Permit •
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r t.,,,,. CITY II TI A #!' I ,) MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00162
irTIG 13125 SW Hall Blvd., Tigard, OR 97223 503.639. DATE ISSUED: 3/26/2007
e PARCEL: 2S111 DD - 08700
SITE ADDRESS: 15815 SW 87TH AVE ZONING: R -
SUBDIVISION: CHESSMAN DOWNS LOT: 013 JURISDICTION: TIG
PROJECT: BROWN
Project Description: Install 25' of gas piping to range location.
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
DALE BROWN Description Date Amount
15815 SW 87TH AVE •
TIGARD, OR 97224 [MECH] Permit Fee 3/26/200 $72.50
[TAX] 8% State Surcharl 3/26/2007 $5.80
Total $78.30
Phone: 503 684 - 1842
Contractor:
KOEHLER CONCEPTS LLC
10772 SE HWY 212
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 650 -9550
FAX 503- 650 -1220
Reg #: LIC 120277
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center.
Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by
calling 503.246.6699 or 1.800.332.2344.
y� ��//1 '' i / -
Issu d B � I Permittee S lam_ � =
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
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V�echanlcal Permit Appflaca$ �a a 1 T 4
` 7- Received "`; a " ` FOR �)1 e mn�
tom.
"ity of Tigard `" ` :,..';'1 i ./ �/ /
D ate/By: d a7� O 1 u µ t No.. M ir•._ L�� 7 _op /6,
3125 S W Hall Blvd., Tigard, OR 97223
Plan Review Ocher Permit:
'hone: 503.639.4171 Fax: 50398.1960 n �� ; , � r Date/By: r) Y:
nspection Line: 503.639.4175 11 : { h / -, ;_) L / ' J i_ Date ReadylB3r l��h ® See Page 2 for
nternet: www.ci.tigard.or.us Notifhed/Method: Supplemental Information
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] New construction [crAdditionialterationireplaejnient 1 Mechanical pernlil fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
] Demolition ❑ Other: t { mechanical materials, equipment, labor, overhead, and profit.
; c T r ` - `t' ,fi o ? IJ s, ;{,.. s ..Fa'" A F' t k c _f k1 , .411 i I::tg,4 474-1 � [ ! Value $
.�i ^IP r ✓ ,. -� �. .;.`s Ea,f `� - r 41 ♦ , 4., d 11 4 ' ,, !: U k :3-7:7,115-72, 5"-1:13 X -e e P+7'�"
i � +,r ,.�Cr- :fi r n s _ r r r o...h ,I ..,... ;1; 1 - • ,- - Y k 3z s v.
- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
• tip 7 L ° :i•I ' z... 4 .iratt�rf.r .t Zi Sa.a^ir t
For special information use checklist,
] Multi- family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total
13.7P t . �r -ri 'lo a ! : -- i F- a a 5
,,..,.7111,1-9 , v,j ' y .0 c _ dd � (a. E' . .i "', r 5 € C' " t+ .a t,,_, i i p A a E aa•_ Heating/cooling
3 l.0 -a:_ 'c�e ra._L�_i n'!K_i <:: - 1, T - mi �a.. e.. ..__...�.._..a_a _.. ........rtrt? Irv:.: �?� N t!'
Fob site address: \\513\G� ` _ tj`' 1 Air conditioning or heat pump
��• (requires site plan showing placement) 14.00
City/State/ZIP: - )J &�v_.,.6\ C)41_ 3...\ Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/veats) 17.90
Suite/bldg,./apt. no.: I Project name: Gas head pump 14.00
Cross street/directions to job si 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: I Lot no. Flue/vent for any of above 10.00
Other: , 10.00 ,
Tax map /parcel no.: Other fuel appliances
- � ter a " r 1F y � t i l t r z l a 't - Water heater 1 0.00
r - i T . r. s,:.; t`.r � l� U i r„ t _ Gas fireplace 10.00
(-r( C NO X ) --Cat C Flue vent for water heater or gas
s Q' `C N Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood ftreplace/insert 10.00
;u � . 1 _ a ' a, , --- e y, ai c- 1 1 � : . . , r , yb , r Q - Al r Chitnneyfliner /fluelvent 10.00
1 i n ° • l ,. y , -t 1 aK tg ' ir, °� [ 4 `6 g "sa . '
=_z! r " c ta..,h x 3 s, ,zni .i?�:c... r:`....., r; `i1,5t,.t. »__.. .*:%r;r ._ i'o t. oth:._L.,,,L Other: 10.00
Name: '`,e.., , Range Environmental
hood/other od ventilation kitchen
Address: \GbtS .>>J ck:t1`rt,A,1/4.. 4e" equipment 10.00
City/State/ZIP: _ C 3 - Clothes dryer exhaust 10,00 ,
Single -dud exhaust (bathrooms,
Phone: (rte: > ) by_ ■ 1/4 Fax: ( ) toilet compartments, utility rooms) 6.80
�sr* Stflrmr it t s h : 1 F Y sK. phi `- "'rr t 7 Attic/crawlspace farts 10.00
r rr U 4 wr 4 t F I:FH't+l. j . 3 -ii4 oil l a xl t k
4X4f...tm . f!... 14F :,,a. .. . : : :% ;a,. 1,11 r m :1-.._ ?rl :w„. :tti.11z itt.f -r. ; Shlcscltill... ca -a5 .mt,..?V-
,.�...,�s - a,,:,,r eras w.� •_.� >_ .., 10.00
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` - __` Other
Business name: �L J+ e., ^ \....\..L.,. Fuel piping
Contact name: $5.40 for first four, $1.00 for each additional
Furnace, etc.
Address: \c,,- N \ c `Z. \Z
Gas heat pump
City/State/ZIP: cs. .7.- o
1 ecie. °`-\or__ _ WaWsuspended/unit heater
Phone: , G-, : , )L ..C S7 I Fax: ¶r3) \Th) Water heater
Fireplace
E- ma11`' e 1 w - ,t r p Range
{ N fz'.. „ i ' i ] y "^-1 5.. F t i` # �`ta ( , E !" 1 S vx. l 4 -cFCI i � M 1 F i riit 5 1 3 4 '1 t^f $ i
a; ��pp��..��rr.. xf � � �`: � �, s, s)_ � �� �� Barbecue
t Jttkl I PV11.01 k „ x ,nai.� 1 . ✓_w, 1�8 _ .; i f:. oth <.sna 2 _;:. - i. ,s�,, .�tr.$+,...,..z1�W ei. ;tiF,a ...
Clothes dryer (gas) .
Business name: Other,
Address: \4 1 `. 111. f clt % :
: 4',M to a`Vt lx' T.s t h=% i 1 1 - , `mow41 " '"'x £v
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City/State/ZIP(� S Cyce " '�U�� Subtotal
r ` Ivfinimuni permit fee (S72.50) '1I„
Phone:) k..2Sp •'�S� I Fax: �� L. i c -NZ:Z.1 , Plan review (25% of permit fee)
CCB lie.: Vt.o -L"A---‘ State surcharge (8% of permit fee) S 47L�
TOTAL PERMIT FEE 1 Q ?,`N
This permit application expires if a permit Is not obtained within 150
Authorized signature: days after it bail been accepted as complete.
Print name', �
Date: 1 • Fee methodology set by Tri -County Building Industry Service Board
islBuildir P miha\MEC•PemuIApp 2/03 4404617T(11M2/COMIW®)
a • d OZZ T - OS9 -EOS 311 S1d30W03 2131H3ON WbO T :O T LOOa E -JeW
CITY OF TIGARD
BUILDING DIVISION ft= PERMIT #: MEC2007 -00162
1 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/26/2007
Phone: (503) 639 -4171 rio t
Inspection Requests (24 Hrs.): (503) 639 -4175 . - ='I � . �� C °2 D0 7 00/ la g.'
INSPECTION WORKSHEET FOR DATE: 3/28/2007 TIME: 7:00AIvi PAGE: 57
SITE ADDRESS: 15815 SW 87TH AVE CLASS OF WORK:
SUBDIVISION: CHESSMAN DOWNS LOT #: 013 TYPE OF USE:
PROJECT NAME: BROWN
DESCRIPTION: Install 25''of gas piping to range location.
OWNER: BROWN, DALE PHONE #: 503 -604 -1042
CONTRACTOR: KOEHLER CONCEPTS LLC PHONE #: 503-650-9550
Inspection Request Scheduled For: Date: 3/28/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 045556 -01 503-469-5266 N
Corrections /Comments /Instructions:
(0\iiitt 1 1�
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K PASS 1 PARTIAL APPROVAL n CANCEL n NO ACCESS
I I FAIL r, CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED •
�� '0 7 1 7
I nspector : Date: --- Phone #: (503) 718- i