Permit 4 ilii CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 00781
'` ar 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/23(2005
PARCEL: 2S110BC - 00700
SITE ADDRESS: 12350 SW CORYLUS CT ZONING: R -1
SUBDIVISION: AMES ORCHARD LOT: 004 JURISDICTION: TIG
Project Description: Fireplace insert, gas line & venting.
CLASS OF WORK: OTR 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:
NAT 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
SCOTT FITZWATER Description Date Amount
12350 SW CORYLUS CT
TIGARD, OR 97224 [MECH] Permit Fee 11/23/20( $72.50
[TAX] 8% State Surcha 11/23/20C $5.80
Total $78.30
Phone:
Contractor:
R & D INSTALLATIONS
5246 SE 62ND
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Phone: 503- 774 -7142
Reg #: LIC 95236
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: a J , ? Permittee Signature: ..(z" �
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
1i'16'2005 06:30 FAl 503598196'0 CI T1 OF TIGARD a 00
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.tViech ®ical Perilni l t� i E / , z . ,FO R () . ICL l5E UNL `,
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City of Tigard c DFocoavad ata ' _ ,Fir ,vl ) aunt - N u., � /II
13125 SW Hall Blvd., Tigard, OOK 972 31 1 8 2005 Al �� an E Odor Permit Phone: 503. =17 t Faz: 503.498.196u' . ,>>5 1 .,:e i+ c.By.
Iaspectiun Line: 503.639A175 a =N Iii Dat - - ___- t,iir: !0 See Pap :tor
Into -net: www.ci.tig.ad.,x.us CITY OF TIG ARD : - , f ya , I fill Supplementallnfernsatlon
BUILDING DIVISION __
1 TYPE OP WQ1tIt� _ - _ i (• r �t71Yb7i G°IAL R7t$ °_SC.. ..iE ^ USE C 3 ' +
rf� New construction Additiorvn t ;Mechanical ptamit fern' are based on the value of the work
i lier tit�/reiilace ttenl i pert ned. lndiratc the value (rounded to the nearest dollar) of all ;
i ❑ Demolition ❑ Other: - -._. mcsnlcalmaterials, equ:jmemt. labor, 'n prn � :
' CATEGORY •OF CONSTRUCTION orbead. and __
Value: $ �
- - - _
- ___ - -• f . RESIDBPITIAL EQUIPP EI'tf I SYS1'Eyf5- $Fuji ", 7 ;
1- and 2-family d.wellinb- 1 Cotrlmerclul'l,xdustrinl 0 Aecessory'b:ltiding -- I---- FD/ SyeC1Or in,�Or72rtflOJl use 4�I 4k'i r. i
lbtultt- •funnily• El Masterllu:ld_t ❑ Othe:'_ Do Ea. Total •
1013 tl1TE 11 FORMATIbN .Al�'IJ LOCATICiV: pity escripti ty. liut~ - -,
Jo _ - -.�.. 5 A it conditioning or heat pump
Job site addlcss: ��S c US _. i _ (:•?g - tilts r l nshoEiu la.:mctx1 I 14.00
CAW StatclzIP_ e ZL .i - 7 • / ��I Futnaee100,000 + ! • mwl - 14.00 � -
• •. - - ---- - Fun�aee 100.000- Ter.r
DTI.; 17.90
Suite/1:114 l ,apt nn.: - - Pn, - or. run - -- - - __._7 Gas hem 14.00 Coss sueeddttrctiQnfi to Oh Sat.. - - - - -- Duet work it -- - - I 1.3.00 00 -
_ "� dty�ie had w'a_er s ystem 14.00
______ �- - Residential boiler (radiator or
r _.
