Permit CITY TIGARD MECHANICAL PERMIT
vr� DEVELOPMENT SERVICES PERMIT #: MEC2005 -00787
" JI 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/29/2005
PARCEL: 2S 110BA -05700
SITE ADDRESS: 11885 SW WILDWOOD ST ZONING: R -2
SUBDIVISION: SHADOW HILLS LOT: 008 JURISDICTION: TIG
Project Description: Fireplace insert and gas line.
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:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: < =10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
MARK BALMER- Description Date Amount
11885 SW WILDWOOD ST [MECH] Permit Fee 11129/20( $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 11/29/20( $5.80
•
Phone: 503 626 - 4652 Total $78.30
Contractor:
T & K MECHANICAL
11525 SW CANYON RD. REQUIRED ITEMS AND REPORTS
BEAVERTON, OR 97005
Phone: 503 626 - 4652
Reg #: LIC 121165
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and
all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not
started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires
you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010
through OAR 952 -001 -0100. You may obtain copies of these rules or direct questions OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By Permittee Signature: , 7>i " �,,,,i,,
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day.'
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
•
FROM : HOTSPOT FIREPLACE ,•_ PHONE NO. : 15036269138 Nov. 28 2005 11:36AM P1
Mechanical Permit Ap pl k ati o n FOR OFFICE USE ONLY
,-
City of Tigard R Da tellsY. 1 • i ` 4,05 • • Permit No , b. _ P_ i� — tom 1 , 7
13125 SW Hall Blvd., Tigard. OR 97223
Phone 503.639.4171 Fax: 503.598.1960 ,- „, - • C. ,.a ...7...7 '• Other Permit:
Inspection Hine, 503,639,4175 Ci - i 'l C_ 0..... v ' °';',1I I
4 I Date Ready /lay' Reis: lid Sec Pagel for
Internet: www.ci.ligurd.ur.us gilt_t�''i\i, � Nonfied/Meu,ud: Supplemental Informatiun
` :,�,,y., ` ; * p 3 ' - : ' 4' - " . _ p; .r it: .w r , pS , �•K....u:..
,V1 : k.'- 1 .1-13 " :rr. .. , x'e ;3';, ^ WO$fi - , • C.] look,lossei8 =:t•' 't`*.... tl ^ 47, F r' w p g r w .„ •
❑ New construction ~� Addition/alteration/replacement
Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
y M j . ;?4
�, :4tsN • 240: : , ✓;y;5 , 01 7^ ' v. r
r a s e - F, i' �' . ' hy :C ``��X!:�p C,/ � } ({� p(7� �' . .. t 7' !. ....' Value: $ '
.�1r.,.
9���Y.' .'F,�I . T ~ , '�!�.`S^ io �1;�!" , ' , '�_ ... .. � .. . N. in ;): .r:. - l9'•. , _ ..
1 and 2 family dwelling ❑ Commercial/industrial ❑Accessory building - —
❑ Multi For special htforntation use checklist,
y 0 Master builde ❑ Other:
:
:r' +„r- y 4 1 r,2 �•-.h A Heat
V. Destatptton , Qty. f E.a. I Total
n, -.' « .n eT ` �• ] <o;Y �":i N �yw y F t in :kaolin
C �� )) J r
Job site address: S S 5W lvC /i 1�1 Oct Szi Air conditioning or heat pump (requires site plan showing placement) _ 14.00
City /Slate/ZIP: j qu /CI t OK qg /( Furnace 100,000 BTU(ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90 '
Suite/bldg. /apt. no.: Project name: _ Gas hen! pump 14.00 w
Cross strcet/directions to job sits: • ' • .. . - • 'Duet work • - • - - • 14.00. --
. Hydronic hot water system 14.00
— Residential boiler (radiator or
' hydronic) 14.00
Unit herpes (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 fact appliances
� RR .. c � .s 4 u , t .7t4O f A.P � '• ` " ar,��4c, .,467 * 3 Water heater L 10.00
Z i s: at .x61•" -'4•i ` + 4 r .A. a Wit,+ .,roe.,, , ;.- (',( %- m ° •.. 'A l
Gas fireplace / 10.00 /Q
• Flue vent for water heater or gas
fireplace / 10.00 k)
Log lighter (gas) 10.00 .
�� — Wood/pellet stove 10,00 •
�y s Wood fircplace/insert 10.00
- .Ni 11,01 5 30 ffi » "a, Y ( I; . Alta „ ? .: . itie
:� a �, o 4 m tat# Chimney/liner /flue/vent 10.00
`a Other: _ 10.00
Name; µa(k lit.lyne r Eevlronmental exhaust and ventilation .
