Permit -Er CITY OF TIGARb MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00028
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/15/2008
PARCEL: 2S104BC -04400
SITE ADDRESS: 12610 SW ASCENSION DR ZONING: R -7
SUBDIVISION: HILLSHIRE WOODS LOT: 055 JURISDICTION: TIG
PROJECT: OLVERA
Project Description: install gas fireplace (no gas piping associated)
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: 1
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
LETICA OLVERA Description Date Amount
12610 SW ASCENSION DR
TIGARD, OR 97224 [MECH] Permit Fee 1/15/200E $72.50
[TAX] 12% State Surch 1/15/200E $8.70
Total $81.20
Phone: 971 - 227 -4254
Contractor:
FIRESIDE DISTRIBUTORS
18389 SW BOONES FERRY RD
PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -595 -3726
FAX 503- 620 -5699
Reg #: LIC 40979
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: ' i Permittee Signature: 1
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.
• 01/15/2008 14:57 5036205699 FIRESIDE DISTRIBUTOR PAGE 01
\1IecUia.nical Permit Application FoR orrIc 1:; 11SE UNIX
City of Tigard /5 ar '1!i Permit No.: iiMI_ E,_
14 1 13125 SW Noll Blvd., Tigard, OR 97223 plan Review
Q Phone: 503,639,4171 Fax: 503.598,1960 Date/f3y: ptlur Pemnit:
Inspection line: 503.639.4175 Date Ready /Bye /uric', HI See Page 2 for
Ttt Internet, www.tigard- or.gov Notified/Method; Suppiemtatal
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Mechanical permit fees* are based on the value of the work
El New construction .❑ Addition /alteration /replacement performed, indicate the value (rounded to the nearest dollar) of all
0 Demolition 0 Other: p mechanical materials, e.ui.men labor overhead, and . oftt,
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A 1 - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist.
0 Multi- family 0 Master builder 0 Other: Description qty. MIMI Total
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Air conditioning or heat pump
lob site address: ,, s \ A * • 1 I I ' re•uires site data showin_ dacement 14.00
Furnace 100,000 BTU ducts /vents 14.00
Furnace 100 000 13TU duets/vents MI 17 .90 ill
Suite/bldg. /apt. no.: Project name: 1 IMME111111111 14.00 1M
Cross street/directions to job Ac: Duct work III. 14.00
H
• ronic hot waters Stem 14.00
Residential boiler (radiator or
11 conic 14.00
Unit heaters (fuel -type, not electric), -
in•wali in -duct, sus.ended, etc. 10.00 MI
flue/vent for an of above _ 10.00
Subdivision: Lorna.: Other 10.00 MIMI
Tax map /parcel no.: Other fuel a fiances
} „ 5 P i 101774 r 7 i f r dl 1 z,t i �I `l9i, t i u , {;6:ii0 W ater heater 10 00
� i..,"isl��!� � , r ;�;� � � .� �. : ��t�. i�� , .at'��s � t �� � � , „ . , . : ,I 10.00
A , 1 40. / , t $ ) , I Flue vent for water heater or gas III
fire. lace 10.00
Lo_ ti_ : ns 10.00 ME
Wood /.elletstove MI 10.00 NMI
Wood fi lace/insert 10.00 MMI
y,�ya,p�uy� ,y{�� , ,•r,:• ;h; 1 + + +6' t: , , , t , ryry r e 1 : ; ,(•i -,y, i . (r; :. „� fi 10.00 MI
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s ,o atlter: 10,00
...1/i► ° Range hood/other kitchen
Address. . a i t . 11 4 / 4,- ' e•ui.ment - 10.00
ity /State /Z I': IA i w 7 a, D Clothes d exhaust 10.00 NM • Singlc -duct exhaust (bathrooms,
Flan 4
''1111111, ii 'a toilet com•artments,utiil rooms - 6.80
~���^ w M I ^ 'lTP P 'Zr w; a t.t h1a+ , 10.00 Mill
z t 1t , l I 2 4 H t' #� rl : , Attic /crawls. ace fans
M i z . ilti1 f "4. In d 1 , a , , ly I d n m 9 r( r. r't i,. I ' ..> a , 'r 11
r !' r. ra;t7! #i�tllll}li+ul�� l r, .. t��hl .,•a�•l i�faa �. I is#, .; i other 10.00 MEM
Business name: ir i I a rl ,4 r_ , l / f /
Contact name: a $5.40 for first four. $1,00 for each additional
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Address: I J M • 0 I! I r'^) A. -4 Gas heat • . MIN
City /Statc&Z1P; �� 0 i l A N f' /Al, Wall/sus . cndcdlunitheater =
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E -mail: '
y T. , 4 ,.. q . : , j , i�ifif.N '� ;t�`, ' f i lly,y� .' 1 ! ',,%tlFl it N , L - ' ;4 h y ri f (v';+,:) y!4'::di ?�lii'j!(!ii, l i t,;, Barbecue _�
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• ' - aa Clothes d r • as
Business name: I / '',. t 11111 T
I , r r'/ //) Other: 1111M11•11111
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Add it AC ' I / / ! flzii�? i� �`;i�°`'i•h',ll,j ' •, %� .- ., `l 41i!�f +s�%tf �
City/State/ZIP: Subtotal mina
Minimum permit fee ($72.50)
MEM
Phone: ( ) Plan review (25% of permit fee) MINIM
CCB lie.: 0 p 1 0 State surcharge -'/o of permit fee) p t l�
TOTAL PERMIT FEE ammo
o
This permit application expires if a permit to not obtained within RIO
Authorized signature: days nfter It has beat accepted as complete. ,fiN
Print natne: / 1 t ; .. / / r Date: ,. 0 " Pen methodology set by Ttl•County Building industry 5ersicc Board
L \BuiidlntPermita1MEC- •ermILhpp.doe 54/00105 446.461rt (!lio1/coM/Wf,A)
CIT, 00 TIGARD
BUILDING DIVISION
A PERMIT #: MEC200B-000213
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/1f.V2008
Phone: (503) 639-4171 4 '" 40 /01101#
Inspection Requests (24 Hrs.): (503) 639-4175 x .1114. - 111. / —t:900cfr
INSPECTION WORKSHEET FOR DATE: 1/17/2008 TIME: 7:00AM PAGE: 67
SITE ADDRESS: WO SW ASCENSION DR CLASS OF WORK:
SUBDIVISION: Hi LLSHIRE WOODS LOT #: of TYPE OF USE:
PROJECT NAME: OLVERA
AO
DESCRIPTION: install gas fireplace (no gas piping associated)
OWNER: OLVERA, LETICA PHONE #: 971-227-4264
CONTRACTOR: FIRESIDE DISTRIBUTORS PHONE #: 603-596-3726
P( M
Inspection Request Scheduled For: Date: 1/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
616 Mechanical rough-in 063372-01 860-369-5372 Y
Corrections /Comments/ Instructions:
0 K.
I
PASS El PARTIAL APPROVAL [1] CANCEL I I NO ACCESS
' I I FAIL 0 CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector:
A
Date: \ 1 1.O Phone #: (503) 718- -,„ r )
... . . .