hvdt'caic) 14 -W _I
1 -__._- I,rnn hr' eetera (fuel -typo, not electric),
-_, - _ - - -` • in-wall. in•d4ctua�ndcd, e - ta � '` - 10.00
- - - - - - -- Flue:d'Cn: for any of above I ;0.00 f
Subdivision: I Lot
__ _.��..1 -- _- - -- -- -� G irr _ . --- -- ___ 10.00
Tax rnap /pmcci t o,: _^ 1 . Other Bret appliadces --- _- . __.. -..�_
- - - - - -- — - - ---- -- - - --- . --- --j Water heater i 10.00 i
i�i'o.,_; :1AN CIF WORK -- .. _ _ -- - —_.—.— —j" --
-- - ---- ( I ' Gas firep 114 i0.00
S yl �� 1 I ln -� _- ; f lue gent fur water h utca or t us
wtn�
�^ M'l S( ♦ ) - - -- _ - - -_ - - f Log tight asl 10 = � -
UX�r - ` _ -- -- I Wood/pellet stave 10.00 -- - I Woad fueplaceiinsc�_ -- � � 10 u0
__ Chicuneldlineriflue/vent 10.00
:. ❑ PACIPSR%Y .00,( ER ❑ Y9E d +.ice? - ther,
I_Na a�c: ��p� nvi�grnneotai exhaust and ventilation
'L Al �/ _....�,�.__. —__ _--_._- Range hoorUother kitchen
A.dt t - _ ____ - _�...� ed�tripment - - - -- 10.00
_ _ 10.00
- ...__ -___._ Clotho, dryer exhaust I
_--.._..— • - - -. -- _. Singhe•dut+t exhaust (bathroom, i
, Phone: ( ) i Fax: { 1 rl_oil ct compartments. ul i'i, rcrtnns'1 1
r - -_- - - -- ---- r-- ...._ . �ti:JrtawU fans
-- I 10.00 6.1;C }- -
- ❑ AP1�JJiC_U`�T_ - (_ --- - ACT PESO _- __ -.- _.. -•-�
�� - �1
pher: i 10.00 ! Business _ rintiae: - - --- 1 Fnet P1 in ..
-.-- ,_..
Cot - " -'- 5s_an to; first four; $1.00 for each additional
—__ _____._ - _____ - ----- __ -. -- - -- - Fumacc. etc. - - - - -- —
Ad • _._ Gashcut .0
City /Statr71P: W;,ll/suspended`unit - - -,_
-- '- `- --- -- - -" -- -_ Water heater
- - - Fireplace ___ f
E-mail: - - }- -- --
- - - - .. - - -- _ ..-
RangC -- _- ---
CONTRACTOR Barbecue
1 ---- "' � _ _ r -! - -- - - -
.-.- - ,� Clothes dryer (gas) t _- _ i — I
9 name: i
_ � � - 4....p4 I P , ,,,, . ;. — �L�a.C�_ -"_._, I ,titer: 1 1- -- __
Address: - t ...t...-c S / f� ) /." r ^� " � � - - - - - --- r_ `MBCHA1`1CAL PERMIT-FBES' - -
1-- -._ l 1 ,� L/ - / - - " Minimum permit fee (572.50) l 4 "
`rR V-1.1...1..-:( i-/l ,� Plan rcvicw i2 ° d b ofpermitfcci
C:Ct3 h c. _ 1 -L- -� r 1 - (J� _ Stax_ wtcharge OM ufpe mil fee) e I
': 4� - -- jr------.. ! ✓ - - -- [ TOTAL L PETiM I C F EE r ' r
This permit apyticetbn expires if a Derma Is not obtained a thin igp
flut}fOtirbd S _gu it u�: - �., days after It bas been accepted as comptsve
• p:izt name; 1'l� ( l 17atc -LJr ,.t 1„ ' Fee methodology set try Tri.Co,snty kwli.ing rnduety Scr v'.;,e Baud
CITY OF TIGARD
BUILDING `DIVISION PERMIT #: MEC2005 -00781
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/23/2005
Phone: (503) 639 -4171 / a �I�
Inspection Requests (24 Hrs.): (503) 639 -4175 :� & J' I �..
INSPECTION WORKSHEET FOR DATE: /2/5/2005 TIME: 7: 00AM PAGE: 32
SITE ADDRESS: 12350 SW CORYLUS CT CLASS OF WORK:
SUBDIVISION: AIMS ORCHARD LOT #: 004 TYPE OF USE:
PROJECT NAME: FITZWATER
DESCRIPTION: Fireplace insert, gas line & venting.
OWNER: FITZWATER, SCOTT PHONE #:
CONTRACTOR: R & D INSTALLATIONS PHONE #: 503 - 774 -7142
Inspection Request Scheduled For: Date: 12!5/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 022929 -01 5037747142 N
Corrections /Comments /Instructions:
4 i r , IMIIIP'
_._.. . il w —
,
,_ ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION n ADDITIO AL FEES ASSESSED
Ci: A . ,.... ,...............
Inspector: 1 l'■ Date: Phone #: (503) 718 -