Permit CITY OF TIGARD MECHANICAL PERMIT
•
A4 1 1 114tf'' DEVELOPMENT SERVICES PERMIT #: MEC1999 -00541
� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/08/1999
PARCEL: 2S111 BA -09300
SITE ADDRESS: 14440 SW 97TH AVE
SUBDIVISION: PP1994 -052 ZONING: R -4.5
BLOCK: LOT: 003 JURISDICTION: TIG
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:
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: Installation of a new wood stove.
Owner: FEES
HARLEY, ROBERT A Type By Date Amount Receipt
14440 SW 97TH AVE PRMT DST 12/08/19 $50.00 99- 320258
TIGARD, OR 97224 5PCT DST 12/08/19 $4.00 99- 320258
Total $54.00
Phone:
Contractor:
R + D INSTALLATIONS
5246 SE 62ND
PORTLAND, OR 97206 REQUIRED INSPECTIONS
Woodstove Insp
Phone: 774 -7142 Final Inspection
Reg #: LIC 95236
ORIGINAL
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 -0080.
You may obtain copi .7thes*- ules or direct questions to OUNC by calling (t )24 - 9189:
Issue B ��� Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
CITY OF TIGARD Mechanical Permit Application Plan Check #
pp Rec'd By
13125 SW HALL BLVD. Commercial and Residential Date Rec'd
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, X304 Date to DST
Print or Type Permit # /I1£'e 4 -605V
Incomplete or illegible applications will not be accepted Called
Na Najne.,of Description
5 "-r 2(�S11 Table 1A Mechanical Code Qty Price Amt
Job street Address t � j I� Sua A) Permit Fee % 16.
t r 00
Address - 44a ��11 -i I ] + � z 1) Furnace to 100,000 BTU
Bldg# City /State Zip including ducts 8 vents 9.65
� 2) Furnace 100,000 BTU+
(j F�2p v/2 722' including ducts & vents 12.00
N (or name of business 3) Floor Furnace
Owner yrj e21' 1 i v2 LC ii including vent 9.65
Mailing Address 4) Suspended heater, wall heater
i 44 1)--5-ti,--) 1 + .Z-NA-5 or floor mounted heater 9.65
/ ' 5) Vent not included in appliance permit 4.75
/stat
C' e Zip Phone Check all that apply: 'Boiler Heat Air
1-I V ✓=/L1.0 i q 72'2- 6 91 ,i For items 6 -10, see or Pump Cond Qty Price Amt
Name (or name of business) footnotes 1,2 Comp ".
YY' 6) Repair units
8.40
Occupant Mailing Address 7) <3HP;absorb unit to
100K BTU 9.65
City /State Zip Phone 8) 3 -15 HP;absorb unit
100k to 500k BTU 17.65
Contractor 9) 15 -30 HP; absorb
N D ■ ,, 1 sti= i 1 unit .5 -1 mil BTU 24.15
1 �J J 1 10) 30 -50 HP; absorb
Prior to permit Mailing Address unit 1 -1.75 mil BTU 36.00
issuance, a copy 11) >50HP; absorb unit >1.75 mil BTU
of all licenses City /State Zip � PPhone �l -7142' 60.15
are required if / 7`f" ' 12) Air handling unit to 10,000 CFM
expired in COT Oregory� C�o nf .� oard Lic.# Exp. Date 7.00
database (_ L / L '} 13) Air handling unit 10,000 CFM+
Architect Name 11.85
14) Non - portable evaporate cooler
Or Mailing Address 7.00
15) Vent fan connected to a single duct
• 4.75
Engineer City /State Zip Phone 16) Ventilation system not included in
appliance permit 7.00
Describe work to be done: 17) Hood served by mechanical exhaust
7.00
New l" Repair 0 Replace with like kind: Yes 0 No 0 18) Domestic incinerators
Residential if Commercial 0 Modification 0 12.00
19) Commercial or industrial type incinerator
Additional information or descripion of work: 48.25
Fi iZc.,- Pi- _� GO I J 2 20) Other units, includin• ood stoves
7.00
NOTE: For Commercial projects only; Units over 400 lbs., located on the 21) Gas piping one to four outlets
roof, require structural calcs. prepared by licensed engineer. 3.75
Type of fuel: oil 0 natural gas 0 LPG 0 electric 0 22) More than 4 -per outlet (each) .75
Minimum Permit Fee $50.00 SUBTOTAL " `' _
thereby acknowledge that I have read this application, that the information 8% SURCHARGE � q �-
given is correct, that I am the owner or authorized agent of PLAN REVIEW 25% OF SUBTOTAL �� °
the owner, that plans submitted are in compliance with Oregon State laws. Re uired'for ALL commercial permits only �
Sign of 0 er /Ag nt Date TOTAL :, a L ��
/2 // 1 / - Other Inspections and Fees:
Contact P rson Name Phone
1. Inspections outside of normal business hours (minimum charge -two hours) $50.00 per hour
2. Inspections for which no fee is specifically indicated (minimum charge -half hour)
Foonotes for commercial projects only: $5o
3. Additional hour
plan review required by changes, additions or revisions to plans (minimum
1. Provide full schematic of existing and proposed gas line and pressure. charge one - half hour) $50.00 per hour
2. Provide drawings to scale showing existing and proposed mechanical *State Contractor Boiler Certification required
units. "Residential NC requires site plan showing placement of unit
I:\mechperm.doc rev 11/1/99