Permit CITY TIGARD MECHANICAL PERMIT
zwi\ DEVELOPMENT SERVICES PERMIT #: MEC2000 -00494
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/18/2000
PARCEL: 1 S134AD -05000
SITE ADDRESS: 10826 SW 108TH CT
SUBDIVISION: BLACK BULL PARK ZONING: R -4.5
BLOCK: LOT: 029 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Installation of gas fireplace insert.
Owner: FEES
GASCHKE, TIMOTHY LEONARD + Type By Date Amount Receipt
SUSAN MARY PRMT CTR 12/18/20( $72.50 2720000000
10826 SW 108TH CT 5PCT CTR 12/18/20( $5.80 2720000000
TIGARD, OR 97223
Total $78.30
Phone:
Contractor:
ANCHOR FIREPLACE PRODUCTS INC
14175 SW GALBREATH DR
SHERWOOD, OR 97140 -9170 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 925 -8888 Mechanical Insp
Reg #: LIC 102814 Final Inspection
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 -0080.
You may obtain co . es of these rules or direct questions to OUNC by calling (503)246 - 9189.
Issue By: Permittee Signature: e71/ /5 /e-.5 i /O N /
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
CITY TIGARD MECHANICAL PERMIT
`wr DEVELOPMENT SERVICES PERMIT #: MEC2000 -00494
`�'` '-° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/18/00
PARCEL: 1 S134AD -05000
SITE ADDRESS: 10826 SW 108TH CT
SUBDIVISION: BLACK BULL PARK ZONING: R -4.5
BLOCK: LOT: 029 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS WIO APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Remarks: Fireplace Insert
Owner: FEES
GASCHKE, TIMOTHY LEONARD + Type By Date Amount Receipt
SUSAN MARY PRMT CTR 12/18/00 $72.50 2720000000
10826 SW 108TH CT 5PCT CTR 12/18/00 $5.80 2720000000
TIGARD, OR 97223
Total $78.30
Phone:
Contractor:
HOT SPOT FIREPLACE + PATIO
11525 SW CANYON RD
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 503 - 626 -9138 Mechanical Insp
Reg #: LIC 00071782 Final Inspection
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 -0080.
You may obtain copies of these rules or direct questions to OUNC by calling (503)246- 9189.
Issue By: Permittee Signature: , /��
Call (5 3) 639 -4175 by 7:00 P.M. for inspections needed the next business day
r
M
Mechanical Permit Application
C Date received: Permit nts.. EC - 262'-0 _� './q'/
.41,1-'.L pity of Tigard ~ ( Project/appl. no.: Expire date:
CirynjTigard Address: 13125 SW Hall Blvd, Tigard, OR 9722
Phone: (503) 639 -4171 DEC 1 A ?QOM Date issued: By: I Receiptno.:
Fax: (503) 598 - 1960 _ Case file no.: Payment type:
Land use approval: COMMUNITY DEVELUPMENf ■ Building permit no.:
TYPE OF PERMIT
', I & 2 family dwelling or accessory 0 CommerciaUindustrial 0 Multi - family 0 Tenant improvement
0 New construction 0 Addition/alteration /replacement 0 Other:
_AM SITVINFOR IATION ,..; ... 1.XIM IERCIALA ALUAIION SCIUsp.I LE,_._. _
Job address: jog-g& 5O /DA ,e T Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: I Suite no.: value of all mechanical materials, equipment, labor, overhead,
Tax map /tax lot/account no.: profit. Value $ •
Lot: (Block: I Subdivision: *See checklist for important application information and
Project name• jurisdiction's fee schedule for residential permit fee.
City /county: - ei () Y I ZIP: cj /Oa 1 & ZF;IMILY D11'ELLING PFRJIIT FEE SCHEDULE
Descri tion and Ideation of work on premises; AND COMMERICAL /INDL STRLAL EQC IPM ENT SCI IEDI LF
QS I / }iv / L7$ i Y1 S t' 1St
Est. de of com Fee(ea.) Total
letion s ection: Description P �P / o� /a 7 pti Qty. Res. only Res. only
Tenant improvement or change of use: HVAC:
Is existing space heated or conditioned? 0 Yes 0 No Air handling unit CFM
Air conditioning (site plan required)
Is existing space insulated? 0 Yes 0 No Alteration of existing HVAC system
MECIIANICAL CONTRACTOR Boiler /compressors
State boiler permit no.:
Business name: /
d-xMP J E c dS p lf ( / et, HP Tons BTU/H
Address: l /$3S Sc: (aW I 0 Fire /smokedampers/duct smoke detectors
City: 4 2 U . e ik 1 State:Oy ZIP: c?-70q S Heat pump (site plan required)
Phone:6A . I Fax:, - ..1/301 E -mail: InstalVreplacefurnace/burner BTU/H
CCB no.: �� / ( !�/ �� Including ductwork/vent liner 0 Yes 0 No
InstalUreplace/relocate heaters - suspended,
City /metro lie. no.: itak, wall, or floor mounted
Name (please print): —7---
•4 6..i (,J 011 Vent fora. .lianceotherthan furnace
• CONTACT PERSON a geratton:
Absorption units BTU/H
Name: _ Q _ Chillers HP
• • Address: C ompress ors HP
Environmental exhaust and ventilation:
City: : p ew .� State: a, ZIP: '70oS Appliance vent
Phone: , , ' , „ Fax: � ,_e j E -mail: Dryer exhaust
OWNS Hoods, Type U lures. kitchen/hazmat
hood fire suppression system
Name: C ascln Q) 7 LtSc:i ti � Exhaust fan with single duct (bath fans)
Mailing address: /aerv(„ Sw Jo `t / Exhaust system apart from heating or AC
Fuel piping and distrib ion (up to 4 outlets) •
City: f t a 1 4 I State: ZIP: r7 ,90. Type: LPG NG Oil J 5
Phone: ,41 -d Fax: E -mail: I Fuel • • i . ing each add ional ove 4 outlets _
ENGINEER Process piping (schematic required) —
Name: Number of outlets
Address: Other listed appliance or equipment:
Decorative fireplace
City: I State: I ZIP: Insert - type lab°
Phone: I E -mail: Woodstove/pelle ve
�l Cher:
Applicant's si lure: ) Date: l /p(J Other.
