Permit t. Q
CITY OF TIGARD
! MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00390
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/24/2008
PARCEL: 1 S133CA -04100
SITE ADDRESS: 11496 SW LOMAX TERR ZONING: R -25
SUBDIVISION: GABRIEL WOODS LOT: 020 JURISDICTION: TIG
PROJECT: BRAY
Project Description: Installing NC.
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:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: 1 DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
MARY ELLEN BRAY Description Date Amount
11496 LOMAX TERRACE
TIGARD, OR 97223 [MECH] Permit Fee 7/24/200E $72.50
[TAX] 12% State Surch 7/24/200E $8.70
Total $81.20
Phone: 503- 705 -9112
Contractor:
RUMBOLD HEATING & AIR COND INC
14214 FIR ST SUITE D
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 656 - 0475
Reg #: LIC 172897
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 B / / ' Permittee Signature:
7f
y� :_..� g
a 13.639.4175 by 7:00 a.m. for inspections that busine s day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
4— . - FgrAl : i . FAX NO. : 656 4572 Jul. 24 2008 02:46PM P1
• Mechanical Permit Application FOR OFFICE USE ON1,V
OS) Received
City of Tigard Datemy 7 7 ,.... Limit No.•
il ...- ' 13125 SW Hall Blvd.. Tigard, OR 97223 ... Plan Review
I I Phone: 503.639.4171 Fax: 503.598.19 C _ 1n3,,, Other penult:
Inspection Line: 503.639.4175 'V' Dote Ready/By
: , , k
g 1...,!,,r...
Internet: www.tigard-or °
gov cd. 1 1 • /Method:
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I zsi t C.) %.4 . .. . .. - . - - . . . - . . .-; ;
•
r-•.- - -. ..;,-.:..:, f.- 1........."--; !' '. :: V i.! • ''.. '''.' : ' TV i WORK ' '.. ': ..A .. .,.c00.0.4c,Ap usE:CHECIOST:.:
0 New consu g-Addition./alteration/mplcV
0 Mechanical permit fees* are based on the value of the work
El Dcmolition El Othcr: 6\\ performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit
. ::::•:: : ' , 7.:;:.: . ii:',. 5 .' . ...:::: - '•: : :': , :r. :. :•:'VVIi.;_el.i**kiyek.* : ' . i0:071:44..ft.to7kk:L.:i;;;:.);,....„::.:j . ; .; - i.!:1•4f,1: 1 ;:V:,:::::: .... .... V illue $
•R1- and 2 dwelling 0 Commercial/industrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder 0 Other:
...„. ,..,,...., .. Description Qty. Ea. Total
... . • 4:. 4., ...;:: ', .:': - :::; ', L : .'' ': : : ::] - : : Jo* : .: 11 k. , lifipitifitiON ' ..01f;;;10 . 0kiiiji.4:'.:: . Q1.]::ff-. • ;JC., - ,:-.4 - .. - ,; , ..;! - ,::; yeath__,,wco_sain ..
Air conditioning or heat pump
Job site address: ( / 4, t, /A , / 7 --,,... g.....
(requires site plan shoWnssylacement) Iri 14.00 i -
.------ Furnace 14.00
100.000 BTU (ducts/vents)
City/State/ZIP: L 1 4 ,,e.. .9 7 2.2.-- - 4
Furnace 100,0004- BTU duetvverits) 17.90
Suite/bldg./apt. no.: Project name: ‘58Ziy Gas heat pump 14.00 I -
Cross street/directions to job site: Duct work 10.00
Hydronie hot water system 14.00
0 1 61,itogoz.as /e ce Itesidential holler (radiator Or
hyCITOrliC) 14.00
— 1 Mit heaters (fuel-type, not electric),
in-wall, in-duct. suspended, etc. 14.00
Flue/vent for any of above 6.80
Subdivision: _.......] Lot no.: ---
— Other: _ 10.00
,....
