Permit •
CITY TIGARD MECHANICAL PERMIT
411 ii l DEVELOPMENT SERVICES PERMIT #: MEC2005 -00329
1 '�" 6 � f ll 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 6/10/2005
PARCEL: 2S 104AC -13400
SITE ADDRESS: 12950 SW 135TH AVE ZONING: R -7
SUBDIVISION: HANDY ACRES LOT: 031 JURISDICTION: TIG
Project Description: Wood stove install.
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:
WOD 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES: 1
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
BAXTER, BARRY FREDRICK AND Description Date Amount
KATHY SUE [MECH] Permit Fee 6/10/200f $72.50
12950 SW 135TH [TAX] 8% State Surchaq 6/10/200f $5.80
TIGARD, OR 97223
Phone: 503 - 524 - 4961 Total $78.30
Contractor:
REQUIRED ITEMS AND REPORTS
Phone:
Reg #:
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: k - kl �
Cal 503 - 639 -4175 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.
Mechanical P , — .40: 1 Avii_AMo FOR OFFICE ESE ONLY
R eceived
City of Tigard — - Da y4 --- m Permit No72)
13125 SW Hall Blvd., Tigard, OR/ 9 A in05
411111,„ vedt,
te/B" d
Plan Review
Other Permit:
Phone: 503.639.4171 Fax: 50398. 1960
LU 4010011'." Date/By:
Inspection Line: 503.639.4175 All A 1 I Date Ready/By: 0 See Page 2 for
Internet: www.ci.tigard.o CITY OF TIGARD Notified/Method: Supplemental Information
iiIMI
- - - BUILDINCi.DIVISION,
- - • - • - , T PE OF:MORK , - ; . . 'i - ' ' 'COMMERCIAL. IF E
Et*IIEDIJLE - ,IiSE=CHEei4
- T.
Mechanical permit fees* are based on the value of the work
0 New construction [E] Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
El Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF'' :• : '' 1 ' . : ': ' Value: $
ESIDENT / SYSTEMSTEW ---,.
2] 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder 0 Other:
Description I Qty. I Ea I Total
. .. ... . . -
JOB INFORMATION. ANIOLOCATIONT. :-. : , ,' : : , : ' Heating/cooling
Air conditioning or heat pump
Job site address: 12950 sw 135th ave
(requires site plan showing placement) 14.00
City/State/ZIP: tigard, or 97223 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name:
Gas heat pump 14.00
Cross street/directions to job site: Fern Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 10.00
Flue/vent for any of above 10.00
Subdivision: Handiman acres Lot no.:
Other: 10.00
Tax map/parcel no.: Other fuel appliances
BESCRIPTION, OF vi3ORK-,..:: .,, .. ' ..,-:...t -'.,-, Water heater 10.00
Gas fireplace 10.00
install new wood stove vented into existing chimney. Flue vent for water heater or gas
nvi, Ae 7 . 1.) (( e. d A- ,-,.., vs . fireplace 10.00
Log lighter (gas) 10.00
/Prood/P Ilet stove / 10.00 /0 • o o
fireplace/insert 10.00
Chimney/liner/flue/vent 10.00
'6g1 PROPERTY bvi '" , ." •- - TkiSTANT''' '
Other: 10.00 _
Name: Barry Baxter Environmental exhaust and ventilation
Range hood/other kitchen
Address: 12950 SW 135th Ave
equipment 10.00
City/State/ZIP: Tigard Or 97223 Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: (503)524 4961 Fax: ( ) toilet compartments, utility rooms) 6.80
'IZI'A,PPLICANT ', . .; - : „ -' 0 'cONtAei PERSON ' s >" Attic/crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: Barry or Kathy Baxter $5.40 for first four; $1.00 for each additional
Address: 12950 SW Furnace, etc.
Gas heat pump
City/State/ZIP: Tigard Or 97223 Wall/suspended/unit heater
Phone: (503) 524 4961 Fax: : ( ) Water heater
Fireplace _
E-mail: kbax@verizon.net
Range
„ .
. .
'CONTRACTOR' Barbecue
Clothes dryer (gas)
Business name: 0 ----, i
Other
Address: ' - I .',. PEES*,
City/State/ZIP: Subtotal
Minimum permit fee ($72.50)
Phone: ( ) Fax: ( )
Plan review (25% of permit fee)
CCB lie.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE (6. ;:!
Authorized signature: '
.------ i
This permit application expires if a permit is not obtained within 180
20 ; 12 --.
days after it has been accepted as complete.
s-'
CITY' OF TIGARD -
BUILDING DIVISION' PERMIT #: MEC2005- 00329
13125 SW Hall Blvd., Tigard, OR 97223 i ATE ISSUED: 6/10/2005
Phone: (503) 639 -4171 �rM�ln��
Inspection Requests (24 Hrs.): (503) 639 -4175 ��� °'__.. ibr
INSPECTION WORKSHEET FOR DATE: 6/14/2005 TIME: 7:10AM PAGE: 92
SITE ADDRESS: 12350 SW 135TH AVE CLASS OF WORK:
SUBDIVISION: HANDY ACRES LOT #: 031 TYPE OF USE:
PROJECT NAME: BAXTER
DESCRIPTION: Wood stove install.
OWNER: BAXTER, BARRY FREDRICK AND, PHONE #: 503 - 5244061
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 6/14 /2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 009062 -01 5503. 524-4961 N
Corrections/Comments/Instructions:
e
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL n CALL FOR INSPECTION • ❑ ADDITIONAL FEES ASSESSED
Inspector: - "'" ' Date: Phone #: (503) 718-