Permit Ir CITY O 1 TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2009 -00026
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/16/2009
PARCEL: 25111 BC -02700
SITE ADDRESS: 10380 SW CANTERBURY LN ZONING: R -3.5
SUBDIVISION: TIGARDVILLE HEIGHTS LOT: 005 JURISDICTION: TIG
PROJECT: MILLER
Project Description: Fireplace insert.
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:
WOD 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:
Owner: FEES
PAUL MILLER Description Date Amount
10380 SW CANTERBURY LN
TIGARD, OR 97223 [MECI -1] Permit Fee 1/16/200 $72.50
[TAX] 12% State Surch 1/16/200 $8.70
Phone: Total $81.20
Contractor:
FIRESIDE DISTRIBUTORS
18389 SW BOONES FERRY RD
PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 684 -8535
FAX 503- 620 -5699
Reg #: LIC 40979
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: aCIA A (I Permittee Signature: Apc I \ Q *ICY)
Call 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.
61/16/2009 11:51 56367 iv WIDDOWS PAGE 81
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JAN 20 _+ Received rmit No .
.City of "b'igAr•d. v J rJat � r B y . Lila ' oct Pe
Other NaCe.20 0
l3 t 25 S W Hall Bivd., Tigard, OR 9Y OF TI Pian R e yi ew I N Phone. 503.639.4171 Fax: 503.5 o TIGARD Date/By r Yermit.
T:I GARia; Inspection Line: d03 639 4175 �t n AA', DIVISION Date ,.._ Bq: - ' luris: 0 See Pngc 2 for •
— — • Int'ernet: wivw,tigard- or.gov BUILDING Dn titl2 nad ethnd; ' ' C Siitipleme�ital lnfoea>atinn
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w,:.• .,:a': „::� � Value: $
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- and 2=family dwelling 0 Commercial /industrial ❑ Accessory building For Atiecial inforrtsattor rise checklist.
0 Multi- family 0 Master builder ❑ Other: Desgfiptipu .. - .. Qty: ` £a. Total
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` // Air combo ling or Beat pump
rob site address: / /2 �• S� �f � ,1 7 L /) -e_. . (re site plat sh n lisg placement) 14.00
City/State (ZIP: \ akar '"—"' r 1 ! '2'4 Fu 100;000 BTU (duc`ts /vents) 14.00
1 • Furnace 100;00 BTU (duetsNeins) 17.90
Suite /bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross Street/directions to job site: Duct .work 10.00,
. f hot w at e r syStem 14.00 .
Residential boiler (radiator or
hydronic) 14.00
Unit heater (fiiel •type, not'electric),
in - wall, in duct suspended, etc. 14.00 •
- Flue/ent f• it any of above 6,80
Subdivision: Lot no.: ..
O'ther: 10.00
Tax inap /parcel no.: Other f u e l appliances
;r s,:a�•,, - •a:_ wv.- ;',.;, "' y"` :i :':;`,'': Water heat' 10:00
'TWO
:'r.
"Ct11�'PCt�N� -
•, � Gas ftrepla •e 10 00
� `�a. `((, €._ t Flue vam f it water heater or gas
fireplace 1,0.00
Log lighter (gas) . 10.00
Wood /pelle t'stove 10:00
Wood firep lace/insert 10.00
, : , , - �,, Cfiimney /li ier7fluelvent 10.00
- � ' :'" .. ,..... .. .,,.: r; te f 2Q l qc¢ lnser� A 70.00
Name: Etrvironmi'cii I exhaust an ventilation
el_.ut� 11
Range hoof. /other kitchen
Addres X 03 g6 (-. xIDL rL l -(av\. equipment 10.00
Gity/State/ZIP: L ca13t' ot C� . , 9 q �Z� Clothes dry:r exhaust 16.6o '
Siiigle=ducl exhaust (bathrooms,
P ( ) 684 t 3 Fax: ( ) • toilet comp ti tnients, utility' rooms) 6.80
• -. :' l i.:c . ;:..:.. i.i1 ,: , Attic/crawlr. ace;fans 10.00.
a '® ?: CbN. �����T '���?��R�.ON'ti•rt p
� t` _ om .'.., ." ; ';. r Other: 0,00
Business name: mo 1 g� �, Ste 1�l c l A DA Fuel piping'-, . .
me: � i , ' 5.4r first four; 51.0
Contact na
\.1,,,c. r `nom 50 fo
_ . . ..... . ... . fo for each additional
.
Address: �� — � t� G as-hee,.en:..
G ar a _
Gity /State/ZIP. t ;;jY � \. ') (? Q V r ltzalL'suspeniled /utiii heater
Phone: (S/S , ) 6q - s Fax:: ( ) Water heater
Fireplace .
E-mail: 12aa1 • e
.,,.ii Barbecue .
Cfi.1V'F€iAG tit' .
Business name: Clothes d ,e (gas) -
-- - - - - -- - - Other:
Address: >:
- -- --- _ - _--- - .- -- - _.._ __. - _.__ ivfinirntirnpermitfee'($72,50)
Phone: ( ) I Fax: ( ) ---
- _t_ -�- -- ---- -._._ _______ _- Plan re' view (25% Of p €rrhit fee)
- .....__ --
C CE3 lie.: _ State surcha (d2 %'ofpe m it fee)
_ . _ — --
TOTAL PEJRIVII1' IEE L "
' g
Authorized i nature: s. ' (' h i.s permit appticatinii expires if a permit is not obtairiec witlein i8(1
_ r� '@ - ���X�. ti 1 f _' i _ e _ t 11 2. �� 1
days after it s c h s Peen accepted as comi,lete.
�),.i t :ia,ne: l f ..- ♦ _ .. ^ -
, Fee anahn i'elog i set by Tri- �'olmty Building Industry °ert:irc ho:vd
.. ..
1 -
CITY OF TIGARD
1 BUILDING DIVISION PERMIT #: 1\4E02009-00026
I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/16/2009
Phone: (503) 639-4171 elrqil
Inspection Requests (24 Hrs.): (503) 639-4175 ,....._._. .....a
■
f
INSPECTION WORKSHEET FOR DATE: 112812009 TIME: 7 PAGE: 5
(JAY lo
SITE ADDRESS: 10380 SW CANTERBURY LN CLASS OF WORK:
SUBDIVISION: TIOARDVILLE HEIGHTS LOT #: 005 TYPE OF USE:
PROJECT NAME: MILLER
DESCRIPTION: Fireplace insert.
OWNER: MILLER, PAUL PHONE #:
CONTRACTOR: FIRESIDE DISTRIBUTORS PHONE #: 503-6848535
Inspection Request Scheduled For: Date: 1/20/2009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
$99 Mechanical final 000085-01 503-590-6085 N
Corrections/Comments/Instructions:
•
• PARTIAL APPROVAL 0 CANCEL - fl NO ACCESS
El FAR r/ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
,
Inspector: _ Date: 1 V C Phone #: (503) 718-
ilb ,