Permit , i ` CITY OF TIGARD : `' ,, , MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00043
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/28/2008
PARCEL: 25111 AD - 02200
SITE ADDRESS: 14575 SW 88TH AVE ZONING: R -4.5
SUBDIVISION: PINEBROOK TERRACE LOT: 019 JURISDICTION: TIG
PROJECT: HENRY
Project Description: install gas fireplace and gas water heater
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:
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: 2
> 10000 cfm: GAS OUTLETS: 2
Owner: FEES
HENRY, LYNN A Description Date Amount
14575 SW 88TH AVE
TIGARD, OR 97224 [MECH] Permit Fee 1/28/200E $72.50
[TAX] 12% State Surch 11281200E $8.70
Total $81.20
Phone: 503 - 639 -6489
Contractor:
COLUMBIA CONTRACTING SERVICES INC
38197 SE HUDSON
SANDY, OR 97055 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 225 -0774
FAX 503- 668 -3701
Reg #: LIC 103764
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: G` ,.- ,--,, Permittee Signature: cl � C � CCU
Call 503.639.4175 by 7:00 a.m. for inspections that business
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.
/I/ If f LIAM LW - 'ttO FA& v....a •Yr• A •■ •■•■•11,Se „, . . .-. • 3
rleclunaicall Permit Application r'; :::+, '9i::,1 1' , ''.1 ( 1 }' :.1 i' ' 1 I ■•"!:.('''' ■ • ■ '.1 - 1,1 ' I "1;'11:1,
,''' CO of Tigard elp Rox4ved i
May ' ;• r ) ir i/.-) fk" Mg 7k)5C poo3 12 tr3
.4 .... 1 13125 go/ Hag aka, r , . % ' „,,\: \ I nark% Wu Oder Penne R/4') ?Ca- 4
, none: 503.639.4171 . :r, r t.-r ._ ,,, nsefits
Inspection Lin= 503.139.41 ,s tk10 DocReadsfar. we fff Storage 2 far 1 I •
'I to weAviigod-or.go.
-_ j CL wannensdethot 519plcuseetd lefeninelee
1 °I-Al°
tr.-M1 to ri 3 : '-'• . ..'' *40 41111 : 60,41
Mechanical permit ,. - are . - on the value unite work
3 New con:auction performed. Meow die Vilint (rounded us the =arcs &owl I
D Demolition 0 Other: e oterhorical materials, endpoint labor, me thod. end pro .
'•;k:',.; . - ...... '. - - • .. - - . •-:•=4,1.• - '. '‘ v ••-•!1_ . .'n
N f - OPYMBSIIVIkefekg ' • • - ' ' ' 'C's. ' Value S , .
i .. 4111150.41:1041008t4rXWM2 i . .
-and 2-forarly dwelling 0 cammcniarnxhavias E) Accrasory bantling • • -• - ' - - - " •
Fbr special ufamuution use checight .
• J Muld-family 0 Master builder 0 Other: Otraistion I gay. F. a i r!1
: ....::-. • • • •5:1..{Z ... . - f- n .M.001 6 4 - $AtTiOU - .. .SAY.OrrifE00 -!: Heatierlosalg .
Fob site address: A4& 7.5 5e.c..7 .i rr__. Air oordltioniog or bottom"
(ropiressivaredlosiwiplsormaV 14.00
......--0
:fry/State/ZIP 60,-..._ Furnace 100.000 BTU tkorActel 14.00
ledg
iuiterJapL no.: 1 5 ( i . 4r.--1
Pame: rif Furnace 100,11001-11TOffiadsherts) ,
Gas begun , 17 90
14.00 _
l'is street/disections to joh site: Dua work 14.00
HYdrasic hot Two system 14.00
- Resideadal boiler (robaror or
htdronic) 14.00 1
MIR healers ifuckypc, not electrieL
ktwall, ie.doet. =waded, etc. 10.00
Subdimision: Lot oo.: Fluchuat for anY of abCrie
Otha:
j 1110.00
Tux map/parcel no.: r Otber fuel osplimmu
•i-l'its:./....-7•;!-."'illt.'"AiliPigt**101:010/likitgl. -. ..• •';'-f*f - 7. .' ' ''''"- - .* ' Walct hada
. - - ". ••••••_•ttt ' •:••:- - ---.-. / 10.00 4 il..)
Gus fireplace / ' 1000 j ,,g,2
iz.-&- - Zi&
F
- lue cad for wantr beater or gas
.___ Z-Z,I ft Z...2.-,14/7--- fireplace 10.00
Lag IOW (PAS) 10.00
10,00
..■,
Wearlipallet stove I
Wood drePlacelimen 10.00 1 '
a • 1 , '..'' - .4 alkibleViliftelli/wivad 10.00
Olber 10.00 • • Nam
/ Erelleallielllal Maud son reabladoe
Address: Range kood/otha kitchen !
' orpiment 10.0o
City/StatdZIP: -
. [ I '
ashes 0Yer Mdtanst
Phone: ( ) , - - Fax: ( ) Single-doer Wawa (badoutunr, '
toilet eoppartmods, utility rooms) -
:• - - -;t 1 E:. c'.... 1344 ;:te C-- : *- --= 4 • - - • • ..... •
. . ..• • . .:- •-.: • : '7 • ;" • : 13 1*.MFT - t i nvilasr 4 `../m* ..- miciwnwisswaran
Basis:less name: . Odicr: 10.00 I 1 1
C.ontact name: Fuel Floe
SSA° for first Faun SLOB for es& additional
Address: Furnace. etc . - 1
,,.
City/Stine/ZIP: Calton OlIMD
WaNnAmeodedimit bear -
Phasic ( ) I Fax: : ( ) WSW MON t 51 '
.road: Amylase / .1 A
"-- •••si - -' •• *:!.:.-. •z• .: *- rl ',• 1 . s • . , ":":'.,...i.,: ' --•:. f".' - :))./...r.::. -.-.. ItanR°
-
Iltusincse name: /:,/, -I
Ce7.4.6' S .-.-,ee..... Clothes drur (ses) _. , .
Address: Other ` -
SR/ 9 7 _56 At ,p,,c..
fty/SatealEP:
5■0,1e...42 z._._ 74,55
?b, Subtotal
--....,, ) 5 2L....( .....26/.113Ce_1# • *': j 72,/ IIIM 0
1WIlligglin pan* fee 07230) I 4
7.CR lit : 1 3 7‘ y WIll Ran MICA' (2.1% amnia he
Authorized signature: 0-e.....e..e.---0' .... - I 1 Sboo MirdsargeOPA efpowns 62)
TOTAL PERMIT FF:E .
lia wok 4 ifi.4
Irint rue= aPPgul "Oh" 0. a Pm* b en 'bak v i a , iss
dais *aerie ert bees scoopkIl as =Wyk.
rnarl ,
of -: 17/ 0 ..._........................_._,_
----- -- -