Permit CITY OF T MECHAN I CAL
DEVELOPMENT SERVICES PERMIT
PERMIT # • MEC97 -0332
!+� " 1. 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639.4171 DATE ISSUED: 09/05/97
PARCEL: 25112CA -06300
SITE ADDRESS...: 15223 SW THURSTON LN
SUBDIVISION • ASHFORD OAKS ZONING: R -7
BLOCK LOT :17 JURISDICTION: TIG
CLASS OF WORK..:ADD FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE •SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:R3 VENTS W/0 APPL: 0 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS • 0
FUEL TYPES 0 -3 HP • 0 DOMES. INCIN: 0
:GAS 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 < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 1
FURN > =100K BTU: 0 > 10000 cfm: 0
Remarks : Installation of gas wood stove.
Owner: FEES
JOHN BULLAS & DIANNE type amount by date recpt
15223 SW THURSTON LN PRMT $ 25. DRA 09/05/97 97- 298987
TIGARD OR 97224 5PCT $ 1.25 DRA 09/05/97 97- 298987
Phone #: 624 -0164
Contractor:
LUDEMAN'S FIREPLACE /PATIO SHOP
12675 SW BEAVERDAM RD
$ 26.25 TOTAL
BEAVERTON OR 97005
Phone #: 646 -6409
Reg L. 000005
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Gas Line Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Wo od s t o v e Insp
applicable laws. All work will be done in accordance with Misc. Inspection
approved plans. This permit will expire if work is not started Final Inspection
within 188 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 952-081-8810 through OAR 952-N1-0880. You may
obtain copies of these rules or direct questions to WC by calling
(583)246 -9187.
Issu By: ki). Permittee Sign ature: U
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + ++ + + + + + + ++
Call 639 -4175 by 6:00 p.m. for inspections needed the net business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Plan Ch
CITY OF TIGARD Mechanical Permit Application Reed Brims J
131g6 SIN HALL BLVD. Commercial and Residential Date Recd J -.' - a 7
TIG►RD, OR 97223 Date to P.E. -
(503) 639 -4171, x304 Date to DST ---
Permit # pco. V7-4-,
Print or Type
Called
Incomplete or illegible applications will not be accepted
Name of Development/Project Description
■!- ,M � Table 1A Mechanical Code OTtt PRICE AMT .
Job street A { (fi Suite# A) Permit Fee - -o- -o- 10.00
Address IS .1. 511- .r o r. Lt-.
Bldg# City/State ZIP 1.) Furnace to 100,000 BTU 6.00
rr ct,-11 C. C ricQ4 including ducts & vents
Name (or name of business) 2.) Furnace 100,000 BTU+ 7.50
Owner J0ks, 4 . -- 1% cta--,-, C,, T La.\ \cA.S including ducts & vents
Mailing Address 3.) Floor Furnace 6.00
15da. SL;W 11 i 1 O,' Lax .x) including vent
City /state Zip Phone 4.) Suspended heater, wall heater 6.00
- Tr tY c O S14 (.001 C L9 or floor mounted heater
Nam lot n of business) ` 5.) Vent not included in appliance permit 3.00
.) + ..4-• 0 i w •r.��LA-tls
Occupant Mailing Address 6.) Boiler or comp, heat pump, air cond. 6.00
1 5) Ta✓skol. L.0 -$A) to 3 HP; absorb unit to 100K BUT"
Cit Zip - Phone 7.) Boiler or comp, heat pump, air cond. 11.00
T c d ( . et 1 - 01.64 3-15 HP; absorb unit to 500K BTU"
Contractor 1 r-r 8.) Boiler or comp, heat pump, air cond. 15.00
(Prior to �.U.0.e- •O�Z 15-30 HP; absorb unit.5.1 mil BTU"
issuance Mailing Address 9.) Boiler or comp, heat pump, air cond. 22.50
