Permit CITY OF TIGARD
MECHANICAL PERMIT
'`'� ' `" COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00593
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/27/2006
PARCEL. .
2 S 104CA -03800
SITE ADDRESS: 13667 SW MICHELLE CT ZONING: R -7
SUBDIVISION: HILLSHIRE LOT: 038 JURISDICTION: TIG
Project Description: Installation of pellet insert.
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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm:
GAS OUTLETS:
> 10000 cfm:
Owner: FEES
BOB & CAROL NATHANSON Description Date Amount
13667 SW MICHELLE CT
TIGARD, OR 97223 [MECH] Permit Fee 11/27/20C $72.50
[TAX] 8% State Surcha 11/27/20C $5.80
Total $78.30
Phone: 503 - 524 -5099
Contractor:
LUDEMAN'S FIREPLACE & PATIO
12675 SW BEAVERDAM RD
BEAVERTON, OR 97005 -2129 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 646 -6409
FAX 503- 646 -8034
Reg #: LIC 51469
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: r'.j��e� Permittee Signature: e Q`
Call 503.639.4175 by 7:00 a.m. for inspections that business day. A
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.
NOV .22.2006 5 :210PM 0.826 '.2/3
Mec apical Permit Applieatiodl' I OI: ell hlc I.( S1: OBI.
>t of Tigard Received �i ( i Permit No w 7.
L.s. , 4,, 13125 SW Hall Blvd.. Tigard, OR 9722,9 t Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 C rHa�i^ „ Niily li t ! Drue/13r Other Permit
Inspection Line: 501.619.4175, NOV 2 2 Zoo u _ ;� 41 1 k pare Ready/By: 21 See Page 2 for
)ntemer www.ot,tigard.or.us ° i ` - Notified/Method! Supplemental Information
CITY OF TiGARC
. e�rAtr_ ni itB1(11\1
7iit 1 OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction Addition /aite[atiotl/teplact meat Mechanical permit fees/ arc based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: _
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
and 2-family dwelling ❑ Commercial /industrial 0 Accessory building
For special Informarion use Checklist_
0 Multi- family ❑ Master builder ❑ Other: Description Qty, I Ea, Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
site Job site address: J (per 7 ,, e,d , A C , .� �' .
Air conditioning or heat p amp
(re wires re plan thawing Incementl 14.00
City /State/ZIP: —7---/ 6 Q r &C o / 97a101-5 Furnace 100.000 BTU (ducts/veins) 14,00
Furnace 100.000+ BTU (duos/venal) 17.90
Suite/bldg. /apt. no.: Project name: )02 IL 411 .50/3
Gas heat pump 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 (fad -type, not electric),
in -wall. in-duct, suspended, etc. 10.00
Lot no.: Flue/vent for any of above 10.00
Subdivision:
J _ Other. _ I o.0D I -
. Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater _ _ _ 10,00
- Pe//e Gas fireplace 10.00
,: h.5 7'0 ii 7i z6s er Flue vent for water heater or can
fireplace 10,00
Log lighter (gas) 10.00
Wood/pellet stove _ 10.00 •
Wood fireplace/insert / 10.00 /a- 00
VPROPERTY OWNER ( 0 TEN , Chimney/liner/flue/vent / 10:00 /0, d 4
Other: 10.00
Name: G d ° • - rcf / / - • /v Environmental exhaust and ventilation
Address: Range hood/other Icitchen
- 7 - G eJ . Q . '" . equipment _ 10.00
City/State/ZIP: 7 - or cje a A, '" 7 a of Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms.
Phone: (5-7J seR v. „5-69 9 Fax: ( ) toilet compartments. utility rooms) 6.80
4[+ AFPLICANT ❑ CONTACT 'ERSON Attic/crawlspaco fins 10.00
Other. 10.00
Business name:
eL 4 4p 1 C /Yf Q 07 g Fuel piping
Contact name: ....to ^' e ,/ ' p{ Y � c R , $5,40 for first four; 51.00 for each additional R or Furnace. etc.
Address: l o� Gv 7,SJ t=ta<rdta 1 �'1 - Gas heat pump
City /Statc/ZU d vet 7 '7 / Of 4 7 7 ca j Wall/suspcndcd/unit heater
Phone: (5 ) Co S/eO • t!oV0 - Fax: : (5 0) C 5/6• cp0.3 Water hearer _
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Clothes drycrjgas)
Business name: 59, m Other. •
Address: MECHANICAL PERMIT FEES*
City/State /ZIP: Subtotal ' aZ Ca.0 0
Phone: ( ) I Fax: ( ) _ Minimum pe fie ($72.50) 7.7
I Plan review (25% of permit fee)
CCB tic.: J 96, 9.. 0 ".._3 P- State surcharge (8% of permit fee) $ aD
TOTAL PERMIT FEE 7 8 .3 Q ;
Authorized signature: T hin permir d °ye after it ns� bRn accepted ne complete thin 180
1 Print name: /� 54/1. ,(/ 1 rate' 0 / c 9 e . Q 6 1 ' Fee methodology set by Tee-County Building Industry Service Boor
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BUILDING DIVISION PERMIT #: h8E<�2ODE�8O593
13125 SW Hall Blvd., Tigard, OR 97223
DATE ISSUED: ��/27/�DOG
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 Ail 'AL.
INSPECTION WORKSHEET FOR DATE: 12/8/2006 TIME: 7:01AM PAGE: 45
SITE ADDRESS: 13667 SW MICHELLE CT CLASS OF WORK:
SUBDIVISION: H(LLSH}RE LOT #: 088 - TYPE OF USE:
PROJECT NAME: NATMANBON
DESCRIPTION: installation of pellet insert.
OWNER: NATMAMSON. BOB & CAROL PHONE #: 603'524-5099
CONTRACTOR: LUQEh4AN]SF|FlEpLACE & PATIO PHONE #: 503'846_64O9
Inspection Request Scheduled For: Date: 12/8/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message .
699 Mechanical final 040827-01 503-534-5099 N
Corrections/Comments/Instructions:
•
S PARTIAL APPROVAL �� CANCEL �� NO ACCESS
| | FA|L LL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: ^ ^ � � Date: 12 ' S—.06 Phone #: (503) 718- 4--446