Permit C ITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00584
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/21/2006
PARCEL: 1 S125DD -03900
SITE ADDRESS: 09855 SW VENTURA CT ZONING: R -4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT: 047 JURISDICTION: TIG
Project Description: Gas fireplace insert & gas line.
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:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
MATT JOHNSON Description Date Amount
9855 SW VENTURA CT
TIGARD, OR 97223 [MECH] Permit Fee 11/21/20C $72.50
[TAX] 8% State Surcha 11/21/20( $5.80
Total $78.30
Phone: 503- 467 -4854
Contractor:
FIRESIDE DIST OF ORE INC
18389 SW BOONES FERRY RD
PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -595 -3726
FAX 503- 620 -5699
Reg #: LIC 40979
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:e _ _ 1 ' Permittee Signature: j�'� g
Call 503.639.4175 by 7:00 a.m. for inspections that business dal,.
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.
11/21/2006 11:47 5036205699
J FIRESIDE DISTRIBUTOR PAGE 02
Mechanical` er1flit Application �� C1ea PermitNA
City of Tigard 2 (� � I � � i �at � EC �
:J ed !� L. . 11/ ��
III 13125 5W Hall Blvd_ Tigard, OR 97 PLanReview Other stag t'
2 01 Phone: 503 639.4171 Fax: 503.598. 960 C r Date/Br- !� gee Page 2 for
inspection Line: 503.639.4175 N11! i , - / �i ' J Date Ready/By; Supplemental Pag 2 for nrmntlno
Notified/Method: I' I G A.K ft
Internet: www.tigard-or.gov , "' ;)
C7:1 y'.' ,f��rT. , , -, Y ftL
�'t J•'JG 1 11 :1•' ., ?''', 66 ' it tliti1{�t 1 OtY�
�a _t >�'
1 V +•�,•„ ,,r, It': ° 'fi:�'s`"i ' "' :'' �• , `9.' � � f the work
" , ,' � ��, ��� nit fees are paned on the value o
' mechanical per
❑ New construction ❑ Addition /alteration /replacement performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead. and profit.
❑ Demolition ❑ Other: • , ,I.r Value: $
,,;e §. JC:''�n'�rr, uN va. ul, �
'
- and 2- family dwelling ❑ Commeretal /industrial ❑ Accessory building For special vrformaiioa use checklist.
❑ Multi-family 0
Master builder ❑ Othcr: Description I Qty J a. 1 Total
_
tJy �)( • ,a ,,,., "'',1,., '
,' " "'j', Heatinggcootiny
"S i � "1' �y Air conditioning or heat pump
Job site address �� j � 6.I�.l C
1 `\ V'Q am' t Q / r y1 , ' }�� j , f4 (requires site plan showing placement) 14.00
�•••'V _
R 7 , ^� Furnace 100,000 BTU (duets/vents) 14.00
City/State/ZIP: 1 { �n fir dYJ Furnace 100,000+ BTU (duets /vents) 17.90
Suite/bldg. /apt. no -: Project name: Gas heat pump 14.00
Duct work
Cross street/directions to job see: _ - Hydronic hot water system 14.00 _
- _ Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric). 10.00
_ in -wall, in -duct, suspended, etc.
Plue/vcnt for my of above _ _ _ 10.00 _
Subdivision:
Lot no.: Other: 10.00
Other fuel appliances
Tax map/parcel no.: 10 00
•
y � n •� r s,•t t r. ,r; t 1, a It Water heater
i(ibl�! " ,11,x i.,. it
� � ��d�� ` 'I, 1 ' ° • „ ,� JI �:: , � „ `ail•;, ";1,. • „r • I 10 00 _ .
. • . ��.,. Gas fireplace
C 0-.S S t 2C flue vent for water heater or gas
.. ��4 `� P
- tirt�7lacc 10.00
Log lighter (gas) 10.00
- �� g Wood /pellet stove 10.00
Wood fireplace/insert 10 00
Chimney/liner /flue /vent 10.00
t l • d �,
tiodt 'oi rtliv i :;, r`.: .'
