Permit 414 CITY OF TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00583
°t 'I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/19/2005
PARCEL: 25111 BB -01200
SITE ADDRESS: 14230 SW 103RD AVE ZONING: R -3.5
SUBDIVISION: TIGARDVILLE HEIGHTS LOT: 015 JURISDICTION: TIG
Project Description: Install fireplace.
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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTYERS:
FURN < 100K BTU: AIR HANDLING UNITS CU) DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
ROB FABER Description Date Amount
14230 SW 103RD
TIGARD, OR 97223 [MECH] Permit Fee 9/19/2001 $72.50
[TAX] 8% State Surcha 9/19/200` $5.80
Total $78.30
Phone: 503- 684 -5683
Contractor:
TOM BISHOP CONSTRUCTION
4578 SW 103RD AVE
BEAVERTON, OR 97005 REQUIRED ITEMS AND REPORTS
Phone: 503- 644 -7868
Reg #: LIC 155679
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503 - 246 -6699 or 1- 800 - 332 -2344.
Issued By: _ _� Permittee Signature: 3ze., Q5.
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
.
. • 21, ' ' a
Mechanical Permit A ' Ili _,._.1..$ I,- - n - roil OFFICE USE ONLY
City of Tigard ..._. , , 1 ,, L__ I-
Permit No..ueict,2605-:0D50
Br ved
....-
I3125 SW Hall Blvd., 11g,ard, OR a
alik Recei
Datc/
Plan Review
. Phone: 503.639.4171 Fax: 503.598.1960 ., r 2005 x.„,„ y,,,,...,.,/,., Dat other Perrnit:
eisy:
..-. ' Inspection Line: 503.639.4175 SEP I ° ..-,,..,44- ' IL I Date Reuly/By:
IBM s El up s , 7 Pa f i o nf r or tion
.. Internet: ww.ci.tigard.or.us
Notified/Method:
t o TIGARD
', s ' . " -•••''' ' '-'*:-.7',-*WA,01,41%,- ValattitiOgYkkieetilfribspi.vsvithEEECKLIST
Mechanical permit fees. are on the value of the work .
. ' o New construction . .11 •, ddition/alteration/replacement based
performed. Indicate the value (rounded to the nearest dollar) of all
13 Demolition 0 Other:
mechanical materials, equipment. labor, overhead, and profit.
....-:c....m.,;„..,,,..s. m .wt1.7., a.e.0
Value: $
L.t..:`,Eii,N,ti;,...Dijay:Lzkli"Aifhtti,i,tl -.. ii le , 1.,:•,,ef^114, 7:.1, c,.. „1- .-T. 0.. ,-;,,,,... . -... , . .. . .
■
414
rA 1- and 2-family dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist
0 ulti-family 0 Master builder 0 Other;
Description Qty. Ea. r Total
S'::',..'s-':."'::Wi'lg-47'UlgkliraZgqADZEX2gPaPr4ieigral:rilg Heatinkeooling.
Air conditioning Or heat pump .
Job site address: /4/Q 3C.) 10 3 1--cl
- (requires silt plan showing placemenj 1C00
Cit Y / State r ZIP: /--- ay d 6 v 17 .2 3 p...., 100,000 BTU (ducts/vents) 14.00
i
- - Furnace 100,000-1- BTU dueta/vents 17.90
' "ASIzite/bIdgJapt, no.: Project name:
14.00
. :V
, Gas heat pump
1 -
Cross street/dircotiona to job site:
Duct work
_
Hydronic hot water s 144.0000
ystem
Residential boiler (radiator or
.---
hYdronic) 1 4.00
-__ Unit heaters (lttel-type, not electric),
in-wall, in-duct, suspended, etc. 10.00
-
Lot no.: ___
Flue/vent for any of above '10.00
- Subdivision.:
I
-
- Other; 10.00
Tax map/parcel no.:
Other fuel_svptiances
.,,,,,.. , .r,....,..., .. :0;,i,,:,,,,:.7,4-if-D5,Ci•irti:WW.W.O.,•Feg:iit„ArigglkW.MKA•4,..iiigi;?0,00 Water heater 10.00
. • '4F L ,"'r.I•ri,:•.8,......,'"':•1.._:•,:qsa,-aVn4A--:-A.,..„_1.4..L.c.44...it,,,...,,,,,r.-..‘ ...." Gas fuslace
10.00
Flue vent for water heater or gas
, ----.
fireplace _ 10.00
0.i 0 pja c -4_
Log lighter (as) 10.00
Wood/pellet stove • 10.00
:7 --------
Wood hr . lace/insert 10.00 • -----
,- - :' .::...:. =4 .; :.; .7.z.'s,,,, 411I,3,•,--.TiK, "•liReSt.,-•%7PMPZ.c43:1IP4f-.41,74'4F,,WIE4r* Chirrmilthcrifitleivet-11- 10.00 O .
