Permit •
Mg CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00126
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/12/2008
PARCEL: 1 S125DB -10100
SITE ADDRESS: 09600 SW SHADY PL ZONING: R - 4.5
SUBDIVISION: THE RAZBERRY PATCH LOT: 021 JURISDICTION: TIG
PROJECT: POWERS
Project Description: Installing natural gas stove.
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: 1
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: 1
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
GLENN & MARILYN POWERS Description Date Amount
9600 SW SHADY PL
TIGARD, OR 97223 [MECH] Permit Fee 3/12/200€ $72.50
[TAX] 12% State Surch 3/12/200€ $8.70
Total $81.20
Phone: 503- 244 -2951
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: c G� jW
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.
M echanical MAR. 1 1 .2009 12:41PM '10.199 .2/3
• ' ' ' - Mechanical Permit Applica 63
City of Tigard ir CEIVED Received
1 Date/B .
r 7 // a
. , -
. q 13145 SW Hall Blvd Tigard OR ' / ' f, D 1 1 LUUti
- .: Plan Review
Phone: 503,639A171 Fax ' 503,598 19 AIN a. Date/By: Other Pernik:
Inspection Line: 503.639 Atris'
T I GARD CIIY T . TIGARD Date Ready/Br ej see Page 2 for ,
Internet: www.tigard•or.gow 011)1810N .....
Notifted/Melhod:
--- ,.. Supplemental information
, 4r.•;,:i.bi if ri VI; I O U ' I T.4 126 4, 1 1 14 ,A1 6 ,10 . 4• ,,.1,4 0: ESSOFfi '
. - .....,... ,... .. :,, ..,,,,,,,...., , .... ,,, :, e . ,,, . .. zw. te to it 1 - at.. ,n A ,.i. . i., .,, ,, r-, , , .. . L .1.A....-. Loalw. dew • . , • Fs ,
Mechanical permit fees* are based on the value of the work
0 New construction Addition/al 1 ation/replacement
performed. Indicate dic value (rounded to the nearest dollar) of all
0 Demolition 0 Other; mechanical materials. equipment, labor. overhead, and profit
',:.,, ,:•.' ' :..;' .:4 .40. ''!kiv tiv4VICrIV.IiirViyitITYPOVIEN910/MBEE Value: 5
'' • ' .. ' ..1 ! ' 4, ■ .tifo ikedele.:4:a.?Iff , d...r.1,..iLusaoir .7.2 .. . 1/1....4 ,..,
Kr
g I - and 2-family dwelling 12 Commerci /industrial 0 Accessory building
For spacial Information use checklist.
0 Multi-family 0 Master builder 0 Other: Description J Qty, i Es. I Total
• .: . ' . . . ':'''': " i . Og 3 17 6- 1=42a, l' ;'2 7; 4 Heatine/cooling
.
Job site address: 9 0 0 ...5 ‘ A 4. cly /'2. . Air conditioning or heat pump
(require site_plan showing placement) 14.00'
Cily/State/ZIP: 77G orc 0 9 1 7 (P.3 Fumace 100,000 STU (dueisfvems) 14.00
FUITIACC 100,000+ BTU (ducts/vents 17.90
Suite/bIdgJapt. no.: 1 Project name PC2ed e r s . Gas heat pump 14.00
Cross street/directions to job sire: Duct work 10.00
1-1ydronic hoc water slistcm 14.00
Residential boiler (radiator or
hydrouic) 14.00
____
- Unit heaters (fuel-type, not electric),
in in suspcndeci 14.00
Flue/vent for an of above 6.80
Subdivision: I Lot ito.:
Other: 10,00
Tax map/parcel no.: Other fuel appliances
I 44 W ater heater 10.00
: ''.. '!'''''• '!' ' '' i '' ' ', ... r, ...ti aritiFEJ,E.Riataktnrittlit
Gas fire lace 10,00
-1- )73 7 . 17 .5 . 7 V - e... Flue vent for water heater Or gas
fireplace 10.00
Lo. li. ter • 10.00
Wood/pellet stove_ n 6 MIMI 10.00 Al dr)
Wood fireplace/insert II 10.00
r.a...,r,+•are Chimney/liner/flue/vent 10.00 /or. dee
...- :: VA ' ' ''' T INOS I ECENIOPETE 7 141 tigia 1 oth„:
i ,i. ,I...• : ^,i mch . :le ' .• ■ " ,.. ,1; ', bl . .. .,' L Ir _, ' , . ■.!.o.,. ' ..,... ' ova. . , 10.00
Name: - /& Y7 Pc ef,/ e r S _ Environmental exhaust and ventilation
Range hood/other kitchen
Address: 96, oc3 cls ....la - 0/, iox , .,,i.m.„, 10.00
City/State/ZIP; 7--- -
c.-v:rcl v g 9 7cR.Q .3 Clothes CT exhaust 10.00
- Single-duct exhaust (bathrooms,
Phone: (503 c :R Vy"- 9,5 / Fax: ( ) toilet comiartments. utili rooms 6.80 1111
r...22reftvr
AtticJerawls.ace fans 10.00
':" ' ' Y, ;; 1 :4 , ....ilealritktgairdkalgAMPZM=CM.T.. 1 141.7.igitfradt&..• .til mid...k .
11111
Business name: L a 0 / eh a r ; Cither:
Fuel pip 10.00 ing .
Contact name: 4APP _ A) A '' • - C. S5.110 for first four. $1.00 for each additioual
ar- Furnace, etc. 1111111111111•11111•
Address: titg 675 1 . 1 13 e , e clan, R c/ NM
, v. Gas heat .0 .
City/Suite/ZIP: 1
.? ea u er 7 fr) C__ 9 7 045. Wall/sus • ended/unit healer
Phone: isko) 6_ _ 61 9O9 I Pax: : (56 6 ye„. "13, Water heater
Fireplace
E-mail: oft A z
A" elrigel - . • Range -
Barbecue 1111
Business name: .., , , _ ENEEMMINIIIIIIIIIIIIIIIIIIIIIIIIIIIIMIll
.
Other! 1111•111111
Address: ESSERIPS05:176.2117577211ffill.
City/Smte/ZiP: Subtotal ( - 30 cro
Phone Minimum permit fee (572.50) c7, o : ( ) : Fax ( )
Plan review (25% of permit fee)
CCB liC.: .5/96 9 State surcharge (12% of permit fee) J 70
This permit application rip a PE RMI T FEE ot obtained (8j. RO
dif km 4 :, 54.4t.44•.4... not within IRO
Authorized signature-
days after It has bean accepted as complete.
Print name: •Pi 54/ I Date:3 - //... 0 F - fee methodology set by Tri-County Building industry Service Board
I 1Buttcluvs■Perms■MEC. ' , t T 0 I if QM 1404617T (11/021COMMER)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008 -00126
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/1212008
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 3/14/2008 TIME: 7:00AM PAGE: 22
SITE ADDRESS: 08500 SW SHADY PL CLASS OF WORK:
SUBDIVISION: THE RAZUERRY PATCH LOT #: 021 TYPE OF USE:
PROJECT NAME: POWERS
DESCRIPTION: Installing natural gas stove.
OWNER: POWERS, GLENN & MARILYN PHONE #: 503. 244 -2951
CONTRACTOR: LUDEMAN'S FIREPLACE & PATIO PHONE #: 503-646.6409
Inspection Request Scheduled For: Date: 3/14/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 06673'7 -01 503 - 244295 N
Corrections /Comments /Instructions:
0 .t■ r7 . .
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: – 14-0 -S Phone #: (503) 718 - - 5,4..01<r-