Range
Address: , l s 9 5 5() LO; 1 w 0 it( , equipmenood/other kitchen 10.00
City/State/Z1P: "T i ', 4 ow 6 . r� ate / Clothes dryer exhaust 10.00
6 7 Single -duct exhaust (bathrooms.
Phone: ) , u - 53 sf Fax: ( ) toilet compartments, utility rooms) 6.80
•";'Y w, " o t� o , g,..:' , h 3T R " tf lr , l a it v�" 044 3 `'� � ; A
h' p',hic/crawlspace fans 10.00
Y • -'- ' �� ° ..-. { �;•tt'� { :!i,, .SF:�• - -. �i"'i^'�"!�'•.�.��' .
' Business name: "1x ` re P` L — O ., m 10.00_
o c p 17 R •
Contact name: " 12, `�- ,ti a e i NT . 55.40 for first four; 51.00 for each additional
Address: 116 r UU 3L) 6 C1.vl o le ,i i
G Furnace, ate.
Gas heat pump
City /State/ZIP: (B Y 4.6 y, Y g76CC Wall/suspended/unit heater
3)
Phone: ( (a __(. I Fax: :)3)(15 ( g138 Water heater
Fireplace / S /V
E-mall: Range
Y i -5 ?k Y. ' iii V •.) Barbecue
�C:��>E? ;���:� :��� "':���� ` 'r . �i�) • `� '3?� ,� R e
Business name: Td"' ' a K(!r-, Clothes drycrsrtas •
Address: i ) C_LL I�Lt�f Q LL T] Othcr
L57....3 ,Z.`.7. t :"., ! °. , . ,.: y
City/State:2l1 ' Subtotal .i
�a ✓t°Y -�Ovl 1 t') y Minimum permit fee ($72.50) 7a,5t)
Phone: ) „,. , 4* Fax: LIB )( ®- 43-3 Plan review (25 %ofpermit fee)
CCB tic.: f 4//(®s w State surcharge (8% of permit fee) <, g(J
I TOTAL PERMIT FEE ,
761 permit nppricotiun expires If a permit is not obtained within 180
Authorized signatur • days after It has been occepted as complete.
NH t name: '/ n-
. . e 1; // • Fete methodology set by'TY- County Building Industry Service Board •
.4m,,:uh. &Pp,e„1a'MIC.PamiIA -..one 17/03 4404(17T(I1/07/COM/ws3)
CITY OF TIGARD
BUILDING .DIVISION PERMIT #: MEC2005 -00787
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/29/2005
Phone: (503) 639 -4171 4 i1l
Inspection Requests (24 Hrs.): (503) 639 -4175 . U F
INSPECTION WORKSHEET FOR DATE: 12/15/2005 TIME: 7:04AM PAGE: 10
SITE ADDRESS: 11885 SW WILDWOOD ST CLASS OF WORK:
SUBDIVISION: SHADOW HILLS LO r #: 008 TYPE OF USE:
PROJECT NAME: BALMER
DESCRIPTION: Fireplace insert and gas line.
OWNER: BALMER, MARK PHONE #: 503-626-4652
CONTRACTOR: T & K MECHANICAL PHONE #: 503- 626.4652
•
Inspection Request Scheduled For: Date: 12/15/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 023545-01 503-844 -9173 N
lS he_thku►cAL 4 -14 -14
Corrections /Comments /Instructions:
57
/ 2 s g5' dd7 is u _
•
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: �`� Date: / � 7 / v Phone #: (503) 718 -
. 1
CITY OF TIGARD t • `� s
BUILDING DIVISION ' _ PERMIT #: MEC2005 -00787
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/29/2005
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ...' 'IL .
INSPECTION WORKSHEET FOR DATE: 12/15/2005 TIME: 7:04AM PAGE: 9 '
SITE ADDRESS: 11885 SW WILDWOOD ST CLASS OF WORK:
SUBDIVISION: SHADOW HILLS LOT #: 008 TYPE OF USE:
PROJECT NAME: BALMER
DESCRIPTION: rireplace insert and gas line:.
OWNER: BALMER, MARK . , PHONE #: 503
CONTRACTOR: 'I' & K MECHANICAL PHONE #: 503 - 626 - 4652
Inspection Request Scheduled For: Date: 12/16/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 023545-02 503 -844 -9173 Y - MA
Corrections/Comments/Instructions:
r /
iiiiuc�s�� - - -
.�� . A. ' Je" / ' _, , _O / ' dA .1 ei -._ . ' 4:: f i
•
•
•
❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
4 FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: VZ Phone #: (503) 718 - °'U7`14'