Name (print eIN 1/114 ei,V1, z—
�'�' ''""``�-�- tl Permit fee $
'Not all jurisdictions accept credit cards, please call jurisdiction for more information.
0 Visa ❑MasterCard Notice: This permit application Minimum fee $ 7.-2.. St )
expires if a permit is not obtained
Credit card number: / / Plan review (a[ %) $
Expires within 180 days after it has been State surcharge (8 %) .... $ � 1
Name of cardholder as shown on credit card accepted as complete.
$ TOTAL $ 1 $ 3a
Cardholder signature Amount i 4441617 tht)
CITY OF TIGARD BUILDING INSPECTION DIVISION - • "
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 MST
BUP
Date Requested Z � AM PM BLD
Location /0 ,F Z G S IA. /U g c4e - Suite MEC Ave c
Contact Person - Ph 7O - O.3 7 C f PLM
Contractor Su ph ?zs' 98 go SWR
BUILDING Tenant/Owner P/165/ co--e( 7a-of 7? .✓ ELC
Retaining Wall 77J ),4 C +'f? 73d - f1;3 ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing "63 c C r. ( 13, 67 D2l 4,-toe,
Insulation
Drywall Nailing • 1 ter ,i. $ - Pc
Firewall
Fire Sprinkler 6rn)) 417 R.5 5
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
Post & Beam
Rough In
S ke Dampers
Fi
S PA PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
ADA
Approach /Sidewalk
Other Date / L — O / Inspector Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.
BUP - Building Permit ELC - Electrical Permit
4 Inspection Description Date Passed By 4 Inspection Description Date Passed By
Footing /Setback Underground cover
Foundation walls Wall cover
Footing drain Ceiling cover
Waterproof bsmt walls Electrical rough -in
Slab Electrical service
Crawl drain Electrical final
Underfloor insulation
Post/beam structural -
Shear walls /anchors ELR - Restricted Energy Permit
Roof nailing 4 Inspection Description Date Passed By
Firewall Low voltage
Tilt -up panel Electrical final
Masonry/Reinforcement
Framing
MFG - Structure set -up MEC - Mechanical Permit
Insulation
Drywall nailing -4 Inspection Description Date Passed By
Post/beam mechanical
Suspended ceiling Gas line / - z 3 - d ; r
Engineered soils Mechanical rough -in
Welding Lab Final Fire damper
Concrete Lab Final Duct work
Bolting Lab Final Smoke detector
Fireproofmg Lab Final Mechanical final -
Structural observation
Final inspection
PLM - Plumbing Permit
4 Inspection Description Date Passed By
BUP - Fire Protection System Permit Plumbing underslab
Inspection Description Date Passed By Crawl drain
Sprinkler underfloor /slab Post/beam plumbing
Sprinkler rough -in Plumbing top -out
Sprinkler final RP /backflow preventer
Fire alarm fmal Rain drain
Storm drain
Water service
SIT - Site Permit Sanitary sewer
Inspection Description Date Passed By Culvert/catch basin
Footings Pump /fill septic tank
Foundation walls Plumbing final
Sprinkler supply lines
Sprinkler underfloor /slab
Catch basin/Manhole SWR - Sewer Permit
Engineered soils . 4 Inspection Description Date Passed By
Engineering acceptance Sanitary sewer
Final inspection Final inspection
INSPECTION RECORD - BUP, PLM, SWR, ELC, ELR, MEC SIT PERMITS
CITY TIGARD MECHANICAL PERMIT
,� DEVELOPMENT SERVICES PERMIT #: MEC2000 -00494
a '- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/18/2000
PARCEL: 1 S134AD -05000
SITE ADDRESS: 10826 SW 108TH CT
SUBDIVISION: BLACK BULL PARK ZONING: R -4.5
BLOCK: LOT: 029 JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
GAS 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Remarks: Installation of gas fireplace insert.
Owner: FEES
GASCHKE, TIMOTHY LEONARD + Type By Date Amount Receipt
SUSAN MARY PRMT CTR 12/18/20C $72.50 2720000000
10826 SW 108TH CT 5PCT CTR 12/18/20C $5.80 2720000000
TIGARD, OR 97223
Total $78.30
Phone:
Contractor:
ANCHOR FIREPLACE PRODUCTS INC
14175 SW GALBREATH DR
SHERWOOD, OR 97140 -9170 REQUIRED INSPECTIONS
Gas Line Insp
Phone: 925 -8888 Mechanical Insp
Reg #: LIC 102814 Final Inspection
8
I
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 -0080.
You may obtain co 'es of these rules or direct questions to OUNC by calling (503)246-9189.
Issue By: Permittee Signature: 07V f} Pf'G / el- i/O /V 4
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
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