Permit Alt) CITY OF TIGARD MECHANICAL PERMIT
° �i�ell ' DEVELOPMENT SERVICES PERMIT #: MEC2006-00015
�' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 1/11/2006
PARCEL: 1S125DD
SITE ADDRESS: 09610 SW VENTURA CT ZONING: R - 4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.3 LOT: 106 JURISDICTION: TIG
Project Description: Install woodstove.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
OTH 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES: 1
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
FAILOR, JOHN W + Description Date Amount
CHERYL R MANSFIELD [MECH] Permit Fee 1/11/200€ $72.50
9610 SW VENTURA CT [TAX] 8% State Surchar€ 1/11/200€ $5.80
TIGARD, OR 97223
Phone: 503 -519 -8793 Total $78.30
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact #:
Reg #:
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: e _ Permittee Signature: vii14 .
Call 503 - 639 -4175 by 7:00 a.m. for inspections th b ness day.
This permit card shall be kept in a conspicuous place on the job site un it completion of the project.
Approved plans are required on the job site at the time of each inspection.
s A
Mechanical Perm it FOR OFFICE USE ONLY
Received
City of Tigard � � i o P No ,16.- ,16.- 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: I I ► _ ��11 — r '
Plan Review
Phone: 503.639.4171 Fax: 50 �}1960 "11114' Date/By: Other Permit:
Inspection Line: 503.639.4175 J/A 1 �oo� _La. e 1 Date Ready/By: MI :% See Page 2 for
Internet: www.ci.tigard.or.us OF TIGABD Notified/Method: Supplemental Information
BUILDING DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction ❑ Additio replacement Mechanical permit fees* 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: $
El 1 and 2 family dwelling El Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
For special information use checklist
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
Job site address: /�/ - l0 S Air conditioning or heat pump
(lC �� � eG� t� (V (requires site plan showing placement) 14.00
City /State /ZIP: l l3.et4Y { (J-� q? z---2_ 3 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name:
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 (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
ZL1Q.G( IDOA Q Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
PROPERTY OWNER ❑ Other:
Chimney/liner/flue/vent 10.00
TENANT
Other: 10.00
Name: 36 1 i& Fiao,/ Environmental exhaust and ventilation
Address: qi, �D SU) rt ` u LTt equipment nt other kitchen
Z V [ e ui mart 10.00
City /State /ZIP: c �( Clothes dryer exhaust 10.00
� 9 v \ Sin -duct exhaust (bathrooms,
Phone: (�?j) 5 l (— g" 71' ' Fax: (, ?id _ 0 tigi 2 toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name: Fuel t t
P
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall/suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name:
e Llikt. Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Minimum permit fee ($72.50)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE 3
Authorized signature: This permit application expires if a permit is not obtained within 180
g days after it has been accepted as complete.
Print name: / Date: r Lk — 0 <" * Fee methodology set by Tri- County Building Industry Service Board
1.\Buitding�Permus\M errnitApp.doc 12/03 440 -4617T (11 /02/COM/WEB)
CITY OF TIGARD A-_1_ . c� g (�
BUILDING DIVISION - 'PERMIT #: MFC200 x;.00 16
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/1mow
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 2/7J2006 TIME: 7:07Al PAGE: 77
SITE ADDRESS: 09610 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES LOT #: 10c TYPE OF USE:
PROJECT NAME: TAILOR
DESCRIPTION: Irid. i woocistove.
OWNER: FAILOR, JOHN W a-, PHONE #: W3-619-0793'
',19 -0793
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 2012008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
026121 -01 603 -519-8793 Y CO - e(A-'
6 51 a'k
Corrections /Comments /Instructions:
ZPASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 946, Date: U" Phone #: (503) 718- -2 7B-6