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Permit C ITY OF TIGARD MECHANICAL PERMIT 414 DEVELOPMENT SERVICES PERMIT #: MEC2004 -00600 --- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/9/2004 PARCEL: 1 S133DB -03500 SITE ADDRESS: 11567 SW SHEFFIELD CIR SUBDIVISION: BRITTANY SQUARE NO. 2 ZONING: R -12 BLOCK: LOT: 059 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: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Installation of new gas fireplace, vent & piping. Owner: FEES ALBERT, KATHERINE M H Description Date Amount 11567 SW SHEFFIELD CIR [MECH] Permit Fee 9/9/2004 $72.50 TIGARD, OR 97223 [TAX] 8% State Surchar€ 9/9/2004 $5.80 Phone: Total $78.30 Contractor: MIKE LARKIN CONSTRUCTION 11901 NE COUCH PORTLAND, OR 97220 REQUIRED INSPECTIONS Phone: Heating Unt Insp hone: 256 - 4909 Final Inspection Reg #: LIC 00068996 • 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: Pioa�l Permittee Signature: Sg - pAP.P Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day Sep 08 04 11:03a Mike Larkin 503 -256 -4909 p.1 Mechanical Permit A 1_ l)! IV 9 FOR OEFIC:E USE ONLY City of Tigard `I D r PemL :No.: 6C..JodV 6O K Cd 13125 SW Han Blvd., Tigard, OR 97223 Plan Review Phone: 503439.4171 Fax: 503398.1960 SEP ' I J L � a � I ". , asouey: Other Permit: fnapeetian Lind: 503.639.4175 . i I. , � � Mc ReadyfRy: hair. EL' See Page 2 for imzra teet: www.d•tigatd or.Us CITY OF TIG • - , Noti6ed/Mretl,od; -C-1(r Supplemental reformation •. ., .• F : RKt :,.:1..: '.. ?: !tcO1H%11 ltlCIAL FICO SOILEDUi:FI tl8E CSLIS " D New construction Addition/altelation/replacement Mechanical permit fees" are based on the value of oho work perfomted. Indicate the value (rotmdc4 to the ocarest dollar) of all ❑ Demolition Other: _ mechanical materials. equipment. labor. overhead. and profit •. • . • • :•, ' • ,. •. Value :5 •:• . • -: ' : • , • .:: • : • CJ►'#'gCr081F 'CONSTRUCTION' , .. :.: , • . „ _ ...1'4s TES . ....... .. :' • g�SIDSM 'LA'�.6_i.Q.UftyjV1SK1� /:9 .. - S* • •••••• •: 1 - and 2 - family dwelling ❑ Comtnerci lder stria) 0 Accessory bu(ldlnr, For special it formarion use chrr ist nzultI•family 0 Master builder ❑over Description I Qty. 1 Ea. _ 1 'natal , . :: i' ', - I :'. - . , 4041TE 10011 * MO •i{4riKTi O.j : - :. : Reatian/cooling lob site address: j J - 7 • w . $ 14...12.„1-; 1- / e /(2) rceeu Bite plan showing lieu t) 14.00 City/State/7IP: n t . - 9 7 2 2- S Furnace 100,000)3TU (ducurvena) 14.00 Furnace 100,000+ BTU (dueu/vente) 17.90 Suite/bldg./ape no.: Project name: . Gas hestistmtp 14.00 , I Cross street/directions to job site: S , it) 'I 3 c re, Duct work 14.00 , • . II Hydronic hot water system 14.00 4 &-- `2•'7`' - it e IC (' � I e i C Residential boiler (radiator or hydronie) 14.00 Unit heaters (titel -type, not electric), in -wall, in -duet suspended. etc. 10.00 Subdivision: I Lot no.: Flue/west for any of above 10.00 Other: 10.00 Tax map /parcel no.: Other fuel appliances :•; .: ' e: roESCRIPTIONt :OP' W I C : • 1 ! .•. • .' 