Permit I
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2005 -00783
�� 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/28/2005
PARCEL: 2S110DD -12500
SITE ADDRESS: 10850 SW HIGHLAND DR ZONING: R -
SUBDIVISION: SUMMERFIELD NO.13 LOT: 695 JURISDICTION: TIG
Project Description: Fireplace insert and gas.
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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
PETER HIGGINS Description Date Amount
10850 SW HIGHLAND DR [MECH] Permit Fee 11/28/20( $72.50
TIGARD, OR 97224 [TAX] 8% State Surchart 11/28/20( $5.80
Phone: 503- 620 -9582 Total $78.30
Contractor:
ANCTIL SHEET METAL CO.
4320 N WILLIAMS AVE REQUIRED ITEMS AND REPORTS
PORTLAND, OR 97217 - 2952
Phone: 503- 281 -0752
Reg #: LIC 8897
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: dl'1. 4ia/Q -1-1- Gcc_ 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.
:
USE . • ! C3t� C L 5E ONLY � "` � �
?�1`�ct�Ia ilical Per[nitA�ppl i on _ `�o EEIE o
� � fl ,f 'l� Received f
City of Tigard ! ( � ■ Date/By: II f OS II PermitNO.:m I 5 —00 $3
13125 Sw Ball Blvd„ Tigard, OR 97223 Plan Review
Phone: $03.639.4171 Fax: 503.598,1960 Njj� j � „ Date/By: Other Permit;
Line: Inspection Lin 503.639.4175 .j l , / 2 3 �� r.�/ Date Itrady/Sy: ®Sec tags 2 for
Internet: www.et.tigard.or.us �Noti ficd'Method; \ Sapplementat information r
• _ f:ITV n1 Ti1 Dre
V TYpE,JOFJ COMMERCIAL FEE' SCHEDULE - USE CHECKLIST
E New construction ❑ Addition /alteration/replacement Mechanical permit tees" are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead. and profit.
CATEGORY OF CONSTRUCTION Value: S •
RESIDENTIAL EQUIPMENT /SYSTEMS FEES`
® I and 2-family dwelling ❑ Cointnercial /industrial ❑ Accessory building
For special inforinarioR use eheekiisr.
❑ Multi family ❑ Master builder ❑ Other.
,� Description Qry, Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cuoling
Job; site address: [ e'5O _4 t g e rrs sit plan conditioning or heat pump
1\ { + � (rcquares sitcplan s h o win v placemenr> I4,OQ
�V�c6 1 4 0 a w • — Furnace 100,000 BTU (ducta/vents 14.00
■ City /State /G(P; � Z
Furnace 100.000+ BTU (ducts/vents) 17,90
Suite/bl4. /4341. no.: Project name: k �+ • ,' � �� n. Gas heatpump 14.00
Cross street/directions to job Site: Duct work 14.00 •
" Hydronic hot water System 14.00
-- _ Residential boiler (radiator or
hydronic) _ 14.00
-- - .. Unit heaters (fuel -type, not electric),
in - wall. in -duct, suspended, etc. 10.00
Subdivision: N .r,- Lot no.: Flue /vent for any of above 10.00
Other:_ • 10.00
Tax map /parcel rto,; Other fuel a. .liances __
. DESCRIPTION OF WORK .. Water heater -- 10.00
t_ • Gas firc•lace L 10.00 E,47:41
1\,S¼\\ _ _cts c tt.P , \ i C Nt. > C t) . ' t , - Flue vent for water heater or gas
fire•lace 10.00
t u I♦l�1 %Ai ' • , , • \ , \ ` - A ' Log lighter (g8) 10.00
nSk \ • . is S • ,•,o - - \ . Nil . wood /pellet stove 10.00
Wood fireplace/insert 10.00 III
❑ PROPERTY OWNER ❑ TENANT Chimney /finer /flue/vent 10.00
Other; 10.00
Name: �r ‘.° \'.1 t �,�' Environmental exhaust and ventilation__
Range hood/other kitchen
— Adddrees - a s; 6! -16 if l ' 4 it w e ui.rfent 10,00 •
f i S • g i- ' e , t 1 , ! Clothes dryer exhaust 10.00
Single -duet exhaust (bathrooms,
Phone: (? t x: ( Fa ) toilet corn artments, utilit rooms) 6.80
V Attic /crawls ace fans 10.00
❑ APPLICANT � I CONTACT PERSON
Business name: Other: 10.00
� ���� t Y• � _s . Fuel piping
Contact name: A `I " tom _ $5.40 for first fours S1 -00 fpr each additiona
Address: Furnace, etc. _
-- Gas heat pump _
Ciw'Statc/ZlP: - �, Wall /suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E - mail: Ran : e
— ` CONTRACTOR Barbecue -
Business name: Q -t�_� 1 � ' ,i Coy% T Clothes dryer (gas)
` � r LJ Other:
Address: 1- 1200„111/A. .. _._ MECHANICAL PERMIT FEES*
6tv /Sioie 00' \,W la \�- - - -.... Subtotal , i
-- Minimum permit tee (572.50) . ll
Phone: (6332_a 1.- ) 2-o p
0-A- �� Fax: ( SS ) ,78,)'" S as _w. — Plan review (i of permit fee)
I CCF'3 lie.' ggq State surcharge (8% or permit fee) " I ,5, ()'1
.... - - - / i..�,/. ,y ._..�. _ .._. ..... To'r.aL, Pl.�rt FEE I , Q ,
/ 1 e rtnit upplic1niO4 C \plt'ts i a permit is not Obtained within ISO
at10 ";111,T1;111.11%.:. ` , /ii/ J ! fie da ;1 1 . 1 „,. a h: s been accepted ai complete.
h[i! n � ezdc ctt r .^ I • /` '7c QL FCC me hodc,lucy cn by 'l ('ot:nty Iiu,IJiag IOJv: ry Scr ,.c $uur.i
tl nine. l �� Date: k G1 4J V
Td Wdt'L:SO SOOZ SE 'A°N ZZLSZ8Z LOS : '0N 3NOHd but loop 'g 6utq}p 1I±ONd : WOZId
- .
CITY OF TIGARD ,
BUILDING DIVISION PERMIT #: MEC2005-00783
1 1 13125 SW Hall Blvd., Tigard, OR 97223
JAt t DATE ISSUED: 11/28/2005
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/22/2005 TIME: 7:03AM PAGE: 60
SITE ADDRESS: 10850 SW HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.13 LOT #: 695 TYPE OF USE:
PROJECT NAME: HIGGINS
DESCRIPTION: Fireplace insert and gas. /.................._______T__
OWNER: HIGGINS, PETER PHONE #: 503
CONTRACTOR: ANCTIL SHEET METAL CO. PHONE #: 503-281-0752
Inspection Request Scheduled For: Date: 12/22/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
605 Post/beam mechanical i 023818-01 503-620-9582 Y go - i f
671 Medzeiii/cat I, 1-1/4 .
Corrections/Comments/Instructions:
/ '
/
•
c4 PASS El PARTIAL APPROVAL Li CANCEL I I NO ACCESS
0 FAIL fl CALL FOR INSPECTION I 1 ADDITIONAL FEES ASSESSED
Inspect .
i
94 /1L/ Date: ( 0 ( Phone #: (503) 718-