time:
Code # Inspection Description Confirm # • Contact # Message
610 Gas line 070178 -01 197-123-6048 l�
Corrections /Comments /Instructions:
r tiLl
___ss
i I PASS r PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
/�
Inspector: Date: �! �)�� Phone #: (503) 718- �(�
CITY QFTIGARD
BUILDING DIVISION PERMIT #: MEC2008-00242
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: U14/2008
Phone: (503) 639-4171 4: '
,,, Zit . lit
Inspection Requests (24 Hrs.): (503) 639-4175 I
INSPECTION WORKSHEET FOR DATE: 5/16/2008 TIME: 7:00AM PAGE: 30
SITE ADDRESS: 14880 SW 92ND AVE CLASS OF WORK:
SUBDIVISION: LAUNALYNDA PARK LOT #: 022 TYPE OF USE:
PROJECT NAME: BARTLETT
DESCRIPTION: Install gas line and logs.
....
OWNER: BARTLETT, JOHN PHONE #: 503-620-0579
CONTRACTOR: FIRESIDE DISTRIBUTORS PHONE #: 503-695-3726
Inspection Request Scheduled For: Date: 5/16(2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 069997-01 197-123-5a48 Y
Corrections/Comments/Instructions:
70 ( (-- i- A-49--C..
IC 'ASS 0 PARTIAL APPROVAL El CANCEL 0 NO ACCESS
0 FAIL CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: Date: S --- / 6 ---- Phone #: (503) 718-