applicant eat, - 15 5\z e av erc -c•, - 30-50 HP; absorb unit 1- 1.75mi1 BTU"
must provide all City/State " Zip Phone 10.) Boiler or comp, heat pump, air cond. 37.50
contractor $tpv ff-\ rs O3, g1CI,S V16- i) l(q > 50 HP; absorb unit 1.75 mil BTU"
license Oregon Canal Cont. Board Licit Exp. Date 11.) Air handling unit to 10,000 CFM 4.50
information if O o5 1 l ' u (1 ( /� / l
expired in -1 "� / l
COT COT Business Tau or Metro # Exp Date 12.) Air handling unit 10,000 CFM 7.50
database). I c K 5 • _ .1 / 1 /
Architect Name 13.) Non - portable evaporate cooler 4.50
or Mailing Address 14.) Vent fan connected to a single duct 3.00
Engineer City /State Zip - Phone 15.) Ventilation system not included in 4.50
appliance permit
Describe work New 0 Addition '- eration • Repair 0 16.) Hood served by mechanical exhaust 4.50
to be done Residential 0 Non - residential 0
Additional ` � Description of work 17.) Domestic incinerators 7.50
\ T s k. locks QJ 18.) Commercial or industrial type 30.00
U Incinerator
Existing use of 19.) Repair units 4.50'
building or property
20.) Wood stove 4.50 "1 l t".SC_
Proposed use of 21.) Clothes dryer, etc. 4.50
building or property
22.) Other units 4.50
Type of fuel - oil 0 natural gas • LPG 0 electric 0 • 23.) Gas piping one to four outlets 2.00 a DO
I hereby acknowledge that I have read this application, that the 24.) More than 4 -per outlets (each) .50
information given is correct, that I am the owner or authorized agent of
the owner, that plans submitted are in compliance with Oregon State QTY. SUBTOTAL I
laws.
Signature of Owner /Agent Date 'SUBTOTAL &)- °
, b )4, 9-5- 5% SURCHARGE
C ontact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL
0 CRS^ 1 t OS -190-910'0 TOTAL c:21
i:ldst4nechpmtdoc (rev 9 'Minimum permit fee is $25 + 5% surcharge
"Residential NC requires site plan showing placement of unit.
1 mono 6A-K__-.5
CITY OF TIGARD BUILDING INSPECTION DIVISION
t jta jAV) , 24 -Hour Inspection Line: 639 -4175 Business Phone: 639 -4171
n 8-9.
--'°"---___—...--- Date Requested: "/ - A.M. P.M. jvIST:
Location: 5 _ - - - A - - -1 C UL ! ' / 4 / 9 / CU AI
Tenant: , ii . • : i
' : 1 MEC: 7— 0 3 302,
Contractor: 0-4•■. r Phone: p - 6 (/ / 0 ) ELC: PLM
Owner Q S-77) Phone: — ' i /
11 �'A J w00 D � �E , 7 1 790- / ELR:
•-4W . J.& • �" .f , (4P ,410 t�G( ; SIT:
BUILDING BLDG (con't) VV PLUMBING &MECHANICAL ) ELECTRICAL SITE
Site Post/Beam Post/Beam Pow Cover /Service Sewer /Storm
Footing Roof UndFl/Slab • ou_ • - Ceiling Water Line
Slab Framing Top Out 401%;f1. Rough -In UG Sprinkler
Foundation Insulation Sewer •. Ct Reconnect Vault
Bsmt Damp Drywall Storm Furnace Temp Service MISC.
Masonry Ceiling Rain Drain A/C UG Slab
Shear /Sheath Fire Spklr /Alm Crawl/Found Dr Heat Pump Low Volt
Approved Approved 0 p ov Approved Approved
Appr /Sdwlk Not Approved Not Approved Not • «roved Not Approved Not Approved
FINAL —' FINAL FINAL
G co— 5 l( pt_•t- hi .5 fee I /0.-', r r?ri cLK d /i ssr /P )
&a-s S - ia vt? I^,ficallot trotfpeci °o`
/Vd / 2 rP5 Sr I re- -Le — / (D i os/ 4) , / op otcc ',T;
•
6 w 113y- 3 3- 3 -4'
O Call for reinspection Cl Reinspection fee of $ required before next inspection Cl Unable to inspect
Inspector:. , V� ct J. "1"; m 6 ofV �1r ✓ hrbate: 9 / /ie/ q 7 Page / of