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Permit C ITY - OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00169 TIGARD 13125 SW Hall Blvd.,. Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/3/2008 PARCEL: 1 S133DA -04600 SITE ADDRESS: 12590 SW GLACIER LILY CIR ZONING: R -7 SUBDIVISION: AMART SUMMERLAKE LOT: 068 JURISDICTION: TIG PROJECT: HICKENBOTTOM Project Description: Installing wood fireplace insert and gas piping. 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: 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: OTHER UNITS: 1 FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Owner: FEES HOUSTON & SHARON HICKENBOTTOM Description Date Amount 12590 SW GLACIER LILY CRL TIGARD, OR 97223 [MECH] Permit Fee 4/3/2008 $72.50 [TAX] 12% State Surch 4/3/2008 $8.70 Total $81.20 Phone: 503 -524 -6128 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: _��� Permittee Signature: � 7 � 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. APR. 2. 2008 5:57PM ,r 0.292 .2/3 Alec i1a 1'el' Illlt Applicat r(Ilt Oil l( I +: l . I, • s _ City of Tigard- / n to a ��� /1,112:_r �?rX )�-- 1:61 Date/By, Pallet Na,: / '4r " 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ' ' - Phone 503.639.4171 Fax: 503,598,1960 Daraffly Ol'hetPernut, - 1'1GARD Inepectton Line: 503.639,4175 t . Date Ready /13y Junin 0 See Page 2 for ,, Internet' wtttiv ttgard- or,gov � lv / �,a iVOttfiad/Meutod Supplemental lul'ortn1tion � j . i -ter-- ,�, , J iry At , !r F v f! t t ^i. I e n `Y w c.. .,4, t I $r 'I' t I 1 n l' i � . 1 °i,I' "', i i• ! T i l l > I 4 y 4� t i �t l •�, l` {,' r l I V 4. , i.. 1 1E (0 i1; •`�.� . t.dl'r , '�; 9 J 11L' l� i - t• �'it I • D' . h'J x^'! 1 F� .� r. , 7, ri , Ike �av E 1 t :, t i "t 4° w . f dddYYY d MIA LC 1'`' 4a r Pit Mechanical permit fees arc based on the value of the work ❑ New construction K Addition /alteration eplae�inen �` � rya �� ,��0 performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ry ❑ Other: ��yry[ N 'POP mechanical materi equjt�men labor, ove rhead, a__ l�d profit, _ _ _ _ , ,,, " ' , v d 'h '. 1')Y l ¢ t is Id�I ' g ;1t' tl(a I, ' 6 Tili�t�l ly { 4 '''',�'Y ,i{' r u r�yf � o value $ 6 t U4, I, 'ki R P . 1 � 11 1 C t t n'. a r4 1 • and 2- family dwelling El Commercial /industrial ❑ Accessory building i' i' ° `� For speeia! information use checkkst, ❑ Multi- family ❑ Master builder ❑ Other: Description Qty Total i 7 t i! lt,,1 nn, 7 f' 14'1171 -F ttl� I , ,,4 ; ,Iroi ,,i _ _ lra, ..' ',, ,I',''0 iNly ,I' � :ii�,�;,1,k 1;1?i,y'�t� /0,4, 'A-, I! �'; ,ii 1,,✓''`, Healin coalinin _ 1 i „ �. , � i t ff � et, 4SOw ( f '� dress. + Air conditioning or heat pump Job site ad �� ©zcJ -c - E r .. (rtgebes aite plan shew(ng placement) 14 00' C ity /St ate/ZIP , /� +� r � �� C� 7 a Furoaoe 100,000 BTU (ducts /yams) 14.00 ;/ Furnace 100,000+ 13TU (duets/vents) _ 17,90 Sutte/bldgfapt. no : Project name; )4/ f<�e_r ,)o 14o h•7 Gas heat pump 14,00 Cross street /directions to Job site: Dint work 10 00 - -. I.1 dronic 11ot water system 14 00 Residential boiler (radiator or hydronic) 14 T -- - Unit heaters (fuel -type, not electric), in- -wall, in -duet, suspended, etc. 14,00 Subdivision, Lot no.. Fluc /vent for any of above 6.60 -_ Other. 10.00 Tax map /parcel no.: Other fuel appliances [ "n, i'. ' itl ffyN^ h4J ;pp p� y,gn rc ,i6 "y� ( t ( � Wate ht 10,00 �� r heater }, , � , i,�fllor l,'Ai il; i, iI L or` '�1•' f9 t �` g'Fl- I, �n� . � '� ='� „ �� ;`,�� #I� ���� .