Permit CITY O F TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00648
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/6/2007
PARCEL: 1S125DB-03702
SITE ADDRESS: 09520 SW 74TH AVE ZONING: R -4.5
SUBDIVISION: BOULEVARD HEIGHTS LOT: 023 JURISDICTION: TIG
PROJECT: COLE
Project Description: Gas line, fireplace insert.
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: IT
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR NIT S:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
COLE, EDWIN J + ELIZABETH LEE Description Date Amount
9520 SW 74TH AVE •
TIGARD, OR 97223 [MECH] Permit Fee 11/6/2007 $72.50
[TAX] 8% State Surcha 11/6/2007 $5.80
Total $78.30
Phone: 503- 452 -1536
Contractor:
FIRESIDE DISTRIBUTORS
18389 SW BOONES FERRY RD
PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -595 -3738
FAX 503- 670 -7285
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. al / / ' i Permittee Signature: ed-I/Y"
Call 503.639.4175 by 7:00 a.m. for inspections that business ay.
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.
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Permit .t ]I i ...1f1 o Ill" ‘ - Fon OFFICE tsr olisal.' ,
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o Received Received h 13125 4W Flan Blvd., Tigard, OR 97223 20 Date/By; 07 / Permit N �. �� / ,
I
' is Phone: 503.639.4171 Fax: 503.59B,1•0;4�� O Plan Review
Ti GA-RD lnspectlonl.ine:503.639.4175 ® A '
Datc/By. Other Permit, • interact: www•tigard•or.gov 3 _ r , n ' ` ' (� See Fuse 2 for
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0 New Construction 0 Addi on /alteration /rCplacernent Mechanical permit fees* are based on the value of the work
Demolition performed. Indicate the value (rounded to the nearest dollar) of all
Othe
,I,; ' a <s'a M:'.i' 'c,:. : i ,9�� °e' y�, , mechanical materials, equipment, labor, overhead, and profit
V la ;i � : ,.`•''I 1 1 t4 " ?Ulf ":01��P, :, ('0,{', w' ). y ,l'Lp �' tC, i3� V , , , i( 1 � Valuc: 5
"` and 2- family dwelling 0 Commercial /industrial Accessory t 1 { t (" ��t / "°
building ,r : „ . . ;?;'
❑ 1VIu,lti- family 0 builder ❑ Other_ �nrspECral infnr»xntdon USE cherkltsr.
tion
Descri
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Job it address CC i� i p s Oily
Air conditioning or heat pump
1 �Q pC to uires showing placement) 14.00
City /State /ZIP:
l 64 t Or. 1 z 2 3 Furnace 100 BTU (ductchtnse) 14.00
Suite/bldg-/apt, no,: Project name:
Furnace 100.000+ BTU (ducts/vents), 17.90
Gas heal pump 14.00 '
—
Cross street/directions to job sic;
Duct work 14.00
• - Hydronic hot watersvatcm 14,00 • - - Residential boiler {radiator or
h dronic 14.00
Unit heatera (fuel -type, not electric),
W _ in -wall, induct, suspended, etc, 10.00
Subdivision: Lot no,: Fiue /vent fob of above 10.00
Other: 10,00
Tax map/parcel no.:
Other fuel appliances
1 , �, ,
�, ,�
;�, ��.. *i iJi h,N, (`,l r,}'I,I ''�, �,674VL "�yXr �,d -1, ^iSMWr ?!i , , Water heater 10,00
n ,,
�� - Gas fireplace 10.00
— > \ I /IR 1 t �q k ce tn5-� ( .Flue vent for water inner or gas
fire lace 10,00
- - - - -' lighter (gas) 10,00
Wood /pellet stave 10-00
Wood frrcplace/insert t 10,00 —
i'I; �' '� ``` Y r n Ch mney /flue/v
? i/ r J 1 (,Co1 .W ' i,l I :.n i. , I, 'I� ,70 '�� 4 11:I t .r !; erlt _ 10.00
i i. r:'. ',.:.: Other: 10,00
Name: mU* C.I.E_ Environmental exhaust and ventilation
Address: 9S 2- U S ri t Range lined /other kitchen
_ equipment 10.00
-
City /State /Z117 f g j4.- C1ot� hcs dryer exhaust 10.00
Phan e: (5 ) 'rt52' y j 14;) Fax: ( ) Single-duct exhaust (bathrooms,
_ toilet cam artmcnts, utili roams 6,80
ha I i ^ 4: �� ,�r�
3a 1"':;:1 .tl :,.,,o q . j� ,-- "",",7^^ -..,
'', .�' ^" • .,1'I :! rl t @+�r` i 1,11 4,I ,I4 :`I'' '� 1 ' ; , 1 l \:1' .G�J „ n.
