Permit 1
CITY TIGARD MECHANICAL PERMIT
I' DEVELOPMENT SERVICES PERMIT #: MEC2006 -00188
s��l'=� DATE ISSUED: 5/10/2006
' =-- '' 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 110BA -03700
SITE ADDRESS: 11645 SW CLOUD CT ZONING: R -
SUBDIVISION: SHADOW HILLS LOT: 028 JURISDICTION: TIG
Project Description: Gas line to pool heater.
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:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
VAN HOOPER Description Date Amount
11645 SW CLOUD COURT
TIGARD, OR 97224 [MECH] Permit Fee 5/10/200E $72.50
[TAX] 8% State Surcha 5/10/200E $5.80
Total $78.30
Phone: 503- 624 -8911
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact #:
Reg #:
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.
•
----,....---7
Issued By: , .66 C u >k Permittee Signature: , - a \ ?,Q
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.
MAY -08 -2006 MON 11:33 33 AM y FAX NO, 915417738445 P 01
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Mechanical Permit A k�o a t ion r � , r , , .. : �,� ., /
,t ,�� .v� g06 1 r
1 Q Permit No. Allk City of Tigard 0 1 6 Dato/By:
■
11125 SW Hall Blvd., Tigard, OR 97223 0 Plan Review Other Permit:
Phone: 503.639.417 Fax- 503.598.1960 1"` f'''' *, it , Date/By: ®dicepage2far
Inspection line: 503.639.4175 :7.11 1 Date Iteady/By: Ifni El se elueatal Information i ��[;,
Internet. wvvw.oi.tigard.or.as 1 , a �`v 101 i. Nonsed/tvletnod:
AAA 1 � �
i�. dfv[-rSC1.8 �< R� rt \� dpi • '.. ..1, ;� } 6 < C1•'�S r � v ;Q. y ,', i� a',' 0 i
F�3 r;,y; oaYR, htr.,�(�. � .aF wv �' �+ 1 •; Y n , "'"""""""' A•• Y.l •� > e� o- a t �' e Cal e ► are based on a value of the work x
f006
0 New construction P, Addition /alteration/replacem performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit.
❑ 17eln011tlOIl 0 � K. , value $
mails, .. ' ..si )• ^ :re . f - , _ `i `G s + value: .�ryf3'U' 74 StK'Y.�AN J11 jil�Y,
171 . .y ' a i ry 1 fS ,1 /'' d,4 •. k el, a ,i ' . iY. •r� . g i' a.t i t, 3.. s ' A l
F � f ,� ... �Y % .rt G ' +iy p e . �f 4 .i �.oe3a c h.'.$ " � }S. : L 1 t, , A, 4 f J a l I t , a. 1, 4,4x,16 a" r, ..
!,I- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building For special information use checklist.
❑ Multi-family CI Master builder Q Other: Description 1 Qty. j Ea 1 Total
1 a+,u u, �i'�."'�s"v y'�°ry��;; • ,r : a ;�. ti y _ '7 . „�, I T Heating/cooling ?t t ■ r • .. . .;s' c;: ks. a.,' y t," i' ' :1i r ;bahafi ' , � ' T ■ .. , s: girooaditioningas heat pump
,;- 1; : s '. ti..h -. 14.00
Job site address: 1/ . 5/5-‘,1„)
--....t.--e-4/ ` � (re4uuoa in an to phut ehowiall pIacemeai)
__ Pomace 100,000 BTU �ucts/vem'� 14.00
City/State/ZIP: T�( -ie pie L� Furnace 100,000+ BTU (ducat/yenta) 17.90
ll Oa heat . um 14.00
-
Suite/bldg./apt no.: Project name: I 4� � �' E �' p � L " . O
Cross street/directions to job site: Dud work 14.00
H drone hat water a r. ... 14.00
s `' `. . ° 1.� _.-.././ _.-.././ , - / Residential boiler (radiator or
7 14.00
L! L'�, bydrenic�
• - . .✓ � ' J . • _ Unit heaters (fuel -type, not cledric),
_ in -wall in -duct au ended etc. 10.00
Flue/vent for . of above NM 10.00
Subdivision: _
Lot no.: Other: r 10.00
Other fnel a 1 ands
Tax. map /parcel no.: �L „ v rK > ;' ' Water heater - 10.00
' ,. vl y � ff �� . .��� n wu i �jO T ; j. - }i fYa* � t . 10.00 •
tt...,," 0 "`, { ' e` : F .,3 i,l .TyA. ius 4 3r> .y ' t' Gas frre.lace
i Flue vest for water heater or gas 10,00
�� TO ' IL' i� �1i�- . ,lace
10.00
Wood/pellet stove 10.00
Wood , .,1acc/inseR 10.00
L Chimn - fliner/flue/vent 10.00
.3' + h ggg " " ",L e� � � ` �' 35�. �y • � r` i � .. 10,W
Ih i ,r � 1 1 , l e t . giip T. a - ,, v , , 1' 1' Other:
J : Y " Environmental exhaust and ventilation
Name: r� ,� • Range hood/other kitchen
_ 10.00
Address: t ( y� $.� yi i Clothes dryer exhaust 10.00
City/State./ZIP: T, i ' , � ♦ � . --- Single -duos exhaust (bathrooms, 6.$0
- .., p Fax. ( ) 6, 1'2,4- A. toilet • . luili rooms Phone (SIA3) . �V - 7 ..» 1 Atti a/cra P 10.00
w �eya tf; u . , w18 aCe fans „m• (1w '. it ,z ,a 1 (� i y 4 7. 7 fr 1 j ; $ " U M. 4 ,, O
'
_ `9/N.",.feI, i .rnx �'�.;i4'.+m "'ilk'A/ 1 '.d :;I.: L i ec A AL7,1,di .. Other. 10.00
Business name: _ Fuel Spins
_ $6.40 for that !soda: $1.00 for each additional
Contact name: 1/111 - Fumace, etc.
