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Permit 1 CITY TIGARD MECHANICAL PERMIT X 1 1 DEVELOPMENT SERVICES PERMIT #: MEC2006 -00428 - I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/5/2006 PARCEL: 2S103DD -00404 SITE ADDRESS: 10685 SW FAIRHAVEN ST ZONING: R -3.5 SUBDIVISION: FAIRHAVEN COURT LOT: 004 JURISDICTION: TIG Project Description: Install gas fireplace insert & run gas line. 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: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: 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: 1 Owner: FEES GINGER MATYCHUCK Description Date Amount 10685 SW FAIRHAVEN ST TIGARD, OR 97223 [MECH] Permit Fee 9/5/2006 $72.50 [TAX] 8% State Surcha 9/5/2006 $5.80 Total $78.30 Phone: 503- 639 -3613 Contractor: LUDEMAN'S FIREPLACE & PATIO 12675 SW BEAVERDAM RD BEAVERTON, OR 97005 -2129 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 646 -6409 FAX 503- 646 -8034 Reg #: LIC 51469 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: � ELZ Permittee Signature: j a Call 503 - 639 -4175 by 7:00 a.m. for inspections that business dal). 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. N0.304 P.2i3 SEP. 1.2006 4 :48PM j , Mtchalolicai Permit A licat �A l i►tt op! R. I. t ,l: t >1.1 • City of Tigard N `1 *A� w 131 SW I•iall Blvd., Tigard, OR 972 r .? d , r H 4 s t]ateBy: el Permit No. 2/ 1 a� Phone: 503.639.4171 Fax: 503.598.1960 - Pia AC11 ° il' ,, ,,N�14 1 : i j` Dat4By: Other Penult ime Inspection Line: 503 - 639.4175 � _ ,, tt - �,y► 1 - D Ready/By' Fl S Pa Internet: wWw.ci,tigard.or.us , , Zoo 1 � � gc i Nf r Narired/Metltad Supplemeami tnt'ormnt �. E O 'ORKorn COMMERCIAL F EE* SOMME - USE CHECKLIST © New construction Addinooti alie nt Mechanical permit fees' are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all 0 Demolition 0 Other: ( ) mechanical materials equipment, labor, overhead, and profir. CATEGORY OF CONSTRUCTION Value: S 1! - and 2 - family dwelling El Commercial/industrial El Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES* [] Multi - family ❑Master builder For special information use checklist ❑ O ther: Description 1 Qt,. l:a Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: / 6 As- „z4.) , r 4V C ...s--, Air conditioning or heat pump �? n . (ret site plan showier; placement) 14.00 City /State/,Z S Furnace 100,000 BTU(ducts/vcnts) 14.00 Suiteibl ds• p /a t n o.: � Furnace 100.000+ BTU {acts/yams) 17.90 l'rojeet m nae :mom Gas heat pump 14.00 Cross street/directions to job site: Duct work 14.00 Hydronic hot water system 14.00 - Residential boiler (radiator or h dronle) _ 14.0_0__ Unit heaters (fuel -type, not electric), ' - in -wall, in -duct suspended, etc. 10.00 Subdivision: I Lot no.: Pluefvent for any of above 10.00 Other 10.00 _ Tax map /parcel no.: __ Other Mel appliances • DESCRIPTION OF WORK Water beater 10.00 T �/ Gas fireplace _ 10.00 �‘ ►/f Flue vent for water heater or gas 4 �r• � �� • , fireplace __ 10 .00 Log lighter (gas) 10.00 Wood/pellet stove 10.00 • Wood fnnplace/insert n G. / 10.00 AG100 (PROPERTY OWNER I ❑ Chimncylliner /liue/vcnt / 10 :00 /400 �,/ Other 10.00 _ Name. G/r? C r /774 7 4i 4 G/'r Environmental exhaust and ventilation Range Address: /0lOje a1Ce) , /r44U0l\ .-.57 « . equipment kitchen 1 P __ 10.00 City/State/ZIP: ¢e r,sQ OA 97e3a a Clothes dryer exhaust 10.00 �l Single -duct exhaust (bathrooms, Phone: (S4) Go39- 4 b/.3 Fax: ( ) toilet compartments. Willy rooms) 6.80 V APPLICANT ❑ CONTACT PERSON Attic/crawispacc fens 10.00 Business name: 2, 4CPt M O.7 5 of - 10.00 F Fuel piping Contact name: - - _ - o n * pc lee .< 5540 for first four; SI.00 for each eddldona Address: ,/c 4 7 �c) . 91;7 ec /t r 01 Rear Gas h ea t p 71 p4 / OR 9 70 Gas heat pump City /State/ZE 4./e"/ Wall/sus tied/unit heats Phone: (503) c 5/6,„ ea f0/ Fax:: (s co 5/6 - 4Pcx3 Y Water heater E-mail: , Fire�laee I 4:90 .531:11 Ronne CONTRACTOR RACTOR Barbecue - _ i Business name: 5 /0 e-- , Clothes dryer (was) Other Address: MECHANICAL PERMIT FEES* City /State/ZIP: _ Subtotal ", Phone: ( ) Fax: ( ) Minimum penult f ($72.50) 7.7,..5 Plan review (25% of permit fee) CCB 11c.: , c.p c224,..__ State surcharge (8% of permit fee) ,Jr,�Q r TOTAL PERMIT PEE 741,3 Q l Authorized sigflatttrC: this permit application entrees if a permit is not obtained within 180 F • data after It has been accepted as Complete, Print name ( >4 n C ,{ I h ate: 91,-, .. Q I Fee methodology set by Tri.County Building Industry Service Board CITY OF .^� .GA..~~ � ~ BUILDING DIVISION ' ~�~°,.�~°""~~~ ~~"°"~,"~~"~ PERMIT #: K4EC200&00428 / 1312GSVV Hall Bhd.. Tigard, ORA7223 DATE ISSUED: 9/8p006 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 INSPECTION WORKSHEET FOR DATE: 9/14/2006 TIME: 7:00AM PAGE: 32 • SITE ADDRESS: 10685 EWFAjRHAuEN ST CLASS OF WORK: SUBDIVISION: FAIRHAVEN COURT LOT #: OQd TYPE OF USE: PROJECT NAME: MATYCHUCK DESCRIPTION: Install gas fireplace insert & run gas line. OWNER: k4ATYCHUCK.8|NGER PHONE #: 603_639.3613 CONTRACTOR: LUQEK8AN^SFfREpLACE & PATIO PHONE #: 503.646'6409 • Inspection Request Scheduled For: Date: 9/14/2006 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 036527-01 503-639-3613 �4 Corrections/Comments/Instructions: • PASS | | PARTIAL APPROVAL n CANCEL NO ACCESS | I FAIL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: ��^ /�' Date: -- &�--~� Phone #: (503) 718- 7