� {.. 1. 1, , S,,.a' { n'Ni,�' Ilyy�, �f�f,tfiv „ d7 ,,ra'��'�,,9Y'ru��r' I Aiticfcrawlspace 10.00
1 tither, 10,00
Business name:
/pas 1 , ye. 0)57E4 tZ 0 r Fuel piping
Contact name: V Y- /d ���
c jrlZ7i” $ for first four; $1.00 for each additional
Address: 1837 &a Gas he
Furnace, a, etc.
Dos heat. pul'rto
—
City /State /ZIP: -1p1Q t'�� q 2_. Wall /su ended /unit heater
Phone: (6(g) 5t--_, 3)3 Fax:: (S" 67o . '7 z 25- - Vliaterheater
E -mail: Fireplace 4
, ' i , , �i�';� {I�p� � � !, Ir+, 1 �-1��.t .r�',r � ' i't , fl y it ., �e
.. 0VI`I'i!CO
,'ta } �IY�kll ,•� I:!'li,, �, 1 (u,..., � r � ..�„ � ,.r � ?.�� ilh I , � I,f .r I �i I )N I _Barbecue
3uginess [>1Ene: Clothes dryer (gas)
address: �`' r ��� /; fit, ` / Otller
" 11 / to ) 5' U 02 — ' ;`) 1' 1' ,� 1 0:1 • 'nt'3 Oil • ,'y 1,w'; ., �'aI Y S ! 14 :
;ity /State/ZTP; 1 t A �A
w - — Subtotal
'hone: ( ) F ( ) Minimum permit fee (572.50) 1 4
Plan review (25% of permit fee)
;C13 Tic.: 01:t' State surcharge (8% ofpermit fee) . .:5 SIa
I ` 'TOTAL P)✓1'2,41 - 1FEE
utl2ortzed signature: , r �� This permit uppalcatdon expires if a permlf fp not obtained within 180
` ' , _
day* after [t has becnncvaptwJ In complete,
rim aerie: ,) t r. — 0,
Date: • Fee meth
tile
{ '• retie 1 (l .. ( •- 0 l oclo set by Tti- County Bu;Jeti,px (010- ubdu_ctry Se e
Buildin lPermllglMIIC •PcrmIrApp.dpC 04/0505 ' 4d0.4617T ({ I /n2�C()M(W1 a) . • k t-o 5u 3 -- r L R,
1
CITY OF
BUILDING bIVISION PERMIT #: M� C2007 -0O O
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/6/2007
Phone: (503) 639- 4171 ,�iif@ "j a
Inspection Requests (24 Hrs.): (503) 639 -4175 °e_... /Ice w 0 7- t v 4 y4
INSPECTION WORKSHEET FOR DATE: 11/13/2007 TIME: 7 :01AIVi PAGE: 92
SITE ADDRESS: 09520 SW 74TH AVE CLASS OF WORK:
SUBDIVISION: BOULEVARD HEIGHTS LOT #: 023 TYPE OF USE:
PROJECT NAME: COLE
DESCRIPTION: Gas line, fireplace insert.
OWNER: COLE, EDWIN J + ELIZABETH LEE, PHONE #: 503 -462 -1536
CONTRACTOR: FIRESIDE DISTRIBUTORS PHONE #: 50 S-58fa :3738
Inspection Request Scheduled For: Date: 11/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 059476-01 603.684-8535 Y
Corrections /Comments /Instructions:
0 _ - .FA L C. - — -/z Am:. - - . =.1.:.l sr.
"" :,, •- -i
/
I I PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS
(l FAIL n CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: - i Date: // — /--C'7 Phone #: (503) 718- ?S'