Address: _ Gas heat ;y _
City /Stato/Z1P:
Water heater
Phone: ( ) Fax:: ( ) Fireplace
Range : i v? Y `" ' Barbecue
.. }�� : '4. 'i {IIIfi � 1}`/�yf • 75/' ' 'i , t . -A 1 �J' 1 Y N , t \ y ( .
Q $, U' F •,i' Fig'" • 1�,� ... \ i C' ,�(I ..d.M[ Y . Cam• .c Clothed )
Business name'
µA T Oth
o v ,,,y„w fir•y µ �Y d i ,
r� 3 J
-....- s: Subtotal
Ciry/Statc/ZIP Minimum Permit fee $72.50
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
_ State surcharge 8% of' • emit fee) ' ��
CCB lie.: - TOTAL PERMIT FEE
-------- Thus permit apptleatton aspires Ito permit is not obtalaed within ISO
days after It has been accepted as complete.
Authorized signature' � I ►Fee methodology sat by ni.ceuaty Building litdu8 y Service aonrd Ca I Tw
Print Print name:
CITY OF.TIGARD
BUILDING DIVISION PERMIT #: IVIEC200S -00168
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 510/200
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 � 'L. / 7 Fe A00 6 -
INSPECTION WORKSHEET FOR DATE: 5/23/2006 TIME: 7:03AM PAGE: 9E;
SITE ADDRESS: 11645 SW CLOUD CT CLASS OF WORK:
SUBDIVISION: SHADOW HILLS LOT #: 020 TYPE OF USE:
PROJECT NAME: HOOPER
DESCRIPTION: Gas line to pool heater.
OWNER: HOOPER, VAN PHONE #: 503-6240911
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 5/23/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 030367 -01 503 - 957.7427 N
Corrections/Comments/Instructions:
c�`1 AS cF ,u s °; < —t - r - (/) S
•
PASS �f PARTIAL APPROVAL ❑ CANCEL NO ACCESS
I FAIL I CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: < Date: 5 =23 — ors Phone #: (503) 718 - 2--s--
CITY OF TIGARD t.
BUILDING DIVISION PERMIT #: IVit 03 O01 ] 3
13125 SW Hall Blvd., Tigard, OR 97223 illili,,,,,\ DATE ISSUED: 5/10/2006
Phone: (503) 639 - 4171 '" " °' (a
t
Inspection Requests (24 Hrs.): (503) 639 -4175 A % .zOde -dc /Pd'
INSPECTION WORKSHEET FOR DATE: 5/23/2006 TIME: 7 :03AM PAGE: 95
SITE ADDRESS: 11615 SW CLOUD CT CLASS OF WORK:
SUBDIVISION: SHADOW HILLS LOT #: 020 TYPE OF USE:
PROJECT NAME: HOOPER
DESCRIPTION: Gas line to pool heater. .
OWNER: HOOPER, VAN PHONE #: 503-624- 11811
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 5/23/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 030367 -02 503 - 957 -7427 N
Corrections /Comments /Instructions:
0 007 . ---recl-197 (0
PASS PARTIAL APPROVAL fl CANCEL ❑ NO ACCESS
M FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: .gi A Date: S ------ 23 a&., Phone #: (503) 718 - -- S