� -- JJ GAS fireplace 10,00 ___, 1 e 7/ i ,j7: ,r 7 Sc'! -I - p G' /7 Flue vent for water heater or gas fireplace _ _ _ 10 00 '” / h Log lighter (gas) 1 0.00 Wood/pellet stove 10.00 — — Wood lirlplace /insert - - )7 (- / 10.00 /Q . ' i i � 7 r 0 g • �� i �1S� r , . i ttT. ;�l i,,.,,, :,,, ,,,,ip , , tt 11 - �i111 P.1' /flllelVellt Roo /.‘3.00 ,C e • Other, t0�a0 Nair ��rar7 Z1� /L' I� �'r� �)o �7�r» Enaironmental exhaust and ventilation + Address: Range hood /other kitchen f • eye, // _ / // * - 2. , e _ 10,00 City /State /ZIP: _ , r is 0 2 9 -? a - Clothes dr eerr exhaust _ 10.00 Single -duct exhaust (bathrooms, Phone: ( x3) „y y_ , / Fax. ( ) toilet compartments, utility mains) 6.80 , 'I " t` ' °'I } (�i 't 'e tie /crawls f 10.00 ace fans ,I 1,µ ti;,`� ` S i t ,' , ; tII, 9ha t �' ,, e r ' � ; q_ � 1 l 1jr, ' 1 '��' 'l'i77 'r" 4 � �49��TId1s)N � t s ! "tNl� � ���1 ` At p - -- — Business n Other: 10,00 Bus ,L, �G /YI „taps__ _Fuel piping Contact name ,disi►. m 1 , ' C Xe A $5.40 for first four; 51.00 for each additional r I Furnace, etc Address / +' J am. ° yr� z ° �.- a o t e C gG:• __ Gas !teat pump -- Cuy /S(ate/ZIP: 8 ,4 u cr7- O R 9 7 cc Wall(suspended(unu heater __ 5 4 , 9 9 ° ? Fax :: ( ,'0,31 6, ve „. f1J f Water heater — /I Fineness 7 do E "mail; Joni to / Y em4ai S. t�(p Range �i�, l'ltf "i },' ,'�� z l; , l lirlh, 19 e b.i. p,i;,, l i,,'r, , , , )I r c d r l u Brb 1 >� ,, 6 ccuc � ,? " i IRA , . X151 iii h, fl ,)i �d,a t Business name. 579_ Clothes dryer (gas) Other: Address: '' '414* yt i f� a' ' f I t I ', ' ( U , , 1.:4 '% 1 t 1 ; i , .,'i C ity /State /Z(P: Subtotal ,c3? -- ;ye") 1 Minimum permit fee ($72.50) 7d- 5-0 - Phone. ( ) Fax: ( 1 Pin: review (25% of petmit fec) CCI3 tic.: .5 7,16, " State surcharge (12% of permit fee) , X) TOT-4.1. PERMIT FEE 8/. c ,, Q , Authorized 51 uitur�_ This permit application eapiree if n permit is not obtained wirhin 1130 _ day's after it line beta accepted an complete, Print name' am'* SW9 airC/C Date: ,/._ — o e Fee mothodeloey Sri by 7ri- Gouniyl3ullata8Industry Service Board O I ^SII Iuing \NeunIcuMac• ' nuApp dvt, QI /I 907 4 (t1 /snCOM/WCb) • CITY, ��m m m �-w�- u �� BUILDING PERMIT #: h4EC2008-00169 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 413/2088 Phone: (503) 639-4171 Inspection Requests (24 Hrs.): (503) 639-4175 *��� INSPECTION WORKSHEET FOR DATE: 4/24/3008 TIME: 7;01/\k8 PAGE: 46 SITE ADDRESS: 12:`. GLACIER LILY C|R CLASS OF WORK: SUBDIVISION: AMART SUMMERLAKE LOT #: 068 TYPE OF USE: ' PROJECT NAME: H\(KENBQlT0kA DESCRIPTION: Installing wood firopkic:e insert 3nd gas piping. OWNER: H|CNENB0TTOKA. HOUSTON &SHARON PHONE #: 503-534-6128 CONTRACTOR: LU[)[ih4AN'3 FIREPLACE. K.PATIO PHONE #: 503'048'6409 Inspection Request Scheduled For: Date: 4/24/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 068814-01 503'5266128 N Corrections/Comments/Instructions: • PARTIAL APPROVAL CANCEL fl NO ACCESS I I FAIL ALL R3R INSPECTION [l ADDITIONAL FEES ASSESSED Inspector: Z �� � Date: Of Phone #: (503) 718- CITY OF TIGARD BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 � Adt � ) Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: TINkE PAGE: SITE ADDRESS: /c. 47 t � J 62 6-@ - L Iy C/re% CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: A )der- Heel- - OWNER: �a USI ?then /D/ PHONE #: 3 -7E - / CONTRACTOR: �5f /', ,eoter // _ j PHONE #: Inspection Request Scheduled For: Date: i t / ` c — Pour Time: Code # Inspection Description Confirm # Contact # Message Corrections /Comments /Instructions: 1VPASS I I PARTIAL APPROVAL ❑ CANCEL n NO ACCESS n FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: 1)17`4 Date: L � Phone #: (503) 718 -