Permit t CITY OF TIGARD MECHANICAL
itirrew DEVELOPMENT SERVICES PERMIT
13125SW Hall Blvd ., Tigard, OR.97223(503)639 -4171 DATE PERMIT
10/26 -0473
PARCEL: 2S111BC -01700
•
SITE ADDRESS...: 10265 SW VIEW TERR
SUBDIVISION • GREENBRIER ZONING: R -3.5
BLOCK LOT :001 JURISDICTION: TIG
CLASS OF WORK..:ALT FLOOR FURN • 0 EVAP COOLERS: 0
TYPE OF USE -SF UNIT HEATERS..: 0 VENT FANS...: 0
OCCUPANCY GRP..:R3 VENTS W/0 APPL: 1 VENT SYSTEMS: 0
STORIES • 0 BOILERS /COMPRESSORS HOODS : 0
FUEL TYPES 0 -3 HP : 0 DOMES. INCIN: 0
:WOD 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 -
N0. OF UNITS AIR HANDLING UNITS OTHER UNITS.: 0
FURN < 100K BTU: 0 <= 10000 cfm: 0 GAS OUTLETS.: 0
FURN > =100K BTU: 0 ) 10000 cfm: 0
Remarks : Stack - install wood insert and vent system in existing fireplace
Owner: FEES
JUDITH STACK type amount by date recpt
10265 SW VIEW TERRACE PRMT $ 25.00 JSD 10 /26/98 98- 310295
TIGARD OR 97224 5PCT $ 1.25 JSD 10/26/98 98- 310295
Phone #:
Contractor:
LUDEMAN'S FIREPLACE /PATIO SHOP
12675 SW BEAVERDAM RD
26.25 TOTAL
BEAVERTON OR 97005
Phone #: 646 -6409
Reg #.. 000005
REQUIRED INSPECTIONS
This permit is issued subject to the regulations contained in the Woodstove Insp
Tigard Municipal Code, State of Ore. Specialty Codes and all other Final Inspection
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 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 question to OUNC b calling
(503)246 -9187. '
•
•
Issue By: dglie Permittee Signature: , 1..ar
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for inspections needed the next business day
++++++++++++++++++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
CITY F TIGARD Mechanical Permit Application Plan B y�i
ti O PP Recd By
13125 SW HALL BLVD. Commercial and Residential Date Recd Pk
TIGARD, OR 97223 Date to P.E.
(503) 639 -4171, x304 Date to DST
Print or Type Permit# r3
Incomplete or illegible applications will not be accepted Called (--r
Name of Development/Project Description J�
Table 1A Mechanical Code Qty Price Amt
Job Street Address / W l/ ,r - Suite# A) Permit Fee 10.00
Address 140Z i re !.e 1) Furnace to 100,000 BTU
including ducts & vents 6.00
Bldg# - C State Zip 2) Fumace 100,000 BTU+
4 0 j / including ducts & vents 7.50
Nape (or am of business} , �/ 3) Floor Furnace
J6J , yy� lJ� including vent 6.00
Mailing Add �"" 4) Suspended heater, wall heater
6
l 0 Z U u7/ ,,bY t /� / r or floor mounted heater 6.00
5) Vent not included in appliance permit / 2
7 8tata Zip Phone (034. / 3.00 /, 6C
8 q - 53 7 CHECK ALL *Boiler Heat Air
Name (or name of business) ' THAT APPLY: or Pump CO Qty Price Amt
Comp
Occupant Mailing Addre 6) <3HP;absorb unit to
OCCU
p 100K BTU 6.00
7) 3 -15 HP;absorb unit
Ctty/State Zip Phone 100k to 500k BTU 11.00
8) 15 -30 HP; absorb
Contractor Name unit .5 -1 mil BTU 15.00
l 9) 30 -50 HP; absorb
lit 'mU 4 - 5
unit 1 -1.75 mil BTU 22.50
Prior to permit Mag in�a Addre 10) >50HP; absorb unit
issuance, a copy 1 !6 7'5 64" (Ch VU z7 >1.75 mil BTU 37.50
of all licenses /state zz Phone (p Y6 - 11) Air handling unit to 10,000 CFM
are required if � i % /f �T� j t y(, C/ 4.50
expired in COT oregon�n�et. c, .�t. Bsa Lic.# Exp. Date ! 12) Air handling unit 10,000 CFM+
database ! l y 7.50
Architect Name 13) Non - portable evaporate cooler
4.50
Or Mailing Address 14) Vent fan connected to a single duct
3.00
15) Ventilation system not included in
Engineer City /State Zip Phone appliance permit 4.50
16) Hood served by mechanical exhaust
Describe work to be done: 4.50
17) Domestic incinerators
New 0 Repair 0 Replace with like kind: Yes 0 No 0 7.50
ResidentiaK Commercial 0 18) Commercial or industrial type incinerator
30.00
Additional information or description of work: `jy Lu l / 19) Repair units
' � A 4.50
kveicei (7'1�1e VSf? S 1/�l Z -e"�/ . 20) Wood stove �
r 7■1 t0lc t 9/ C � e / 7 e' « 1 4.50 - /'' .eZ
21) Clothes dryer, etc.
4.50
Type of fuel: oil 0 natural gas 0 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
given is correct, that I am the owner or authorized agent of 2.00
the owner, that plans submitted are in compliance with Oregon State laws. 24) More than 4 -per outlet (each)
.50
Signature of Owner /Agent Date Z �
Minimum Permit Fee $25.00 SUBTOTAL /
5% SURCHARGE ) . ZJ
Contact Person Name Phone PLAN REVIEW 25% OF SUBTOTAL -
� � -- ' //t9/) Required for ALL commercial permits only
�T� � (J �{3��t(/ << TOTAL MIN � �` /
*State Contractor Boiler Certification required !� �
"Residential NC requires site plan showing placement of unit
I:\mechperm.doc rev 07/20/98 c I 11(-0/7-6-0
(z
CITY OF TIGARD BUILDING INSPECTION DIVISION
MST
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
0.90 ' ' 'L °itipa s BUP
Date Requested AM PM BLD
Location - 02-COS Suite '0 y 7
Contact Person VIA a Ph (029- qS7 PLM
Contractor Ph SWR
BUILDING Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation FPS
Ftg Drain SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
•
Ext Sheath /Shear
Int Sheath /Shear
. Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Misc:
Final
PASS PART FAIL
•
PLUMBING
Post & Beam
Under Slab
Top Out •
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
EECHANICA'L�
Post & Beam �A;
Rough In a �,
Gas Line
Smoke Damper
�+(r P PART FAIL
ECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspec ion RE: [ ] Unable to inspect - no access
ADA
Other
oach /Sidewalk Date Inspector 6/ Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.