I;IE- ,r,q,li.;,,•, .: a"'. •,�l,�t,�y ,n0. 't
il ;i ' ;;,, ' „d, ; ;'I Other: 10 00
Name” ol00- ,Yohn Environmental exhaust and ventilation
R ange hood/other kitchen
i : 4 e•ui.meet 1000
Address: � A: 6.0 II .] if 10,00
City /State /ZiP: �- . - 11 Q __ / D — Clothes dpi- exhaust Single-duct exhaust (bathrooms,
c �1 Fax: ( ) toilet compartments, utility rooms) 6.80
Phone: l , yy �y :III•,;: ,;t;,, t AtticJerawlspace fans _ 10.00
�`',i�lrr�i`i ,. ;.'!� •i,l„l i18 • • 1`l p .' 10.00
`� ' � Other:
Business name: .• rest , 1 1 • I ' • J A Fuelpiping
$5.40 for first four $1.00 for each additional
Contact name — Furnace, etc,
Address' IS 5,b0 , �s Gas heat pump
City /S tate /Z1P: v D 0 ri J4 Wall /suspended /unit hoater
C7r -'a ot i Water heater
Phone: ) Fax: : J 60 �/ - Fireplace
E- mail:, 1 / l • e , <' / - • . Al Range -
• dt�l ,�y t``S,Tri "' ,, ::
^', . '..n'' s '''`•' • Barbecue
_Clothes dryer (gases
BLLsinessname: _c/' r'2 Li Pith )rO�Cz' Other:
4-4471/4/ " ,�; "; ' ', ; : :. M.E' 1� L tlitH l i g *..: —
Address: 51-4311) i �` � Subtotal
City ( /ZIP: — Minimum permit fcc ($72.50) -
Phone: ( ) Fax ( ) Plan review (25% of permit fcc)
/� --.Z57 State surcharge (8 °h, of permit fee)
CCD 1ic.' lL t QJ - — TOTAL PERMIT FEET. , 0
` Thit permit application aspires If a permit h not obtaln wt I n Ian
Authorized signature: / l � days after it has bee accepted as complete,
".4641 - 7 ) ' - • Fat methodology set by Tn•County Building lnduetry Service Boned
Print name: ��'f/J�� /A V .e Date: ! J
„a„Iidn.APermits - L�t mitApp doe 04/06/06 MO-4d I 7T I I ira /C0M/Wfia)
CITY OF TIGARD
BUILDINcf DIVISION Af PERMIT #: MEC2006 -005 &3
13125 SW Hall Blvd., Tigard, OR 97223 OF ' I �� DATE ISSUED: 1 1/21/2006
Phone: (503) 639 -4171 Inspection Requests (24 Hrs.): (503) 639 -4175 -- ±+r ° Jl.
INSPECTION WORKSHEET FOR DATE: 7/9/2007 TIME: 7:02AM PAGE: 72
SITE ADDRESS: 09855 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 047 TYPE OF USE:
PROJECT NAME: JOHNSON
DESCRIPTION: Gas fireplace insert & gas line.
OWNER: JOHNSON, MATT PHONE #: 503 - 467 -4(354
CONTRACTOR: FIRESIDE DIST OF ORE INC PHONE #: 503-595-3726
Inspection Request Scheduled For: Date: 7/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Me :. • - e, ,
699 Mechanical final 051441 -01 503 - 595 -3726 n �""
Corrections /Cor tints /Instructions: /1 Z-`7/7 S 4C--6( j
A---- 1._ ce C Le„.4r0.-0 1"..)/ L•■•■■•••• . 0X so____ c j
. Li--o S.-e-C f fry`
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-/ I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: q% Date: A (�l Phone #: (503) 718 - 2 Y /
z�...r
CITY F GARD
4�t
BUILDIIV TI IVISION PERMIT #: MEC2006- 00(';84
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/21/2006
Phone: (503) 639 -4171 .. ,,
Inspection Requests (24 Hrs.): (503) 639 -4175 �i''1 .
INSPECTION WORKSHEET FOR DATE: 6/14/2007 TIME: 7:00AM PAGE: 27
SITE ADDRESS: 09855 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 047 TYPE OF USE:
PROJECT NAME: JOHNSON
DESCRIPTION: Gas fireplace insert & gas line.
OWNER: JOHNSON, MATT PHONE #: 503 - 467 -4854
CONTRACTOR: FIRESIDE DIST OF ORE INC PHONE #: 503.595.3726
Inspection Request Scheduled For: Date: 6/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Go.s line 050224 -01 503- 684 -13535 Y
Corrections/Comments/Instructions:
al 57 q O .v c i= ✓ � e2c - Cc/4771 44 /-1
-7 s —
( 77) A6 1 / �dst_./
/, 5 Pec9» J
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Dater — f4` Phone #: (503) 718-