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Permit [ . CI1Y OF � PERMIT COMMUNITY DEVELOPMENT DEPARTMENT PERMIT #.......: MEC96-0034 13125 SW Hall Blvd. Tigard, Oregon e722308199 (503) 639-4171 DATE ISSUED: 02/07/96 PARCEL: 2S111BD-01510 SITE ADDRESS...: 15060 SW 100TH AVE SUBDIVISION....: ALDERBROOK FARM ZONING: R-3.5 BLOCK ..........: LOT.............:7 _________ ___ _ ___ - ______ CLASS OF WORK..:ALT FLOOR FURN....: 0 EVAP COOLERS: 0 TYPE OF USE....:SF UNIT HEATERS..: 0 VENT FANS...: 0 OCCUPANCY GRP..:R3 VENTS W/O APPL: 0 VENT SYSTEMS: 0 STORIES........: 0 BOILERS/COMPRESSORS HOODS.......: 0 FUEL TYPES------------ 0-3 HP....: 0 DOMES. INCIN: 0 : 3-15 HP....: 0 COMM. INCIN: 0 MAX INPUT: 0 BTU 15-30 HP....: 0 REPAIR UNITS: 0 FIRE DAMPERS?..: 30-50 HP....: 0 WOODSTOVES.. : 0 GAS PRESSURE...: 50+ HP....: 0 CLO DRYERS..: 0 NO. OF UNITS ---- AIR HANDLING UNITS OTHER UNITS.: 1 FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1 FURN }=100K BTU: 0 } 10000 cfm: 0 Remarks: Installing gas fireplace insert Owner: - - - - FEES --- DON COMEGYS type amount by date recpt 15060 SW 100TH PRMT $ 25.00 B 02/07/96 96-275728 5PCT $ 1.25 B 02/07/96 96-275728 TIGARD OR 97224 Phone #: 620-2048 Contractors - - - LUDEMANS INC 12675 SW CANYON RD BEAVERTON OR 97005 __- � F�� IA-- �~� »��uz�� '� �_'«________ Phone #: 646-6409 $ 26.25 TOTAL Reg #.. 51469 - - REQUIRED INSPECTIONS ------- This permit is issued subject to the regulations contained in the Gas Line Insp ________ _____ Tigard Municipal Code State of Ore. Specialty Codes and all other Mechanical Insp ______ applicable laws. All work will be done in accordance with Final Inspection ___ _____ approved plans. This peroit will expire if work is not started ___ ___� within 180 days of issuance, or if work is suspended for uore _ _ ____ than 180 days. _ _ ___ __ __ �� —1_*- �� Permittee Si t : '�-� _ /� _________ Issued By: /k i`� _ - _ ---__-___ --- � Call for inspection - 639-4175 • ' . - - City of Tigard MECHANICAL PERMIT Planck/Rec. # 13125 SW Hall Blvd. APPLICATION Permit # IrC /0- 603 Tigard, OR'97223 (503) 639 -4171 Name of Uevebpment Description - ef, 4/ C i V, ' ass Table 3A Mechanical Code QTY PRICE AMT ese Job S ‘-z) 5- u i o T�' 1) Pertna Fee o- -0- 10.00 Address z 0 G ,4 O j� c, 7,2J-4 J- 2) Supplemental Permit 3.00 ame Or name a b0s as Furnace to 100,000 BTU © (gip .i t F cy� 124.--iii ,} 1) incl. ducts & vents 6.00 awing Address Phone Furnace 100,000 BTU + Owner l 6 6 re .5 Gam(/ , J 0 ! 2) incl. ducts & vents 7.50 Ca^ �P Floor Furnance ) S /91W e,R 17119 3) incl. vent 6.00 me (« name of hosanna) Suspended heater, wall heater p �{7 C olio 4G / 4) or floor mounted heater 6.00 Occupant g �d Phone Vent not incl. in ife , ,e , 52 / c /1 I33 / 7 1' 5) appliance permit 3.00 °ij�e ro Repair of heating, refrig. / 6 ,4 ,� OA 5 �� 6) cooling, absorption unit 6.00 m 6ag k 4.. Boiler or comp, heat pump, air cond. 1- f RAE ph.Ac,L' 7) to 3 HP; absorp unit to 100K BTU 6.00 /1.4_5 Maeng Address Tone Boiler or comp, heat pump, air cond. Contractor s G �N� o / v 4'jJ 8) 3 -15 HP; absorp unit to 500K BTU 11.00 Le uty'S d 1e Boiler or comp, heat pump, air cond. • Pr j/� U/,! d R ci 7Dd, 9) 15 -30 HP; absorp unit .5-1 mil BTU 15.00 state Recast/soon " No. Cay Bus. Tao w. Boiler or comp, heat pump, air cond. e3) 6 10) 30-50 HP; absorp unit 1 -1.75 mil BTU 22.50 I hereby acknowledge that I have read this application, that the Boiler or comp, heat pump, air cond. ` information given is correct, that I am the owner or authorized 11) > 50 HP; absorp unit 1.75 mil BTU 37.50 agent of the owner, that plans submitted are in compliance with Air handling unit to State laws, that I am registered with the Construction Contractor's 12) 10,000 CFM 4.50 Board, that the number given is correct. (If exempt from State Air handling unit registration, please give reason below.) 13) 10,000 CTM + 7.50 Non portable 14) evaporate cooler 4.50 • Vent fan connected 15) to a single duct • 3.00 tO Ventilation system not • a — 7 — 9Dj 16) included in appliance permit 4.50 m ature (oan � 1. -Z-� or agent) / Date Hood served by 17) mechanical exhaust 4.50 Describe work new 0 addition k alteration 0 repair 0 Commercial or industrial to be done residential 0 non - residential 0 18) type incinerator 30.00 Existing use of Other i.e., woodstove, water— f'ivIW-f 1 building or property fie 4 19) heater, solar, clothes dryers, etc. '015e 7 ( 4.50 Proposed use of 20) Gas piping one to four outlets 1 2.00 building or property 21) More than 4 -per outlet (each) 2.00 Type of fuel - oil 0 natural gas LPG 0 electric Q NOTICE • _ Minimum Fee $25.00 SUBTOTAL �j� , °h PERMITS BECOME VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS, OR 5% SURCHARGE 1 , 25 i IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME PLAN REVIEW 25% OF SUBTOTAL AFTER WORK IS COMMENCED. - i TOTAL 2k. -S Special Conditions Date issued ll��JJ e,m/t1644.1( ')- / Clli by `'�— R9COGIMDSTSIMECNPMT CITY OF TIGARD BUILDING INSPECTION NOTICE Inspection Line (Rec -O- Phone): 639 -4175 Business Phone: 639 - c Inspection: 6 )/9 5 Footing Susp. Ceiling Sprink. Rough -in Appr /Sdwlk Foundation Plbg. Underslab Mech. Rough -in Fireplace Post /Beam Struct. Plbg. Top Out Elec. Rough -in F Post /Beam Mech. San. Sewer -B dg. Plbg. Underfloor Rain Drain Framing - Plumb. Alarm Water Line Insulation ,, Underflr. Insul. Shear Wall 1 Gyp. Bd. - Elect. Date Requested: �vl -2 -A 1° • Time: AM PM Address: f 5---- C 6 / 6 U Bui : -o--- l.:2- Permit - 60.,- . .• THE FOLLOWING CORRECTIONS ARE REQUIRED: = /0 • . - ,-- 2;C = -: --Q-al - . - = - • Inspector: Date: 2_/2- Z /IC PROVED DISAPPROVED APPROVED SUBJECT TO ABOVE _Call For Reinsp.