Permit F t .
It
CITY OF T MECHANICAL
! g 1 , 1 DEVELOPMENT SERVICES PERMIT #PERMIT : MEC98-0433
(%% DATE ISSUED: 09 /25/98
r■17 14 PARCEL: 2S114BB -04500
SITE ADDRESS...: 10350 SW SERENA WAY er
SUBDIVISION ° PICKS LANDING NO.1 ZONING: R - 4.5 PD
BLOCK LOT :022 JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN ° 0 EVAP COOLERS: 0
TYPE OF USE °5F UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:R3 . VENTS W/O APPL: 0 VENT SYSTEMS: 0
STORIES ° 0 BOILERS /COMPRESSORS HOODS ° 0
FUEL TYPES 0 -3 HP ° 0 DOMES. INCIN: 0
3 -15 HP ° 0 COMML. INCIN: 0
MAX INPUT: 0 BTU 15 -30 HP ° 0 REPAIR UNITS: 0
FIRE DAMPERS ?..: 30 -50 HP ° 0 WOODSTOVES.. : 1
GAS PRESSURE...: 50+ HP ° 0 CLO DRYERS..: 0
NO. OF UNITS-- AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 1OOK BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN 7 =100K BTU: 0 > 10000 cfm: 0
Remarks : Install freestanding gas stove.
Owner: FEES - --
MARYLEE WRIGHT type amount by date recpt
10350 SW SERENA WAY PRMT $ `5.00 GEO 09/25/98 98- 309498
TIGARD OR 97224 SPCT $ 1.25 GEO 09/25/98 98- 309498
Phone #: 639 -8241
Contractor:
B & T GAS SERVICE INC
KEITH TEASDALE -- --
8528 SW 190TH AVE $ 86.25 TOTAL
BEAVERTON OR 97007
Phone *: 642-7843
Reg #..: 000911
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the W o o d s t o v e Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Fire Damper Insp
applicable laws. All work will be done in accordance with Final Inspect ion
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 by the Oregon Utility Notification Center. Those rules are
set forth in OAR 952- 001 -0010 through OAR 952 - 001 -0080. You may
obtain copies of these rules or direct questions to OUNC by calling
(503)246-9187. 7/
I ssue By / k l-- Permittee Signature: T
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7 :00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + ++ + + + + + + + + + + + + + + + + ++
r ig Plan Check #
- - CITY OF TIGARD Mechanical Permit Application Rec'd By
13125 SW HALL BLVD. Commercial and Residential Date Rec'd
TIGARD, OR 97223 - Date to P.E.
(503) 639 -4171, X304 Date to DST
Print or Type a Permit # Iy/e Q -46 /35
� Called
Incomplete or illegible applications will not be accepted
re of Development/Project L Description
5 �� /�Q ' a Table 1A Mechanical Code QTY PRICE AMT
Job l Street Address I Suite# A) Permit Fee -0- -0- 10.00
Address / 035 ..)1/43 $ �h,
Bldg# City/State Zip 1.) Furnace to 100,000 BTU 6.00
including ducts & vents
Name (or nam iness) 2.) Furnace 100,000 BTU+ 7.50
1' r [�
Owner 1u - of , I-/ ewit 7 including ducts & vents
Mailing Addiss �. / - �,,, . 3.) Floor Furnace 6.00
- /®. 50 SU) t/ JktatL including vent
/ tate Zip Phone 4.) Suspended heater, wall heater 6.00
�� D� (° 9 7, y X39 -� / or floor mounted heater •
Name (o ame of busine ).. 5.) Vent not included in appliance permit 3.00
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00
to 3 HP; absorb unit to 100K BUT
City /State Zip Phone 7.) Boiler or comp, heat pump, air cond. 11.00
3-15 HP; absorb unit to 500K BTU" .
Contractor Name 8.) Boiler or comp, heat pump, air cond. 15.00
134-TG1A. ! tq.ne--, 15-30 HP; absorb unit.5 -1 mil BTU"
Prior to permit Mailing Address �, 9.) Boiler or comp, heat pump, air cond. 22.50
issuance, a copy $�j,g 5w /go j'{J 30-50 HP; absorb unit 1- 1.75mil BTU"'
of all licenses ny /State / � Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
are required if aW , (, `9 7CD1 (/) -7d X3 > 50 HP; absorb unit 1.75 mil BTU"
expired in COT Oregon Cord. Board Lic.# Ex . Date �� 11.) Air handling unit to 10,000 CFM 4.50
l JV
database C f / (Y,
Architect Name 12.) Air handling unit 7.50
10,000 CTM+
or Mailing Address 13.) Non - portable evaporate cooler 4.50
Engineer City/State Zip Phone 14.) Vent fan connected to a single duct 3.00
Describe work New ® Addition 0 Alteration 0 Repair 0 15.) Ventilation system not included 4.50
to be done Residential 0 Non - residential 0 in appliance permit
Additional Description of work: I - �/� c ,gyp 16.) Hood served by mechanical exhaust 4.50
9 j Q Q ' '‘el rd'i - P t J( , . S* V e-- 17.) Domestic incinerators 7.50
Existing use of 18.) Commercial or industrial 30.00
building or property type incinerator
19.) Repair units 4.50
Proposed use of 20.) Wood stove /' 4.50 11 50
building or property
21.) Clothes dryer, etc. 4.50
Type of fuel - oil 0 natural gas ® LPG 0 electric 0 22.) Other units 4.50
I hereby acknowledge that I have read this application, that the information 23.) Gas piping one to four outlets 2.00
given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State laws. 24.) More than 4 -per outlet (each) .50
Signature f Owner /Age i Date *SUBTOTAL ':- 0 m , .� - ire
/// //7Tuj 09/0 * 5% SURCHARGE `x ` ^ b.` Z
Contact Perso Name Phone PLAN REVIEW 25% OF SUBTOTAL
`' / (,� /,, (0-10)-(43 Required for all commercial permits only `.5: A ;_ , s y
_�1
c(_ / / O0a) V TOTAL v‘., � ' v't 07 (P S.
r ', fl y -4::
' Minimum permit fee is $25 + 5% surcharge
"Residential NC requires site plan showing placement of unit
lArnechprmt.doc rev 4/15/98
6/13/00 Activities for Case #: MEC98 -00433 t �A
2:34:40 PM 'iii
kt,
Assigned Hold Updated
Activity Description Date 1 Date 2 Date 3 To Done By Disp. Level By Updated Notes
MECA007 Application received 9/25/98 GEO MAIL CTR 9/25/98
MECA008 Create Permit 9/25/98 GEO DONE CTR 9/25/98
MECA799 Final Inspection ST 2/17/00 2/17/00- inspection request to
Hap
MECA720 Woodstove Insp 9/25/98 CTR 9/25/98
MECA740 Fire Damper Insp 9/25/98 CTR 9/25/98
MECA060 (F) Issue permit 9/25/98 GEO PASS CTR 9/25/98
MECA705 Gas Line Insp 9/29/98 KS PASS KBS 10/1/98 #-1- support sst gas tubing @
crawl space four ft o/c will
recheck @ final inspection. pt
test = 36 psi for 15 minutes
MECA845 Request inspection research 3/24/00 JMT DONE No Hold JMT 3/24/00
MECA880 Expired by limitation 6/7/00 HAP DONE No Hold AKJ 6/7/00
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