Permit CITY TIGARD MECHANICAL PERMIT
'' " DEVELOPMENT SERVICES PERMIT #: MEC2004 -00818
-111 DEVELOPMENT
SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/20/2004
PARCEL: 2S 102DD -00801
SITE ADDRESS: 13855 SW HALL BLVD
SUBDIVISION: EDGEWOOD ZONING: R -4.5
BLOCK: LOT: 006 JURISDICTION: TIG
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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES: 1
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Installation of woodstove.
Owner: FEES
BOGAN, BUTCH AND SUSAN HANSON Description Date Amount
13855 SW HALL BLVD [MECH] Permit Fee 12/20/20( $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 12/20/20( $5.80
Phone: Total $78.30
Contractor:
LUDEMAN'S FIREPLACE & PATIO
12675 SW BEAVERDAM RD
BEAVERTON, OR 97005-2129 REQUIRED INSPECTIONS
Phone: 503 Woodstove Insp
Final Inspection
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.
Issued By: % � r _ e _ Permittee Signature: c� \rt.
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
DEC. 18.2004 3 :48PM 0.005 .2/3
Mechafl ca1 Permit A 1 s lication
j F T and + G Rey: " 1,'0 !1 7- pit Na.:��( ? i y 0 P/
13125 S r • ` 81vd., Tigard, a It 97223 Plan Review Other Permit:
Phone: 503.6 I : .4171 Fax: 5 t 3.598.1960 .% m t' ngpo4;�" I i1 DatcBy:
Inspection Lt 503.639,4175
DEC 4 .., Dan Ready /By: — curio. El See Page 2 fir
U E� 2 21 _
ard.or.us "' Hetified/method: -j I � , supplemental Intermadon
Internet; I Ci.tii; _
CITY OF TIGARD
ki l T + - I -`: COMMERCIAL FEE* SCIIEDULE – USE CHECICLIST
.,� Mechanical permit'fele are based on the value of the work
In New con - traction Ia iadition/alteration/replacement performed. Indicate the value (rounded to the nearest dollar) of all
o Demoliti1 n ❑ Other: mechanical materials, carnotite& labor, overhead, and profit.
Value: $
ATEGORX OF CONS IIZUCTIOPI RESIDENT AL EQUIPMENT / SYSTEMS FEES*
land 2 - ly dwellin l ❑ Commercial/industrial Ej Accessory building
For 1Q(Wprnearion use checklist.
O Multi -fa ily C] Master builder 0 Other: Description I Qty. I Ea. I Total
JOB 1TE INFORMATION AND LOCATION Heating/cooling
5 fJ i - /
Air conditioning or heat pump 14.00
Job site add L �U immures 5ite 0ian showing piecemeal)
Furnace 100,000 DTUSduc�lvents) 14.00
City /Statt:lZ; t� � 7°V� Furnace 100,000+ BTU (dams/vents) 17.90
Suite /bldg. /; +i, no.; Project name: 43 q /) Gas heat pump - _ 14.00 _
[Duet work 14.00
Cross stree I� irectiorls to jo • site: Hydronic bet wate s tem 14.00
Residential boiler (radiator or
hvdronicl _ 14.00
Unit heaters (fuel -type, not electric),
• in -wall, in -duct, suspended. etc. 10.00
- Flue /vent for au of above 10.00
Subdivision J Lot no.: - Other.
Tax map /p: � 10.00
Other feel appliances
10.00
DESCRI TION OF WORK Water heater
Gas f5Iace _ 10.00
_/7 4/1 GdQoaOsiau-C Flue vent for water heater or gas
fireplace 10.00
Le i ter as 10.00
llet stove / 10.00 /Q "–
cod fireplace/insert 10.00
---- -- Chimney/liner /flue/vent / 10:00 fet
: PROPERTY OWNER ❑ TENANT Other. I 10.00 -
Namte: i_4 . p h Environmental exhaust and ventilation
4 Range hood/odter kitchen
W., equipment 10.00
-
Address: 856— �SeJ �q � • .t 1 _ Clothes dryer exhaust _ 10.00
City /Sts IP: --7-7 d 9174,13 _ Single -duct exhaust (bathrooms,
Phone: ) (9O7 ��DSt� Fax: ( ) toilet compartmetts. utility rooms) _ 6.80
., _ 10.00
� Amu a A _ ❑ CONTACT PERSON Attic%rawlspace fans
Omer. 10.00 r
Business i e tr - 'C /» q h g — Fuel aping
Contact n= e: 5 /' 044_ Ar' / . $5.40 for fiirstfour; 51.00fr each aiditiona
L � Fumace etc. 1 l�
Address: / C _ � ♦r1 �X Gas heat pump
City/stet ■ 1 1 L ear � O2 ' 7 cc ' Wall/suspended/unit heater
Fa x :: (rg) eo s/4 ' c Q�3 V Water heater
-
Phone: (J • X0 - Fitt place
E-mail' Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business = • e: ` ' co nA Q, _ ,_ Other: . •
Address: MECRANICAL PERMIT FEES*
-
Subtotal --
City/Stat 1,1P: Minimum permit fee ($72.50)
Phone: ( _ Ftlx ( ) Plan review (25% of permit fee) J
CCB lie. 0 AS State surcharge (8 ° 4 of permit fee) '
TOTAL PERMIT PEi 7 3Oi
'r hi* permit application expires Ira permit is het obtained within ISO
Authorize. signature' �' days after it has been accepted as complete.
r sy(J r)atc , Fee methodology Sat by Trt.County Suilding Industry SeMee Board
Print nAT:: / C A.),,,./e... �,�.� ...1 Q• ay
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested /) f t AM PM BUP
Location
/ 3 S. Ss r Suite MEC ?'O -!)U WY
Contact Person _ Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/U> ELC
Footing a 4- 3 40.5
ELC
Foundation
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing ;_
Insulation ��
Drywall Nailing I - ? �t jt� ` II
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other:
inal
F / mat-
PASS PART FAIL
PLUMBING: i Wart i ��
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
°
Post -& Beam
Rough -In
Gas Line
S • Dampers •
• ASS PART FAIL
L R ICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required befor: next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call f r reinspe ion RE:-k7' Unable to inspect - no access
Fire Supply Line
ADA F
Approach /Sidewalk Date Inspe Ext
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL