Permit p „ iv CITY OF TIGARD MECHANICAL PERMIT
11' ,`.' COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00562
*3ws• DATE ISSUED: 11/14/2006
'DTI , C 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 25111 CD -07600
SITE ADDRESS: 15755 SW SERENA CT ZONING: R -4.5
SUBDIVISION: KERWOOD ESTATES LOT: 011 JURISDICTION: TIG
. Project Description: Install gas fireplace and gas line.
CLASS OF WORK: OTR 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: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
BRENTWOOD HOMES INC Description Date Amount
15170 SW SERENA CT
TIGARD, OR 97224 [MECH] Permit Fee 11/14/20( $72.50
[TAX] 8% State Surchaq 11/14/20( $5.80
Total $78.30
Phone: 503 624 - 4663
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 266 -1249
FAX 503- 266 -3478
Reg #: LIC 14008
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center.
Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OU NC by
calling 503.246.6699 or 1.800.332.2344.
Issue
i By % :6(7 std_A ? Permittee Sign _ure: :1 % jam-` ,
\------ ... CaII 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
01/01/2000 13:30 15032632513 ROTH MECHANICAL PAGE 02
Mechanical Permit Application 1'0l4 01 I'I(' USI. ()NIX
Received emit No,: Nfe �p — p� j �(p 2.
City Of Tigard //
13125 SW Hall BIvd., Tigard, OR 97223 Piaa Review )they Permit:
Phone: 503.639.417J Fax: 503.598.1960 , in.;ig y f;r ,+, ■ Date/Dy;
Inspection Line: 503.6394175 , -t.],1 '! J Date Ready /By; �✓ Id See Page 2 for
Internet: www.ci.tigard,or,us Notified/Mcthod: / 09, Supplemental Information
{, '1'Y$ W
. �.;, ; , .; f 1'!:1;+!!!!•!!! OMMEFfCIAt:';I± Q *' SCHEI)1UG'E T{SF:�riPEC
p r . Mechanical pernvt fee le arc based on the value of the work
CI New construction Addition /alteration/ � performed. Indicate th : value (rounded to the nearest dollar) of all
❑ Demolition [0 Other. mIWSTAi mechanical materials equipment, labor, ovenccad, and profit.
•s? i,':' ` q • :ie.A '•O . .. , ,� :.
: ,, a. ; , ... 1VI}r 71 :51!S'I'IiMS ;R E E S. i, i'.
' . ,.;,:RE9ID7�1!ITdAL'EQUTP.
iil 1- and 2- family dwelling 0 Commercial /industrial 0 Accessory building For spec ill Information use checklist.
0 Multi - family 0 Master builder ❑ Other: Description "Qty. [ Ea. I Total
i.;::;ii:: ;:;: OBMATION'AND:LOCATJDN . ' : `-a . ';;•:a ',i Hextin /yf_cooling
7 C � 5 •c f �� A Air conditioning or he it pump
Job site address: 5 5 5 v (f (requlm9 eiteplan showitil placement 14.00
City/ State/ZIP: ` III • Furnace 100,000 BTU Wyatt/vents) 14.00
.� �� Furnace 100,000+ BT J (ducts/vents) 17.90 _
Suite/bldg. /apt. no.: Project name: . Gas heat zrtmp 14.00
Cross street/directions to job site: Duct work 14.00
-- - - Hydmnic hot water sy stem 14.00 _
Residential boiler (rad iator or
• hydronic) 14,00
Unit heaters (fuel -type , not electric),
. in - wall, in -duct, suspe tided, etc. 10.00
Flue /vent for any of a bovc , 10.00
Subdivision: Lot no.: Othar. 10.00
Tax map /parcel no.: Other fuel appliance i
Water heater 10.00
iao,:i ' ,, t.. (':: j1El3 W.0
;c�.. ,.... . OR ■, , � ' , .,.._ � 10.00 � C7
�:n�� :,,i= .�,: ` , �� Gas fj�lace ,., O.a
,� . Flue vent for water b :atcr or gas
. I. .=.. minor, .r, _ _ fireplace 10.00
ity mfr J 1 ( ► Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimnay/iiner /flue/V! nt 10.00
',pi . �.. �•r, : ....) .......... ...: : ..:..p .' L r�:i'i f ., . , .ci ;,. Yi'•:, "..f:'i " ::;:.::. OIhOr. _ _
10.00 _
Name: WO ' S Environmental exile use and ventilation _.
