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Permit CITY TIGARD MECHANICAL PERMIT AA DEVELOPMENT SERVICES PERMIT #: MEC2005 -00187 ' VIII 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 4/21/2005 PARCEL: 2S111 AC -00100 SITE ADDRESS: 09075 SW PINEBROOK ST ZONING: R -4.5 SUBDIVISION: PINEBROOK TERRACE LOT: 042 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: LPG 3 - 15 HP: COMML. INCIN: MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS: FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES: GAS PRESSURE: 50 + HP: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1 FURN > =100K BTU: < =10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Owner: FEES WAYNE & JA KITTELSON Description Date Amount 9075 SW PINEBROOK [TAX] 8% State Surchaq 4/21/200E $5.80 TIGARD, OR 97224 [MECH] Permit Fee 4/21/200E $72.50 Phone: 503 639 - 8568 Total $78.30 Contractor: R D PLUMBING INC 13900 NW SPRINGVILLE RD REQUIRED ITEMS AND REPORTS PORTLAND, OR 97229 Phone: 503 297 - 7422 Reg #: LIC 73913 • 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 0 a : ' - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503 - 246 -6699 or 1-80i-332-2344. Issue : . - Permittee Sign ., ture: Call 503 - 639 -4175 by 7:00 a.m. for inspections tha •usiness 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. . WED 10:50 AM R, D, Plumbing, Inc, FAX NO, 503 297 7344 P. 1 iiecilanical t ern,. ttp, ..c .,ii..0., . ,_ r.,...,,„„,.,...,..„ .•..'.!1.',.. .._.,.?,...■,. ...:,',..■.:,......igi . E 0,..,„„ ..4 • 'City of Tiga H 131 • d _ Eli _... _ l'\ 13125 SW all rd.. Tigard. ,,,, , ; ._- REc i.,;,,,,„%•,,,,, • ,„,,,, ,.....,„,, s . pi,o,,: 503..9.4,71 Fax: 503. 9ti.1g()0 ._. ,.„ ,iiii.,,,. 1>iiiellly ' ., •-...."--,,r7•-v-t.- ^.^ inpection Um: 503,639.4 APR 2 0 2005 „,m,„,,,.,,,!_.:,;;,-.,, tilternct: www.ei.tigard.or,us 175 NoliriccVMeihod. --fro sapillelitt:ilialtitrom'atio ) - Ci- y9E ;SW '.1.4•K . - COMMERCIAL FEE' SCIllf,DULE - l'SIXI14.CICIJST : . : .. . : . z . mechanical r i,....nii fees* no: (1.v ld :et' on the I dtItt.:t oie ‘X•ot 1 ri New construction 1 .it1 Addition/alteration/replacement perfoi med. Illti Kith: OW ■ ■ 1111 1 : 11011+ 11 ' 111 ■•• wiiii'l‘e doll. ... 4,111 [] Dcmoliiion 0 oilier ,,,,,I,;,,,i,..,,i ioiiimli ,.., 4.4.4 j CATEGORY O1 CONS.I.RLCTION - _ RESIDENTIAL EQIIIPNIENT / SVS 14:AIN '111■::•. ' Xrl- and 2-family dwelling 0 Commercial/industrial 0 Accessory building km. specull tillorillatif in IIAL• ehe. .. ,. _ 0 Muti l 0 Master builder 0 Other: _ r i x:scripl 1 . (x.. : i ___--------- JOB SITE INIOR!IATION AND LOCATION Draiingkooling - — Air comfit irinin or heat pomp i Job site address: q PI y).c )31r .S 6-- . .„,:,„H,,,,,„,,, .1.,,,t, mg IA& ottc12■t , , 1-1.no • I•nottkce 100 11111 ftlti■ t, ‘t;itt. __. , 2,•■• ,_, . „ _. J City/Slate/ZW: r i aatict_____O q - 01 , c: G loo.noo, Ifni «ilk r■ ,,,11,1 ,.._--- __ Suite/bldg./apt. no.: Project narnc: Gas 1 ),s12ti2tITE_____________ ., . . ....1...P.I.M. ----, . - Cross street/directions to job site: Duct work - 1. 141.11L. .. .• ; ••• • -,---------: --=.....f...„...ti ,,, • , ....J--,. ---------_ - • 1 lydrottie hot watcr ..,stel'Il L 14 .0 •,,' ,, . _ Residential hoiler 0 .,,I• iiO , - t Intl heaters I rue1 rte. 1101 elNIOct, i n-wit11, in-kluct.MIT.:111.1 .,,,,,...., .1 .. .