10.00 ' : t' Water heater - ; Oas fireplace / , 10.00 / p. GD Flue vent for water heater or gas fuelace 10.00 Log lighter (Ras) 10.00 Wood/pellet stove _ 10.00 , Wood fireplace/Insert 10,00 ChinuVliaer/flue/vent i , 10.00 / 0 ►OC .21 . . r . ether. i0.00 Name; K Q /J v . t N y '1'' Enviropmental exhaust and ventilation Range flood /other kitchen Address: equipment 10.00 City /State/ZIP: l Clothes dryer exhaust _ 10.00 Single •duct exhaust (bathrooms, • Phone: (SV9 a_ y — yd 1•.1 Fax: ( ) ton etcompartments, utility Moms) 6.50 • • • p • APP LICAl it • ' • ' ' . b cDPIYA.QT• PEJi$ON' •• Atrie erewlepnee fans _ 10.00 Other: 10.00 Business name: - Fuel piping Contact name: 55.40 for first lbnr; 31.00 for earls additional Furnace, ere, Address: Gas heat pump City/State/ZiP: Well/suspended/tmitheater � Phones Water heater _ ( ) Fax: ( ) Fireplace / rS•Ya E-mail: Range • r: •:.: 7. ....• :•� i:.�•: : 7 ..77: ■• • CONT'RA'CTOR =`• j : :: '' ....!'.':::•!:.i'-'1-.-. � f'c:'. Barbecue ` Clothes dryer (llama) Business mama Z C am v L t1 � r (i - Other: Address: / ! /�- Addre !! 9 O ! cn c.,_0_1___ r ... i_• :t ti _ ... -kMEirl3A - NreAL quiha >( e. ::• • : : ' . + : ' = ci ss: !LIP: , O Subunit J ,..9. .7d . �� r ` } / / K ( J / Minimum permit fee (572.50) 7a- lb Phoot (OS ) ?�6 lrr 6 I Fes ( ) - Plea review (25% of permit fee) CCB lie.: 6 g 9 g , ri p i — _ C Stares charge (e•!. of pendl fee) 1 / Y ( V TOTAL. PrAMIT FEE . 3 d Authorized signature: , Mao =picot If a permit la aotdeWned within 111(1 �a Loa /( days after it has bum accepted ae complete. Print name: �✓ f RQ , r Date: Iv • Fes methodology set byTri.COhmty Building indaiRy Service Board CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST c.� BUP Received Date Requested / - 16 AM PM BUP Location _ ��/ Suite o ai j1 2'X 1O(oO� Contact Person / / Ph ( ) 5/5 PLM Contractor �/ Ph ( ) SWR K BUILDING Tenant/ ire ELC Footing ELC Foundation Access: Ftg Drain AAILLAi4 EL R Crawl Drain . � _ ..� Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath/Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING Post & Beam Under Slab Rough -In / • Water Service Sanitary Sewer Rain Drains Catch Basin / Manhole Storm Drain Shower Pan Other: Final PASS PART FAIL trECH ANA L Post m t &Bea Rough-In a mew �• •ke Dampers PART FAIL CTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: ❑ Unable to inspect — no access Fire Supply Line �� / %,,/ ADA 6 ' / Approach/Sidewalk Date /7 / 0 Inspector Ext Other: Final DO NOT REMOVE this Inspection record from the Job site. PASS PART FAIL C ITY OF TIGARD MECHANICAL PERMIT 414 DEVELOPMENT SERVICES PERMIT #: MEC2004 -00600 --- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/9/2004 PARCEL: 1 S133DB -03500 SITE ADDRESS: 11567 SW SHEFFIELD CIR SUBDIVISION: BRITTANY SQUARE NO. 2 ZONING: R -12 BLOCK: LOT: 059 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: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: Remarks: Installation of new gas fireplace, vent & piping. Owner: FEES ALBERT, KATHERINE M H Description Date Amount 11567 SW SHEFFIELD CIR [MECH] Permit Fee 9/9/2004 $72.50 TIGARD, OR 97223 [TAX] 8% State Surchar€ 9/9/2004 $5.80 Phone: Total $78.30 Contractor: MIKE LARKIN CONSTRUCTION 11901 NE COUCH PORTLAND, OR 97220 REQUIRED INSPECTIONS Phone: Heating Unt Insp hone: 256 - 4909 Final Inspection Reg #: LIC 00068996 • 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: Pioa�l Permittee Signature: Sg - pAP.P Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day