Range hood/other kit Ihtm
Address: I S 170 5& c Y1 1 r1.12.., ,_-, equipment 10.00 _
City/State /Z1P: 1 8 ` Clothes dryer exhaust 10.00
• • Single -duct exhaust ()athmoms,
Phone: (co') ) (o Z . — 40(9J Fax: ( ) toilet compartment, unity roomer 6.60
p .,'t i;,.:;,: , `i l<' . 0 :iC NTACT 'PERSON i tsp ce fhtu
., :Ap
::: ,: .)I;,i.,,,., %, >.:.t,,_..,,..,.. A :., ra 10.00
PI:IC .. ..:, •;:...
Business name: Fuel piping _
Contact name: $5.40 for ni'st four; $1.00 for each addltlon_l
Furnace, etc.
Address: Gas heat pump
City / State/ZIP: Wa11/auspendod/unit heater
( ) Water heater
Phone: Fax:: ( ) - 1 3 k) 5 Fireplace
E -mail: Range _ - -
,:' :' ::r:? ::., a,;;.i;:r!F .,:; x:r;: " 'i _;;; ''i Barbecue
� T ;i !?h;� : a'. «I : +:n' 'CO . ,,�'.R' ,;. :a.. . '::iiL' ?''L..... � 3r,,.i.:
t1� 1 A . S�NxC r T J r/,L /1/
.
.:. ,: 11 " �,i!� ".i. , . , �..,: � .::'f .... .V :.., I ' v , es dryer (gas) ,.
;: , ,... ,.,. ,,. , . Cloth d er
Business name: I U/ / e ther i ti-
/ r{�� ��r�/+ * b �� Q
/ - ZW5 .$41,i f l y''�u� l xiiiiVAH; FE t • F Fi R M..i, , .: , ::; ?.i'i . • Address: /� :;
City/State/ZIP: j,f i �J /D/ Subtotal _
—YY M inimum permit fee ($72.50) 77 .. SQ
Phone: ( 05) Z,010 { Zq1 Fax: (5 5) 2. 4 - . 7d9 PL:n review (25 %of permit fcc)
CCH lie.: � 0 4
r State surcharge (8% of permit fen),_ c�.
TOTAL PERMIT FEE 7 ij. 50
- This permit andlcatf on expires !f a permit u not obtained within 180
Authorized signature: f • � A`
days oft v It has been accepted as complete.
-- — . 11 1 1 ' ... / • Fee met odoloev to t by Td. County Building Industry Service Beard
..-.... • . : - • • .. _ ,
, g
.
CITY OF - TIGA P RD
BUILDING DIVISION
PERMIT #: MEC2006410562
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2006
Phone: (503) 639-4171 . lt'
Inspection Requests (24 Hrs.): (503) 639-4175 /1E A0196, - 605k a
INSPECTION WORKSHEET FOR DATE: 11/21/2006 TIME: 7:00AM PAGE: 18
SITE ADDRESS: 15755 SW SERENA CT CLASS OF WORK:
SUBDIVISION: KB:MOOD ESTATES LOT #: 011 TYPE OF USE:
PROJECT NAME: BRENTWOOD HOMES
DESCRIPTION: Install gas fireplace and gas line.
OWNER: BRENTWOOD HOMES INC. PHONE #: 503-624-4663
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503-266-1249
Inspection Request Scheduled For: Date: 11/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 040113-01 503-407-9686 N
Corrections /Comments/ Instructions:
•
•
.7
,./
PASS n PARTIAL APPROVAL CANCEL fl NO ACCESS
_
FAIL fl CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
Inspector: ,
Date: i/2/- 6 & Phone #: (503) 718- -7 ---9 - 4--( -
— -
CITY OF �''IGARD
BUILDING DIVISION PERMIT #: MEC2006 -00662
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2006
Phone: (503) 639 -4171 As_11iigll �I
Inspection Requests (24 Hrs.): (503) 639 -4175 „ IJ �
Al � DD (� V�s� °2-
INSPECTION WORKSHEET FOR DATE: 11/17/2006 TIME: 7:01AM PAGE: 638
SITE ADDRESS: 15755 SW SERENA CT CLASS OF WORK:
SUBDIVISION: KERWOOD ESTATES LOT #: 011 TYPE OF USE:
PROJECT NAME: BRENTWOOD HOMES
DESCRIPTION: Install gas fireplace and gas line.
OWNER: BRENTWOOD HOMES INC, PHONE #: 603 -624 -4663
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503 - 266 - 1249
I Inspection Request Scheduled For: Date: 11/17/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 039911-01 503-407-9686 Y
Corrections /Comments /Instructions:
n PASS �� _ PARTIAL APPROVAL _ CANCEL I I NO ACCESS
FAIL •
4 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: d Date: l`-17 G Phone #: (503) 718 - 2-