„...,.....,., ___,..... .- _ __ __ _____________ - Fltie/veni for am or ■itiOs'y I 10. Oil Subdivision: ------ 1 Lot no.: -- Other ' '10 kg1 • - -- Tax map/parcel stn.: Other riicl auliai2iNs . _ ... .,.' ._ • . ,_ Water heater . 101)1/ l .____ . ..., DESCRIPTION OF %VOW: --- - ---- r I — this fireplace _±.1,..10.24. is i vow m e_._4.ey 4 Flu, v„„t li „.„1,,.1,01,r-,,:-...-,-,:,---- - , riii_ Log lighter Qua%) _ .........._ 1 __--- Wood lire *lee/insert 1--);Y •,-, --- . — , Chironcv/lineilllue/vent 1(1 IS ' • ••• - . ,• . • .'',',.; D OWNER D TENANT ...,..... — OdIcr: i 0.4/1) Naroc: W WI 0 . -• — Environ merlin' c‘ltinist untl %NA/11111On '''. a • ' 41 ....,,, ....._ Range hood/olher kitchen . , Address: equipment 1 10 itn — — Cily/Statc/Zils; Clotho tin et eNh;q1:0 ' II) 4 , , ._._ Fax; ( single...oc c■hati...trbaiici:i),;10,. ---• ---- - 1---- - • - - .. I Prio ( 0 — R56 .g ) . ,„,,,.., co„,„.,„... ,,,ii,,,,) _.,. ,....„.,, •--t..- • - 1 1 .4 . 9) •' _.■ _._____ - • . •••••' • . 0 APPLICANT 0 CONTACT PE.IISQN Attie/cratIlspace , • • • •• • - t )(her. _ ..,,...,..,,, 13usin,ls5 name: -- Contact name: S5.-10 Nu- nor lour: 5 1 . 1 1 1 1 Inr4qic1i mkti.1110!iii1. ., -- 1:untocc. etc. - Address: . (ias lIcat pump ---- City/Slate/ZIP: Wall/susvenletl/unit healer Phone:( ) Fax: : ( ) \Nato beater ____ • - —__ Firept■i!:e ------ CONTRACTOR - ------ narbecue - Cloth s e dryer ("a.) :Business name: . . •• II . II A --- Oilier - ----- 1 --- .------j():Q2... Address' j A 1 9' • All1,ANIC..11 PERAil I FP.3.:, City/Stato/ZIP: p, oK ___7,..19' . .. s . . _..........._______,.. ., wilimompc,•,„,41.0:00:401.,• 7) Phone: ( ) a 6 1 1 7q)3_ rilX: ( _ ) I ifrYY__ ...... ' -...... Nag CO kInV Cg' a Nritlil (eV) ; •.:, • . L CCB lie.: ,,,,,v,„<„.....) .. st;„„ sureltai ge I V..,; or prrrnit Itli ' ... • , thorized inatu sGre: v IA...., k-ilj TOYA I, PERNM VV, ... Au .. • • ; 0 ' - Tim iltranit Niiplica thin vspires Ira iirrinit iS fitrt ctilli . tto. 11 111.1 iiii 11;11, pr11 it int 1/01 3o. 1 t - 71 - irlt lIzz:=Dj, € 0 0 , c, , Date: 14,14 05 1..nimi,„1,,i„,, .,., 1,, ,,,, ,,iiio iiwitliiir 1 ..1 \ .....i..0.,, fi• ----__ 013uildinercroIt3\ MEC IVrI3 J.Iii,..10171 (11/02,CONIAVE11) . -.. . . . .._. ..-............ .... ........ CITY OF TIGARD BUILDING DIVISION PERMIT #: MEC2005.00187 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/21/2005 Phone: (503) 639 -4171 ; Wilt Inspection Requests (24 Hrs.): (503) 639 -4175 ,:: -!. : INSPECTION WORKSHEET FOR DATE: 4/22/2005 TIME: 7:12AM PAGE: 69 SITE ADDRESS: 09076 SW PINEBROOK ST CLASS OF WORK: SUBDIVISION: PINEBROOK. TERRACE LOT #: 042 TYPE OF USE: PROJECT NAME: KITTELSON DESCRIPTION: Install gas fireplace and gas line. OWNER: KITTELSON, WAYNE & JANICE PHONE #: 503 CONTRACTOR: R D PLUMBING INC PHONE #: 503 - 297 -7422 Inspection Request Scheduled For: Date: 4/22/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 005157 -01 503 -297 -7422 N Corrections /Comments/ Instructions: C 4S) #- 674-i.,5 ASS ❑ PARTIAL APPROVAL ❑ CANCEL ii NO ACCESS n FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 4--�Z Phone #: (503) 718-