Tax map/parcel no.: Other fuel aepliances
, . - d i ,(::, ,• :; - Iff..,.....; .F .gi'i....>2.,A: . :ya;;P:t:444#41 7 .:g*tgOlit:*.:4sf .0.*:;.=:.:;:.:7 Water hQatCr 1000
10.
GaS fire lace 10.00 ....
/4 p /4/ e."-,,,a4,4„.,........_ Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/. Ilet stove 10.00
Wood fireplace/insert 10.00
'*-. . - ' . - • ' •'.. '-'"• ••••• i:-:. :Y . : .. 10.00 ;. ;..-.:......--,,,.:,...,:;:.,-;:„-.; Clinney/liner/flue/vent
i!: . ....-:.•:-:• .. M..: ; ' -• ":::%• oth
i 0.00
Name: Environmental exhaust and ve
7 vntilation
Address: //
_
Range hood/other kitchen
46, 4 -pd
equipment 10.00
-
City/State/ZiP: 7 ,9 7 z •2• 3 Clothes dryer exhau.st 10.00 •
— Single-duct exhaust (hathmoms,
Phone: (5 705- 9/f 2. Fax: ( ) toilet corn, - ems, milt rooms 6.80
'....- :t:'P•:: Attie./crvIspace fans 10.00 .
Other: 10,00
Ruttiness name:
Fuel piping
Contact name: 55.40 for first four; $1.00 for each additional
. ..-
Furnace, etc.
Address:
Gas heat pump
City/Statc/ZEP: .
Wall/sus • ended/unit heater
_
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E-mail:
[ango
.7 Barbecue ...
Business name: ,e id g v iA t e ff ., 74 /,) ,L , Clothes dryer (gas)
Other:
Address: /4 z,/4. i).e_ ‘ 54, a si e ,',Z e , D , E ,.., .. , :: . :::.:: . ......: , .: , ......,:-..kto.ititsift4t.itiolititts.::::::::-..:),:, ,, 1 ::::::::::.
„.
City/State/ZIP: 0 - e . , A-. -7045 Subtotal
I ..-
Minimum permit fee (S72.50)
Phone: (533) 4 -6_ 04 7 $ Fax: (5 6 5 - 4s2 z—
Plan review (25% of permit fee)
-
CCB lic.: 7 - - 7
, State surcharge (12% of permit fee) WWII
TOTAL PERMIT FEE W.90
Authorized si . e: -
This permit permit application expire5 if a permit it not obtained within (80
l. li A ..- '
days after it has been accepted as complete.
[ Print name: / -7 a l. 0 9, 7 Date: . /$e 3 • Fee znethodolooy sci by Tri-Couuly Building industry Service 1.10041
I.U3uildinu\Perrnits\MRC-PerrnhAue.00c 01/19/07
FROM : FAX NO. : 656 4572 Jul. 24 2008 88:38AM P2
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CITY OF TIGARD
BUILDING DIVISION PERMIT #: MCC2008 -00390
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/24/2000
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 __'__ "'I��
INSPECTION WORKSHEET FOR DATE: 81812008 TIME: 7:00AM PAGE: 41
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 11496 SW LOMAX TERR GABRIEL WOODS 020 LOT # : TYPE OF USE:
PROJECT NAME:
BRAY
DESCRIPTION:
Installing NC.
OWNER: BRAY, MARY ELLEN PHONE #: 503- 705 -9112
CONTRACTOR: , RUMBOLD HEATING & AIR COND INC PHONE #: 503.656 -0475
Inspection Request Scheduled For: Date: 8/8/2008 Pour Time:
Code .# Inspection Description Confirm # Contact # Message
699 Mechanical final 073857 -01 503656 -0475 N
Corrections / /Instructions:
4 0 0 i 4.14 / �1LiC G i?. '7 o,e >vo.� 1, -
/VD a'74/072, yss,... 5 ll
1 t
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 8'-0 `a' Phone #: (503) 718-