Permit r i..
CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00475
T[GARDD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/31/2007
PARCEL: 1 S125DB -05500
SITE ADDRESS: 07260 SW SHADY LN ZONING: R -4.5
SUBDIVISION: SHADY DELL NO. 2 LOT: 029 JURISDICTION: TIG
PROJECT: MATTHEWS
Project Description: Install pellet stove insert and liner.
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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 1OOK BTU: AIR HANDLING UNITS CLO DRYERS:
•
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 2
> 10000 cfm:
GAS OUTLETS:
Owner: , FEES
MATTHEWS, C BLAKE + HELEN MARIE Description Date Amount
PO BOX 23515 •
PORTLAND, OR 97281 [MECH] Permit Fee 7/31/20W $72.50
[TAX] 8% State Surcha 7/31/20W $5.80
Total $78.30
Phone:
Contractor:
CHIM -PRO CO.
18430 SE BURNSIDE
PORTLAND, OR 97233 REQUIRED ITEMS AND REPORTS •
Contact #: PRI 503- 669 -9301 L'
FAX 503- 667 -9698
Reg #: LIC 84985
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 Signatur
Call 503.639.4175 by 7:00 a.m. for inspections that business 1)
a y.
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.
i r
Mechanical Permit Appli 'off - FOR OFFICE USE ONLY
City of Tigard i \ ' I 0.-4.... S'�_/1.) Permit No.: I i t„ (J ��J�V1�� 9,.- i A .
13125 SW Hall Blvd., Tigard, OR 972
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By: Other Permit:
1 A R I� Inspection Line: 503.639 JUL 1 2007 Date ReadyBy: gyps; s See Page 2 for
Internet: www.tigard - or.gov Notified/Method: - //6' Supplemental Information
CITY . . — -+
TYP L opiN la c r 9 T f (y) COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Additio alte �'lation / I epcement Mechanical permit fees* are based on the value of the work
❑ New construction
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: S
1 - and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Healing /cooling
Job site address: 7 O ` C' f ,� ®� A L h conditioning or heat gg placement) )
J Y ` wires site plan s lace 14.00
City /State /ZIP: ] 7 3 _2_3 J Furnace 100,000 BTU (ducts/vents) 14.00
T1 J p Furnace 100,000+ BTU ( ducts/vents) 17.90
Suite/bldg. /apt. no.: `l Pro' t name: 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
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue /vent for any of above 10.00
Other. 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
•
1 I Gas fireplace 10.00
i v1 547.1, `' r \ lr o , .[ \- s p V P , 1 h �• 1 -- Q In. d Flue vent for water heater or gas
■ �r fireplace 10.00
Log lighter (gas) 10.00
Woodtpellet stove )n sir +) 10.00 /b • CO
Wood fireplace /insert 10.00 /
Chimney /liner /flue /vent 10.00 /Q ,Lb
PROPERTY OWNER ❑ TENANT
Other: 10.00
Name. C S I (Ike_ e_ YYLA t ' Environmental exhaust and ventilation
Address: r7 '1. 0 5' ) 5'k � Range hood/other kitchen
�"4� equipment 10.00
City/State/ZIP: f rA O I 4-72_2__3 Clothes dryer exhaust 10.00
/ �J Single -duct exhaust (bathrooms,
Phone: ( 503) gag/4_ 7l t1 2_. Fax: ( ) toilet compartments, utility rooms) 6.80
0 APPLICANT I 0 CONTACT PERSON Attic/crawlspace fans 10.00
Other. 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four, $1.00 for each additional
Address:
Furnace, etc.
Gas heat pump
City/State/ZIP: Wall/suspended/unit heater •
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: Clothes dryer (gas) —
Other:
Address: 'N%... MECHANICAL PERMIT FEES*
CilbTP-Fira Cc - City/State/ZIP: C CB: 84985 Subtotal I
18430 SE Burnside T: 503 -669 -9301 Minimum permit fee ($72.50) /7,, , cd
Phone: ( ) Portland, R 97233 F: 503 -667 -9698
d Plan review (25% of permit fee)
CCB tic.: ZI / 115 State surcharge (8% of permit fee) 5,eo
TOTAL PERMIT FEE 8 , 30
Authorized signature: /� /n , n �� This permit application expires if a permit is not obtaine within 180
C 61/r days after it has been accepted as complete.
I Pnnr nam, 7 ? es^s e ,. t I plot.• - - 30 -0 7 I * Fee methodology set by Tri- Countv Building Industry Service Board
CITY OF TIGARD
BUILDING DIVISION / „ PERMIT #: MEC2007- 00476
13125 SW Hall Blvd., Tigard, OR 97223 / J09/7 / DATE ISSUED: 7/31/2007
Phone: (503) 639 -4171 4+a- l
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 8/9/2007 TIME: 7:0OA PAGE: 71
SITE ADDRESS: 07260 SW SHADY LN CLASS OF WORK:
SUBDIVISION: SHADY DELL NO. 2 LOT #: 029 TYPE OF USE:
PROJECT NAME: MATTHEWS
DESCRIPTION: Install pellet stove insert and liner.
OWNER: MATTHEWS, C BLAKE + HELEN MARIE, PHONE #:
CONTRACTOR: CHIM -PRO CO. PHONE #: 503.6€9 -9301
Inspection Request Scheduled For: Date: 8/912007 Pour Time: 5
o
Code # Inspection Description Confirm # Contact # M- age
699 Mechanical final 053645 -01 503-244-7142 Y
Corrections /Comments /Instructions:
.., Ci----------.
7
li 0
P ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
p________
Inspector: r\4; Date: 9 / (----1 Phone #: (503) 718-
Zc/