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Permit
� C ITY OF TIGARD �- MECHANICAL PERMIT �""� �� f DEVELOPMENT SERVICES PERMIT #: MEC2005 -00023 '�' F 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/18/2005 PARCEL: 2S104CC-07300 SITE ADDRESS: 13482 SW ASCENSION DR SUBDIVISION: HILLSHIRE WOODS ZONING: R -7 BLOCK: LOT: 092 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: MF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: LPG 3 - 15 HP: COMML.INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: GAS PRESSURE: 50 + HP: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: OTHER UNITS: FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Remarks: Natural gas stove and run gas line. Owner: FEES CHOWN, THOMAS H + BONNY JEAN Description Date Amount 13482 SW ASCENSION DR [MECH] Permit Fee 1/18/200E. $72.50 TIGARD, OR 97223 [TAX] 8% State Surcharl 1/18/200: $5.80 Phone: 503 - 579 - 1440 Total $78.30 Contractor: LUDEMAN'S FIREPLACE & PATIO 12675 SW BEAVERDAM RD BEAVERTON, OR 97005 -2129 REQUIRED INSPECTIONS Phone: 503 646 - 6409 Gas Line Insp Mechanical Insp Reg #: LIC 51469 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 -0100. You may obtain copies of these rules or'direct questions to OUNC by calling (503)246 -6699. Issued By: Citi A Permittee Signature: Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day JAN. 15.2005 5:26PM 0.136 '.3/4 Mechanical Permit Application 14 ()1.1 (1 i , I ( 1 N 1.1 * b My of Tigard r Received ) p N 3 ` . 13125 SW Hat Mid.. Tigard, OR 9 : t Phone: 503.639.4171 Fax 503,5 CE1VE7A DRte/By:./ ` - DS a /36 o : (� C o2(,�J� Q9D Plan Review :.I. r'� 44 li ,, Other Permit: Inspection Lint: 503.639.4175 � ! " IhneQ3y: ti Internet cv�vw.ci.tiga.d.or.us JAN t.� � __� Date 2e"dv/BV: mr;s � See Rage z for Internet 18 2W0,;1 Notified/Method T /&, Supplemental Information • �-' . a t J T f�� - . , cemiikkorm, .FFgk so pa* - ; .._ tmtvoIS]C� Mechanical emit fees* are based on the value of the work ❑ Now construction „� 1 g P performed. Indicate the value (rounded to the nearest dollar) of all El Demolition ' % s. er: mechanical materials, equipment, labor, overhead, and profit ` CIATJGofv OF CINSTRUCT ION - . „ . —__ -- Value; $ and 2 - family dwelling 0 Commercialindustrial 0 Accessory building `' 0 7 / - w ' . . ID Multi-family ❑ Master builder 0 Other; For special information use checklist Description I Qty. I Ea. I Total • JOB SITE +'On11I'A'A'ID1'11 AND LOCATION ' _ Hcetin /coaling Job site address: 43 [y/,07 set) i s c e n sic 2� Air conditioning or heat pomp (R site plan showing placement) 14.00 City/State/ZIP: P: m /�pa ace 100. 000 BTU (ductslvents) 14.00 � / 9 �aa 3 Ftrmaoe MAO+ BTU (ducts/vents) 17.90 Suite/bldg./apt. no.: ! ' ' J P roject name: C 4 ey ecin Gas heat pump 14.00 Cross street/directions to job she: Duct work 14.00 Hydronia hot water system _ _ 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fire! -type, not electric), in wall in -duer. su pended, eta, 10.00 _ Subdivision: l of Flue/vont for any of above 10.00 , Other. 10.00 Tax map/parcel no " Other fled appliances T nrsta IF T 3ST 01? WljRE. • . Water heater 10.00 t3as fireplace 10.00 —Z- /2 S 7 V C Q "? ee..9 ^ _ Flue vent tar water heater or gas rCI y Q C //1 C., - Leg - lace 10.00 Q / Log Iighi r (gas) 10.00 Weed/peellet stove 6. / 10 -00 /O, IVO Wood fircclace/msert 10.00 V PRO/PERT> p'1 kik . ' ' 1 ' �. , Chimuey/linadflue/vent / 10.00 /o -ela Other: 10.00 N ame: 7 7,. , • C Adv., n Environmental exhaust and ventilation Address: 139P� . S 4.! aS c e-� S/v ei P� e hood /enter l iitchen a equipment 10.00 City /State/ZIP: "� cee7 a ! 7cle2 3 C( othes dryerexhaust 10.00 Single -duct exhaust (bathrooms, Phone: (54 ,t 7 _ /V9 7 Fax: ( ) toilet com artm ents_ utili roomsl 6 • APPLICANT ' (', coNT!'Ack1 ©N ° i A{tic/crawlspace fans 10.00 • Business name: al., 4 in * n er 10.00 Fuel piping Contact name: ea /0/ . ` - c A A $5.40 for first fear; $1.00 for each nddldonal Address: /e�� �.� J eQpe _ �'1 2 r� Furnace, etc. - . City /$ p Gas heat ptm p "�Z47 02 7 7 J WWael/suspendedArn t heater Phone: ( .J) 6, /6, - 6p t/py Ferc : (54ty) G S/t, - cpc2 3 5/ Water beater )email: P "Mace 1 S5rE7 �. VQ Brave colrRttcxR ' ' Barbecue Business name: ,..,'5 M Q_ - Clothes dryer (gas) Address: wOhher. Gity /StatrfL)P: l LI�L�A�,1C�" , Subtotal ,. S/0 Phone: ( ) P est: ( ) Minimum permit fee ($72.50) 7 ,7 CCB lie.: y� I , . .. Plan review (25 6 of permit f e) t� a' State urge (8% of permit fee) .57":9 TOTAL PERMIT FEE 7,;;;,..3 Q Authorized signature; �' Thta per tit application espires ff n permit is not obtained within tao r lays niter it Lae bees accepted as Complete Print name: / / C j,Ir� ante: ! / 7- ®0 ' F eemethe401oryr set by IYi- Comity Building Industry Serviee Board CITY OF TIGARD 24 -Hour BUILDING " Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST BUP Received Date R- •uested 1 AM PM BUP • Location Suite ae05 - 'Oj d a 3 Contact Person �l Ph ( ) PLM Contractor Ph ) SWR BUILDING Tenant/ ne ` d ELC I N1\ Footing I� ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: Gas S SIT Post & Beam Shear Anchors / . 6 ,_ Ext Sheath /Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING - Post & Beam Under Slab Rough -In Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan • Other: Final P ART FAIL CHAL Post& Beam Rough -In. Gas Line S ampers V PART FAIL CAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Ei Please call for reinspection RE: 111 Unable to inspect — no access Fire Supply Line ADA f Approach/Sidewalk Dat® Inspector Ext Other: Final DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL