Permit A, CITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2001 -00334
�y, DEVELOPMENT H BMEN9 r S o ERV SERVICES 639 -4171 DATE ISSUED: 9/21/01
PARCEL: 1S136AD-05600
SITE ADDRESS: 06716 SW PINE ST
SUBDIVISION: ZONING: R-4.5
BLOCK: LOT: JURISDICTION: TIG
CLASS OF WORK: ALT FLOOR FURN: ' EVA P 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:
OTH 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU:' AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: < =10000 cfm: GAS OUTLETS:
> 10000 cfm: -
Remarks: Installation of pellet insert..
Owner: FEES
PALMER, DAVID E + Type By Date Amount Receipt
JONES, LINDA V PRMT CTR 9/21/01 $72.50 2720010000
6716 SW PINE ST 5PCT CTR 9/21/01 $5.80 2720010000
TIGARD, OR 97223 •
Total $78.30
Phone:
Contractor:
LUDEMAN'S FIREPLACE + PATIO
12675 SW BEAVERDAM RD
BEAVERTON, OR 97005 -2129 REQUIRED, INSPECTIONS
Final Inspection
Phone: 646 -6409
Reg #: LIC 51469
EXPIRED
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore.
Specialty Codes and all other applicable Taws. 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 -0080. You may obtain copies of these rules, or direct questions to OUNC by calling
( fl 94R -Q1R •.�
Issue By: .� _ , /! Permittee Signature: el>7
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit • 1 plication
� Date received: g./ t91 Permit no:: Al 8O 1 -C2253€1 i
i.'!".0!: Cl of Tigard Project/appl. no.: / Expire date:
City ofTigard Address: 13125 SW V Et vvo Date issued: By:66 I Receipt no.:
Phone: (503) 639 -41
Fax: (503) 598 -1960 SEP 1 8 2001 Case file no.: Payment type:
Land use approval: Building permit no.:
-. -r. -)n
TYPE OF PERMIT
�1 & 2 family dwelling or accessory O Commercial/industrial 0 Multi - family 0 Tenant improvement
O New construction )'Addition/alteration/replacement 0 Other.
JOB SITE INFORr9ATION CONINIERCIAL VALUATION. SCHEDULE
Job address: (p 7/t' Sec) / 1',7 c. S Indicate equipment quantities in boxes below. Indicate the dollar
Bldg. no.: — Suite no.: — • value of all mechanical materials, equipment, labor, overhead,
Tax map/tax lot/account no.: - profit. Value $ •
Lot: 'Block; I Subdivision. •See checklist for important application information and
Project name: pq Tir! rot juri:d €tier's fee schedule fer residential permit fee.
City/county: -j� gra/ ZIP' 9 70,073 I & 2 FAMILY DWELLING PI RrIIT FEE SCHEDULE
Description and location of work on premises: /A )57741.L nP kNI) COr1rlERICA 1JINDUSTR1 :kLEQUIPrIENTSCIIEDITE . Total
iQc //c =nS e• i•- IL R
Est. date of completion/inspection: E',/ a f . Sr-fn - , CIO / HVAC: Pa
Tenant improvement or change of use: Air handling unit CFM
Is existing space heated or conditioned? 0 Yes O No Air conditioning (site plan required) • - .
Is existing space insulated? 0 Yes 0 No - . Alteration of existing HVAC system
SiFC!1ANICAL CONTRACTOR
L pt_t'IRNS A P.EPLR CE ANU P4T10 stateboilerpermitao.:
Business name:
Address: / a (07 5 . Sj, j ,5 Alt v4darrl Road...... Fire/smoke dampers/duct smoke detectors
City: State:ti . ZIP: 'j pp Heat pump (site plan required)
Phone:$36`4 (o of Fax:536% 2 E-mail: -- ns rrrep : , : - -t -.
Including ductwork /vent liner O Yes O No
CCB no.: - $3 a ... Install/replace/relocate heaters -suspended,
City/metro lic. no.: — wall o floor
Bence mounted
than furnace
Name (please print): 4./A, DEirl 4 IU
Absorption units BTU/H
Name: ,rid 44 . L- t-t.O& 44 44) Chillers HP HP
Address: :5'lchli E A-S o1 Co ors ad 4
mental exhaust and vendlatlon:
City: State: I ZIP: Appliance vent •
Phone: Fax: E-mail: ' . - Dryer exhaust
OWNER Hoods, Type I/ II/res. kitchen/hazmat
hood fire suppression system
Name: - 709 V! a/. e , r ,/s PA /i„ e 2 Exhaust fan with single duct (bath fans)
Mailing address: CL 7/6 5(.c) Piti 5 7e . Exhaust system art from heating or AC
City: State: 02 ZIP: Q 7 as 3 ' el p1 and on to 4 outlets )
Phone:0 y - 5 9 yea Fax: E-mail: — Fuel piping each additional over 4 outlets
EN G IN 1. E R Process piping (schematic required)
Number of outlets
ame: der listed appliance or egtdpment:
E g: :. Decorativefueplace . . . . .. T
: State: ZIP: . Insert-type _J %a. ac 10.01':
• on. • Fax: ' , . tov pe etstove
App ✓.: �1.s1:.�* _I�.- . — Date: ' -/ - M en
••!' r ':t) : !_ a /. ....46...:60,
i -/c _ .
:. . . - ...
i - Li.A t& bl.}t_) � ..... ._.. .- Permit fee $
juristricdons ae . `- - . foe Notice: This permit application 72 . $b
-.7 - - - - . Minimum fee � $
Credit era - - - - expires if a permit is not obtained Plan review (at %) $ ��
Expires within 180 days after it has been State surcharge (8 %) $ 'i. c1C)
m ehoaB oB : accepted as complete. TOTAL $ �]g. 3D
9anrinweaern end Few:
Cardholder signal= , i Y _� ' 1. $72 ho m noon* busbies, ran (mbivnrn wps+.o bars) 44x4617 (6d10IC01�
' 2 bnndiors for whkh no roe is spedfically kdlorted (mhim+m d earl
$7250 per her
A Additional pfen review repvmsd by charges. additions or IWO= to pis (m6
dsrpeors.ntll hoar) $72.50 per her
'5ste contractor Baker cerBBfuden required for rids 0200k BTU. .