Permit • -
a
CITY O F TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00437
TIGARD DATE ISSUED: 8/22/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S112BC - 13000
SITE ADDRESS: 14559 SW 83RD CT ZONING: R -
SUBDIVISION: STARLING'S CROSSING LOT: 011 JURISDICTION: TIG
PROJECT: KEKUA
Project Description: Install pellet stove.
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:
OTH 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
JAN KEKUA Description Date Amount
14559 SW 83RD CT
TIGARD, OR 97224 [MECH] Permit Fee 8/22/200E $72.50
[TAX] 12% State Surchai 8/22/200E $8.70
Total $81.20
Phone: 503- 684 -2009
Contractor:
HAVEN SPAS AND POOLS
10560 SE HWY 212
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 655 -9440
FAX 503- 655 -9514
Reg #: LIC 175820
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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
Issued = : , �J / Permittee Signatur
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.
PI • - ..
Mechanical Permit ARAcalo IS FOR OFFICE l:sl: ONLY
�J'1
City of Tigard Qtid ��� - Date/By: i � p , Ptrmit No.:
13125 SW HaII Blvd., Tigard,OR 97223 I , y � Pla Re Gyf 6 O�.r00 II
,,IN . M
p Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 7 �•i1 V Date/By: Other Permit:
T I G A R D Inspection Line: 503.639.4175 8 000 � p � g L9n t Date Ready/By: �� VI See Page 2 for
Internet: www.tigard or.gov . Notified/Method; � 000000O00yOOO70Oor
I
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❑ New construction ,� AdditionIalteration/replacement Mechanical permit fees* are based on the value of the work
❑ Demolition performed Indicate the value (rounded to the nearest dollar) of all
❑ Other: mechanical materials, equipment, labor, overhead, and profit
1 1 �tt''9l g r t .. y -r. .._ ;- , r -cr;:R u, uxa r ,. '°'S. ..... - t -
j .....1 } � git 3JFVO,FSigt0.. 1L- "lc ' ti li ; �' ` _ j r � Value $
1 -and 2- family dwelling ❑ Commercial/industrial ` li i `� ° "i °.P. p 'a 4- r a
❑ Accessory building �a, °'
11 Multi family • ❑ Master builder ❑ Other: For special information use checklist.
D
s au ,, !r':r+.;,., y M f r Description � Qty. I Ea. To
escri tion
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.__.. .., ,,, ., �� ', Hearin coolie
Job site address: / T (/ G - Air conditioning or heat pump
(requires site phut showing placement) , 14.00
City /State/ZIP: 'S CA Cil]t d l.J ..- a 72 t Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: I Project name: /� Furnace 100,000+ BTU (ducts/vents) 17.90
l/L:CL Gas heat pump 14.00
Cross street/directions to job site: , Duct work 10.00
�, - -- - - • `.... - - Hydronic hot water system - 14.00
t: ..
• Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Flue/vent for any of above 6.80
Subdivision: I Lot no.: ether. 10.00
Tax map /parcel no.: Other fuel appliances •
. - ; v vY+ h� ii 3 r te' t ?1 r 1 -!n y ii eW 1 t ' r r r , e is
' 1 .' .r- 44!1: . .., .1. , . Q . R ' : , I L 1•:':'11::•!!):`; Water heater 10.00
'" * Gas fireplace 10.00
- � / i Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00 •
Wood/pellet stove t 10.00 10
Wood fireplace/insert 10.00
- fox: 0 . 00 , i , ' . ' + T . , , y Chimney/liner /flue/vent 10.00
Other. 10.00
Name: 3 Y1� Environmental exhaust and ventilation ,
q C c ,�' e , 551 r s , I Range hood/other kitchen
Address: q 7 ` >lN �T equipment 10.00
City/S tate/ZIP: ° sara, c re _ 9- 7.a..1 4 Clothes dryer exhaust 10.00
Phone: (5 3) v ci Fax ( ) toilet compartments, t util (bathrooms,
rooms) 6.80
. r"r/
,lu. Y 'L�� 4• 4
ii 1 t, .I l Ire a �, • ^: a y'" •!i 1� � 6 . r , , i� 4 a 1 .. ,c Attie crawlspace fans 10.00
^` Other: , 10.00 IC (�0
1
Business name: et el �S (p ci_ P c r J 1. Fuel piping
Contact name: -��r -Q y1Q $5.40 for first four; $1.00 for each additional •
Address: 1 b S d F., ? 4 'jj L4 p_ t o Furnace, etc.
l Gas heat pump
City /State/ZIP: et�C1 "N Cl of at-7 0tS Wall/suspended/unit heater
Phone: 6-6 C a 5 q tit( I Fax: : j3) (5 ' 9s/ C/ Water heater
y Fireplace
ea E m I azl �-.eC7 4- L Q • � //1�� Range
r w 1, . . ,._ ,� if , k ; i t '4 _ n. .' yr+• A .y; ri . f `.
IF"h r A.;lr-., r : t ... irl' .. I, -',1, . . f', I.,i �RA _QR ., , .v if ,:, r. K. `T', +, r ,tt Barbecue
Business name: S j y 1 n. �. Clothes dryer (gas)
�l • Other;
Address: =: - -,-.. ,., , -- r ° $; H .
City /State/ZIP: Subtotal • .-(X)
Phone:( ) Fax:.( )
Minimum permit fee ($72.50) "7i
_ Plan review (25% of permit fee) •
CCB lie.: / ?5 8 Ao 0 (;i y' State surcharge (12% of permit fee) t'.?D
TOTAL PERMIT FEE S' I , a/)
Authori d Signature' This permit application expires if a permit is not obtained within 180
_ ■ ■ � y days after it has been accepted as complete.
Print tam i, � �.T�` . l r '� �1� ��, ± ,y: Fee methodology set by Tri County Building Musty Service Board
l:\ Building \PerminlMEC- PermitApp.doc 01/19/07 . 440.4617T (1 'r CO •
Z00/T001J XV,4 5E :ZT 8002/ZZ/80
CITY OF TIGARD 4
B UILDING DIVISION PERMIT #: MEC200B-00437
1 3125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 0/22/200{
Phone: (503) 639 -4171 140 .1I I
1
Inspection Requests (24 Hrs.): (503) 639 -4175 .. &W ' ...
INSPECTION WORKSHEET FOR DATE: 9/3/2008 TIME: 7:01AM PAGE: 36
SITE ADDRESS: 14659 SW 03RD CI CLASS OF WORK:
SUBDIVISION: STARLING'S CROSSING LOT #: 011 TYPE OF USE:
PROJECT NAME: KEKUA
DESCRIPTION: Install pellet stove.
OWNER: KEKUA, JAN PHONE #: 503-684-2009
CONTRACTOR: HAVEN SPAS AND POOLS PHONE #: 503-655.9440
Inspection Request Scheduled For: Date: 9/3//2.008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
605 Post /be mechanical p 074967 -01 503.655 -9440 N
(egg 'i�47 p At 1J /oa f
Corrections /Comments /Instructions: -
Can1<< 1 P65 +/ b
a V\0
a PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
1 Inspector: Es Date: 3 5100 g Phone #: (503) 718- •2'