Permit •
CITY OF TIGARD
MECHANICAL PERMIT
°'CIA DEVELOPMENT SERVICES PERMIT #: MEC2004 -00730
- �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/9/2004
PARCEL: 2 S 103 BA -01001
SITE ADDRESS: 11975 SW WALNUT ST
SUBDIVISION: ZONING: R -4.5
BLOCK: LOT: 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:
WOD 3 - 15 HP: COMML.INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: 1
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Install wood stove insert with single wall liner.
Owner: FEES
ED ANDERSON Description Date Amount
11975 SW WALNUT ST [MECH] Permit Fee 11/9/200L $72.50
TIGARD, OR 97223 [TAX] 8% State Surchart 11/9/200 $5.80
Phone: 503 - 579 - 5760 Total $78.30
Contractor:
TOM BISHOP CONSTRUCTION
11525 SW CANYON RD
BEAVERTON, OR 97005 REQUIRED INSPECTIONS
Phone: 503 Woodstove Insp
Final Inspection
Reg #: LIC 155679
•
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 -6•:
Issued B / % / I f Permittee Signature: �' e i / % ,.
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the nex business day
FROM HG SPOT FIREPLACE PHONE NO. : 15036269136 Nov. 04 2004 04:04PM P1
_____ ar ice[ Permit' A lication
City of Tigard --'c ��� FOR OFFICE USE ONLY
' L_ \ ' ; ' � y l_-_ L Rived
13125 SW Hall Blvd., Tigard, OR 977 3 ,__ - - - Date/8y; ft
Phone: 503.639.4171 Fax; 503, 598.1960 Plan Revtew • • " 00730
Inspection Line: 5 03 , 639.4175 ot�]; `=- t. ��:h. r .= •, \
Internet; www.ci- rigardor.tis �/ �" 1 �-� ar •��ij , Date Rea other Permit:
_-• bete Ready, �.. (� Se P a e
NotiZed/Mcthod: t: t ror
� „ y I�+ Supplomeotal information
, � r.. :+_ r.. ;:a»t1`." ;:�.Jd':7 tr Q 2` i '� i� ;5. ,- k►._ . ro_ • '- 1
7+�Ci i ! " ): ,r', . ioflY �'' t4 . 9, T • w
•
0 New Y � r, . eta' SHE
;: ,� . S � t :1ST
construction l; (rounded M
Add ition /alteration/replacemen ,a
0 Demolition �`'A'+�a ' nrc Oases On the va tee 0 the work
Q Other,
performed.
�� s r p rnned. Indicate the value nearest dollar
r t •. s mechanical mate ( ed to the n dollar) of all
, 4 Z ,L 141 rl s f ; o f a • 1 l t sl k 2, " , 1. , . materials. e • ui . meet. tabor, overhead, and
. ..�� rsL ~M s s e o . + ; ; ,._d�' . . .rOfit
'I 1- and 2-family dwelling ;`� ' ' ti >: Yalu!: $
11 Multi-family ❑ Commercial/industrial Accessory building
' t t '�. ; -, 3 V- .�i'!'Ytl i>3Y8 MS.FELS*
❑ Accessor
Q Master builder For ecialIn 0
. ti, � � y,.,.r,u r2 tea ,� _ ❑ p f rmarron use checklist.
