Permit CITY OF ' T I G A R D MECHANICAL
4 4/11 11 a DEVELOPMENT SERVICES PERMIT
I ' 13125 SW Hall Blvd., Tigard, OR 97223(503)639 -4171 PERMIT #. 1 : MEC98- 0501
DATE ISSUED: 11/06/98
PARCEL: 16134AD -01600
SITE ADDRESS...: 11375 SW LAKEWOOD CT
SUBDIVISION....: ENGLEWOOD ZONING: R -4.5
BLOCK ° ' LOT °056 JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN....: 0 EVAP COOLERS: 0
TYPE OF USE....:SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:R3 VENTS'W /0 APPL: 0 VENT SYSTEMS: 0
STORIES........: 0 BOILERS /COMPRESSORS HOODS ° 0
FUEL TYPES 0 -3 HP ° 0 DOMES. INCIN: 0
:WOD 3 -15 HP....: 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP ° 0 REPAIR UNITS: 0
FIRE DAMPERS ?..: 30 -50 HP.....: 0 WOODSTOVES..: 1
GAS PRESSURE...: 50+ HP....: 0 CLO DRYERS..: 0
NO. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 0
FURN ( 1O0K BTU: 0 (= 10000 cfm: 0 GAS OUTLETS.: 0
FURN > =1O0K BTU: 0 > 10000 cfm: 0
Remarks : Install new woodstove insert into already existing fireplace
Owner: FEES
MIKE REID & JAN REID type amount by date recpt
11375 SW LAKEWOOD CT PRMT $ . 25.00 JSD 11/06/98 98- 310621
TIGARD OR 97223 SPCT $ 1.25 JSD 11/06/98 98- 310621
Phone #: 590 -4593
Contractor:
R & D INSTALLATIONS
5246 SE 62ND
$ 26.25 TOTAL
PORTLAND OR 97206
Phone #: 774 -7142
Reg it..: 95236
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Woodstove Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection .
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 by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952 -Y4-0010 through OAR 952- 001 -0080. You may
obtain copies of these rules or direct questions to OUVC by calling
(503)246 -9187.
Issue B . ���� Permittee Signature: "1►�1 L
.IfiA)L
f
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Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
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Plan Che
Crr(OF TIGARD Mechanical Permit Application Recd By _..
13125 SW HALL BLVD. Commercial and Residential Date Rec'd / U � / c �
1
TIGARD, OR 97223 Date to P.E.
(503) 639 - 4171, x304 Date to DST
Print or Type Permit# /}trG.9g-dS�(
Incomplete or illegible applications will not be accepted Call 0 7--''
Name of Development/Project Description
C J 00L. Table 1A Mechanical Code Qty Price Amt
Job Street Address Suite# A) Permit Fee 10.00
1) Furnace to 100,000 BTU
Address 11375 61,3 1 including ducts & vents 6.00
Bldg# City/State Zip 2) Furnace 100,000 BTU+
I 1 c( 97.4 - 3 including ducts & vents 7.50
Name (or name of business) 3) Floor Furnace
Owner i 4 . •f 3 tun 12 2.1 including vent 6.00 .
Mailing Address 4) Suspended heater, wall heater
or floor mounted heater • 6.00
5-t.-L . &too 5) Vent not included in appliance permit
city /state Zip Phone 3.00
590 - y 5 3 ' CHECK ALL *Boiler Heat Air
Name (or name of business) THAT APPLY: or Pump Cond Qty Price Amt
Sew caber Jot. 6) ..
Occu Occupant Mailing Address 6) 0K BTU unit to •
p 100K BTU 6.00 .
•
• 7) 3 -15 HP;absorb unit
City /State Zip Phone 100k to 500k BTU 11.00
8) 15 -30 HP; absorb
• Contractor Name •
unit .5 -1 mil BTU 15.00
t .-r-t in ailoJio H 5 9) 30-50 HP; absorb
unit 1 -11 :75 mil BTU 22.50
Prior to permit Mailing Address KCL 10) >50HP; absorb unit
issuance, a copy 5 66 Co a- >1.75 mil BTU 37.50
. of all licenses City /State Zip Phone 11) Air handling unit to 10,000 CFM
are required if Pp,+1" d 9 73'L 77y- 71 4.50
expired in COT Oregon Const. Cont. Board Lic.# Exp. Date - 12) Air handling" unit 10,000 CFM+
database 1/111 'f 7.50
Architect Name 42/ 13) Non - portable evaporate cooler '
. 4.50
or Mailing Address 14) Vent fan connected to a single duct
3.00
• 15) Ventilation system not included in -
Engineer City /state Zip Phone appliance permit • . 4.50
16) Hood served by mechanical exhaust •
Describe work to be done: 4.50
17) Domestic incinerators
New 0 Repair 0 Replace with like kind: Yes 0 No 0 . 7.50
' Residential g Commercial 0 18) Commercial or industrial type incinerator •
• 30.00
Additional information or description of work: . - • 19) Repair units
Zn dal l 1 vtc A 4.50
u 00a J.t, i n`� '' lk,1 20) Wood stove
aJv�A - QX /5�n - re..)Iaat 4.50
21) Clothes dryer, etc.
4.50
Type of fuel: oil 0 natural gas 0 LPG 0 electric 0 22) Other units
4.50
I hereby acknowledge that I have read this application,. that the information 23) Gas piping one to four outlets
given is correct, that I am the owner or authorized agent of 2.00
the owner, that plans submitted are in compliance with Oregon State laws. 24) More than 4 -per outlet (each) •
.50
Signature of Owner /Agent Date •/
Minimum Permit Fee $25.00 SUBTOTAL " , , ,;
l 5% SURCHARGE (- Id
ntact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL `'
t �' Required for A commercial permits only ( F _
30t..„ P. el& 5 - ? L r 3 - TOTAL ; * - , " " :: .!
*State Contractor Boiler Certification required
* *Residential NC requires site plan showing placement of unit
I:Unechperm.doc rev 07/20/98
CITY OF TIGARD BUILDING INSPECTION DIVISION PAS
T
24 -Hour Inspection Line: 639 -4175 Business Line: 639-417 6 ,a � 3 (�
UP -
10 1001 Date Requested 1( — /Z - 9 AM PM ■ BLD
Location < I - SW ga. etav C , Suite s'3.-050)
Person feet/ `'
Contact o ���-�� Ph � zi ?3
-
Contractor Ph SwR
BUILDING: ` ;`4 A «fir Tenant/Owner ELC
Retaining Wall y� EL .R
Footing o // (�C/ 1, a 1 36 - 3- 7 30
Foundation Access: FPS
Ftg Drain
Crawl Drain Inspection Notes: SGN
Slab SIT
Post &Beam C-07-56
Exf Sheath /Shear /
Int Sheath /Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
PLUMBING <k . >:.:..m,
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS---Pficiff----. FAIL
GHANIC'
• Post & Beam
= ough In UJ
me
�, =v =a• -D ampers
0► PART FAIL
ELECTRICAL vF, `,,;''
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call f reinspection RE: [ ] Unable to inspect - no access
Approach /Sidewalk J /
Other Date ( Inspector Ext�
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.