. . ..:,!.::.`.7_',Ve:rifi:..q;a-0,•.iA,..ii''Airia.':iietr-1.1Ato.h-crrtrLArlke.A.urarAks,,,rittt.:1? k-klloartai.r.x.. , ..7.1 ' -': • oth
10.00
giame! • ' .. ... F ,, t.-
Environmental exhaust and ventilation
Range hoocVother kitchen
. (1 0 /?1_35Z-3
equipment
10.00 •
____..... ,
7 .qty/State./ZIP: 11 /a ‘ ,..z. A .7-7 0 3 Clothes d er exhaust 10.00
Single-duet exhaust (bathrooms,
Phone: ( a , 4 ii--S6i.t3 Fax: ( ) toilet compartments, utility rooms) 6.80
Attic/crawl 10.00
' ' ":. ; .•'...:/'..• `t..:1-;:.,1:',!'7•'::L.I.N.IKasirl..71-t'Itif.',ErnaWla.,,,,r,..:41:4,--tic',..t•-r:4M.Liat_ .
... „ .
Other:
- 10.00
Businc' os name: --- 721 ir - 1 I I a I r n,s, Le c , ;6
space fans ____
Fuel piping
Contact name: / e ) ,.. 14 , ... l ie)
$5.40 for first four; $1.00 for each additional
A • d c fr C5_- -- - e. - .) ' Minf • ■',_ , Furnace, etc.
Cras heat pump
t so eel e 1/ 6 i 4- '''' Za- Wall/suspended/unit heater
Irilkes Fax: : ( ) Water heater
Fireplace
gnail:
III
Ran , e
. ---..':' .....:XV%A7.213iTERPLIBILARTSIREnagglar 8arbecuc
evt •
IUSiness name: r-B-
,, o .. 4
Lddreu, i 1 ,. s a 6 Clothes dr as III
; .4 , •
statemp '-,:te , .1..6,-, c..),-. .6? c subtotal
Minimum permit fee ($72.50) - 7.7 , e..,
_,, baG -cit 39
?Ian review (25% of permit fee)
7, 7 - 7 - 0 7 State surcharge (8% of permit fee)
/
- _
.--
TOTAL PERMIT FEE
This pOrrrift applIcatiOn eXpircs if a permit is nor Obtained withi 180
ithorized sigriature: • , _ . c... ) 4C c _ .
_ - -,. 1„5 .
days after It bas been accepted as complet
.1 Date e-
' Fee methodology set by Id Building Industry Service Board
Li ktingTerinkstMlIC-PrrmilApp do4 12/0.)
Td WdSP:20 SOOE ST .das 82159E920ST : 'ON aN01-1d
3DUld32JIA lOdSIOH : 1,10d
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2005 00683
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9f19f2005
Phone: (503) 639 -4171 Alt DgiAgAillr
Inspection Requests (24 Hrs.): (503) 639 -4175 `._�
INSPECTION WORKSHEET FOR DATE: 9/22/2005 TIME: 7:12AM PAGE: 81
tu- c7e N/34--r)
SITE ADDRESS: CLASS OF WORK:
14230 SW 103RD AVE
SUBDIVISION: TIGARDVILLE HEIGHTS 016
#: Of5 TYPE OF USE:
PROJECT NAME: FABER
DESCRIPTION: Install fireplace.
OWNER: FABER ROB PHONE #: 503-684-5683
CONTRACTOR: TOM BISHOP CONSTRUCTION • PHONE #: 503-644-7868
Inspection Request Scheduled For: Date: 9/22/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 016311 -01 503 -644 -7868 Y AM
Corrections /Comments/ Instructions:
•
•
61 F.
PASS n ' A - TIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL eCA FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector:
_ ^ �� Date: Phone #: (503) 718 -