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Permit 6 ,.: e.. R '' CITY OF TIGARD MECHANICAL PERMIT i DEVELOPMENT SERVICES PERMIT #: MEC2001 -00472 . 13125 SW Hall Blvd., T igard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/26/01 PARCEL: 2S110BD -00500 SITE ADDRESS: 11790 SW WILDWOOD ST SUBDIVISION: SHADOW HILLS ZONING: R -2 BLOCK: LOT: 003 JURISDICTION: TIG CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS: TYPE OF USE: SF UNIT HEATERS: VENT FANS: OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS: 1 STORIES: BOILERS /COMPRESSORS HOODS: FUEL TYPES 0 - 3 HP: DOMES. INCIN: LPG 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: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1 > 10000 cfm: GAS OUTLETS: 1 Remarks: Installation of fireplace insert, venting and piping. Owner: FEES - MARLEN STEVENS Type By Date Amount Receipt 11790 SW WILDWOOD ST. PRMT CTR 12/26/01 $72.50 2720010000 TIGARD, OR 97224 5PCT CTR 12/26/01 $5.80 2720010000 Total $78.30 Phone: 503-624-7946 Contractor: SUBURBAN©HOME 6014 NE 112TH AVE. PORTLAND, OR 97220 REQUIRED INSPECTIONS Gas Line Insp Phone: 503 - 257 -5438 Mechanical Insp Reg #: LIC 143335 Duct Inspection Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. Y u may obtain copies of these rules or direct questions to OUN - by / -Iling (n1194.s_cli ft Issue By: �� �% P ermittee Signature: I ,i' S 0 �� Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day 10/03/00 Ti1E 14:59 FAX 503 598 1960 CITY OF TIGARD 2002 "C Mechanical Permit Application City "7-16 "7-16 Date received: Permit no.: _ J�/ /. 1,2--- �, � ;,__A . y of Tigard ProjecUappl. no.: Expire date: City of Tigard Address: 13125 SW Hall Blvd, Tigard OR 97223 Date issued: B q g Receiptno.: Phone: (503) 639 -4171 Fax: (503) 598 -1960 Case file no.: Payment type: Land use approval: Building permit no.: j TY,PE PERMIT 1 & 2 family dwelling or accessory D Commercial/industrial D Multi - family D Tenant improvement ■ New construction 0 Addition/alteration /replacement 0 Other: .1013. SIT'EINFORIMIATIOi$ . I COMMERCIAL VALUATION SCIIEDULE Job address: ' 0 L. ir, l,� a Indicate equipment quantities in boxes below. Indicate the dollar Bldg. no.: Suite no.: value of all mechanical materials, equipment, labor, overhead, Tax map /tax lot/account no.: profit. Value $ Lot: Block: Subdivision: *See checklist for important application information and Project name: jurisdiction's fee schedule for residential permit fee. City/county: ZIP: 1 , alums. 1 &. 2 FAMILY DWELLING PERMIT FEE SCHEDULE Description and location of work on premises: r20 AND COMMERICAL/INDUSTRIAL EQUIPMENFSCHEDULE V 4 th, ,! _ . . _ Fee(ea.) Total Est. date of com etion/inspec 'on: • - 2 Description Qty. Res. only Res. only Air handling Tenant improvement or change of use: A handling unit CFM III Is existing space heated or conditioned? D Yes ❑ No Air conditioning (site plan required) 1.1 Is existing space insulated? 0 Yes O No Alteration of existing HVAC system NM __ " - . MECHANICAL CONTRACTOR. - . r Boiler /compressors State boiler permit no.: I■■ �l�lV -' HP Tons BTU/H Address: , • \ F, r Fire/smoke dampers/duct smoke detectors - EN 11 16Ak All. S tate : b J ZIP: „Tell Heat pump (site plan required) — Phone. - �� E -m ail: Install/replace furnace/burner BTU/H CCB no.: y �S Including ductwork/vent liner 1] Yes 0 No 111 InstalUreplace/relocate heaters - suspended, III City /metro lie. no.: e p wall, or floor mounted Name lease print): Vent for app lance other than furnace in MiInELWR i (P P ) C O ,it ii, � E _ Refrigeration: �_- CONTACT PERSON Absorption units BTU/H Name: Chillers HP = Compressors HP MI Address: a vironmental exhaust and ventilation: II City: State: ZIP: Appliance vent Phone: Fax: E -mail: Dryer exhaust - OWNER I Hoods, Type I/ 11/res. kitchen/hazmat ■__ hood fire suppression system Ir "l, _ . 1l L Exhaust fan with single duct (bath fans) -__ Mailing address: 1' . � ; . nMIM���- ,. 41 .. � lank Ck i/e� State 111 ZIP: — 2r.. ! Fuel piping and dis b tion (up to 4 outlets) MI _ Type: LPG NG Oil � o Phone: I�� - I Fax: E - mail: uel pi .ingeachadditionalover4outlets Mil ENGINEER ' rocessp pmg (sc emancrequired = == r equired Number of outlets I er e , appliance or eq pment: � -- Address: Decorative fire 'lace City: State: ZIP: V► sA s p�( ood stov pelletstove Phone: Fax: E-mail: Other, MIN Applicant's signatur-: 11iry ._! �'.i�, ,.. Date: a' al Other: MI Name (print): �, . e • - . a i Nshty - �� Not all jurisdictions accept credit cards, please call Jurisdiction for more information. Permit fee $ ❑visa ❑MasterCard Notice: This permit application Minimum fee $ l .S Credit card number: exp if a permit is not obtained / / Plan review (at %) $ Expires within 180 days after it has been State surcharge (8 %) .... $ 5 y I Name of cardholder as shown on credit card accepted as complete. y p X TOTAL $ Cardholder signature Amount 440-4617 (6/00/COM) 'CITY OF TIGARD „BUILDING INSPECTION DIVISION - MST 24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171 • BUP - Date Requested / D - 2-1 AM PM BLD Location 1 7 9 0 ( - 0--Q,e(1izj lf It Suite MEC 2-O / Vst '7a)., Contact Person �1.� �1�rc� Ph �-.� 7 ��,� 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 PACS ART FAIL ' MECHANICAL) PosTSBeam Rou •mo a Dampers - S ASS PART FAIL CTRICAL • 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 reinspection RE: [ ] Unable to inspect - no access ADA Approach /Sidewalk _ Other Date / t — -Dj Inspector Ext Final PASS - PART FAIL DO NOT REMOVE this inspection record from the. job site. -