_s �� i r 5! t . �_1,.nr^y u �� �St � ' t P 11� s i o's Description Total
1•s7 ..r ca . . "rte �.C) ;t".:1/ L 4 Hi' �, a Q. Ea -['
Job site address: • � .�".p,t n�._ - z�`•` ��� rL Heating/cooling conditioning or heat pump rnt Gttyl$tateQlP: �'
(mots= site plan showin..lacement 14.00
L Q vI Furnace I00,000 BTU
F / "' ducta/vor[ts) 14.00 MI
5ttite/bldgJapt no.: Project name: Pomace 100,000# BTU (ducts /vents)
17.90 S
Cross give/directions to job site: Gas heat .0 ,. 14.00
< <s Duct work 14.00
EI dronic hot water system II 14.00
5 i , , , Residential boiler (radiator or
!`` hydronic)
( type, not electric)
S;''
+
Unit heaters fuel- 14.00
,
in-wall, in -duct, suspended, etc. 10.00
'311
Lot no.: Flue/vent for an of above 10.00
map/paneel no Other:
' 10.00
a , f r h jr�t r �., t , y w Other fuel appliances
- - .:' uy ' 5$;:.x ` Sa , ,�b��,.?%,N . \r 1 J i � ` L'Tt ^ M y i,ri ' k"1 ➢�I Water heater 10.00
Y r ♦, [� • Gas fire&ce 10.00
F lue vent for w ater heater or gas
l fi • lace 10.00
10.00
� 10.00
_ Wood tirt place/inscrt IMAM 10.00
.. ' 1 � ; . ' 4.: , , V u 1:x!5 „y, %' I ' ey Ft; ,T 7.4.2 177 .�'1-1,N 1 , ' eF i c, i,_xr Chimne n' IZEIM
, 4 y :41/ t i , e, a,, , :nl 11,:1 cZ � i•,lj y mer /fl ucJveat 10.00 /
�Ntt , a . r.f y S!'� tul Other:
10.00
• ' Yi 4 4
Environmental exhaust and ventilation
�,Addtas$. l • 1
s J 1314-1 Range hood/other kitchen
telZlp: • /� -• ui • meet 10.00
A a u , 9 7, x 3 Clothes dryer exhaust
10.00
( • 5 5 , 8 Fax ( ) single duct exhaust (bathrooms,
�,� , toilet co •artrnents utili rooms) 6.80
..7 r..<...".,i_::,5� ✓ � rl °Yr Wt�t r7 FS �VT 'Y ,�l jr � A, � `a +' Attic/
crawl , . S:','. £' 7 ' _ -, ,.':.S_ik *f^' 1:..24l.._ _R'I '..M ya CTBWi • ace fans 1
0.00
•.r S la .i 1.14.--€...
.P Other: 10.00
etname: Qe 14y1 Fuel piping__ -
$5.40 for first four; $1.00 for each additional
L .. l.() e (r( Furnace etc. r= • a , M• Gas heat p ,.
h°rDE / / � t• • ♦e, '`fit_ Wall/sus •. ded/unitheater
� �3 ) • a6 (o , Fax:: 6)3) &ale -- 71, 3P Water heater
k �
il; f J Fireplace
..' w 4'16 1 ti t R,e fi; + n� ✓ 41;i.J f -+� r1 ,�y 4, '�,� J y a 7 Rail e
. r - .c o _ , - .9.' , . i , 3,,.� � C.a:i!�ia�f ' "" ' ` ` vi {�xa,� �ivt `�1, ✓ �.; ' Si� $ . Il � � � Barbecue
s name:. 1!yI t Y1S� • ` 0
Clothes dryer (gas)
Other: l •'.' - '-''
t � ! 46 ✓ -. r ' n i t er W t N n 1.r1,r , Jr 1 1 dJx , N. I � ' '
tsdstateJZn: , g&Ve 0:1 ov I-41 t j n _ ,a.c•� s a,L `subto
Bone: (56a.)6- Fax: (i,� )/00_6/ �t 3
Minimum permit fee ($72 50) 7,Q, •
lm : S S 7 Plan review (25% of permit fee)
State Surcharge (g% of permit fee) ; 47
_ / TOTAL PERMIT FEE 7
4 ort2ed signature
O, ,4 ,4 2_ / This permit application expires It a permit Is not obtained within 190
days after it has been accepted as complete.
NiIIL OAIDe: ■Cie.- i A, 'e 1 riftly . Fee methodology set by Tri•County Building Industry Service Hoard
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION- '' Business Line: (5.03) 639 -4171 MST
BUP
Received Date Requested C ° AM PM BUP
Location (( 9 7 uc) Suite C ,206 d0 7.3
Contact Person Ph ( _ ) PLM
Contractor P ( ) SWR
BUILDING TenantI I 6 — S 76 6 ELC U t2
Footing
Foundation Access: /404-,- /2./ sr ELC
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: d & SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear yel--(A-/ j
Int Sheath/Shear
Framing
Insulation k / Q 6 f t 6 � ' �, / � o � G
Drywall Nailing y►'Y J ✓�/
Firewall
Fire Sprinkler
Fire Alarm
• Susp'd Ceiling
Roof
Other:
Final
PASS PART FAIL
PLUMBING
411/
Post & Beam
Under Slab
Rough -In
- Water Service - -
Sanitary Sewer
Rain Drains w =
Catch Basin / Manhole
Storm Drain -
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL t
Post & Beam
��)
Rough -In CL 1 6 '
Gas Line
ampers
740 PART FAIL
RICAL
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 Q Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line -
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from t Job site.
PASS PART FAIL