Permit CITY TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2006 -00522
14 I . � DATE ISSUED: 10/27/2006
a 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 1 S125DD - 05301
SITE ADDRESS: 09810 SW VENTURA CT ZONING: R - 4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.2 LOT: 061 JURISDICTION: TIG
Project Description: Install gas line to range.
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: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
JIM ALLEN Description Date Amount
9810 SW VENTURA CT
TIGARD, OR 97223 [MECH] Permit Fee 10/27/20( $72.50
[TAX] 8% State Surcha 10/27/20C $5.80
Total $78.30
Phone: 503- 692 -1565
Contractor:
ARROW MECHANICAL
10330 SW TUALATIN RD
TUALATIN, OR 97062 REQUIRED ITEMS AND REPORTS
Contact #: FAX 503- 691 -1879
PRI 503 - 692 -1565
Reg #: LIC 5193
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.
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Is ed By: ♦ �/ ���� /'L/i Permittee Signature: A /4
Call 503 - 639 -4175 by 7:00 a.m. for inspections that
This permit card shall be kept in a conspicuous place on the job sit- . • completion of the project.
Approved plans are required on the job site at the time of each inspection.
I
Mechanical Permit Application �.eito `ee , 4014 awf"r,�t:a �. � ' i` ° v �
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City of Tigard Renewed
Date/By: / O At ( Permit No./ G.„e2.1.)4.7...., -
13125 SW Hall Blvd, Tigard, OR 97223 .3,4„, � / .„e2.1.)4.7....,
Plan Review
Phone: 503.639.4171 Fax 503.598.1960 Other permit:
Inspection Line: 503.639.4175 ' , 1
Internet www.ci.tigatd.or.us _ .,;i;(4 Date Ready/By: ��G H See Page 2 for
Notified/Method: Supplemental Information
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la New construction Addition /slteration/mplacement Mecfian teal permit fees' are based on the value ofthe work
• • , . performed. Indicate value (rounded to the nearest`dollar) of all
❑ Demolition 0 Other. . .
mechanical materials, equipment, labor overhead, and profit.
'� i' } ! rF•t �i';F) � .J�K• G� *N q E* kini'� ). t s Value S
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Y �g ❑ Commercial mdustnal ❑ A ccessory b u il ding , 0 : . ' : ,r A . _,.• - . .... v _., i ,, ,,_, . ,ti ......��
builder 0 Other: For special information use ch
❑ Multi - family ❑ Master b
Description I Qt
€ y I Ea. I Total
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Job site address: �/� 51,j ,/ N , 4 (�_ Air conditioning or gt pump
(requires site plan showinng placement) 14.00
City/State/ZIP: 7)-&.,4,I_) o2 9 4. 2 Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU ( ducts/vents) 17.90
Suite/bldg./apt. no.: I Project name: Gas heat um
P p 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic bot 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
,: L4 ,� r_ .. A�� s ilk T, 5 " 44; '- "°- n." * Water heater 10.00 L
. z. , -,•: .. 2-1 ..z�^, ,,._ «_r •fr.• ' mo t• oSC+,....?i.s
///VS �- Gas fireplace 10.00
, _J L-._ 1 S'� c / iiJ E / ) p A)O-- - Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
. =: g` Qp - a ,` ;"? r - VI "f� a - Chimney /liner /flue/vent 10.00
Other: 10.00
Name: `i ' q A / i Environmental exhaust and ventilation
/ Range hood/other kitchen
Address: 9 g/ �Og
S ly/ J/ga.d %J2-dE C- equipment 10.00
City / State/ZIP: ,/ / e ,. ' 07Z ci. -? ZZ Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (c","?) Z■ 6 O Fax: ( ) toilet compartments, utility rooms) 6.80
a a t; e r e x. W T Attic/crawlspace fans 10.00
-.• , s .`.
�^ Other: 10.00
Business name: r ,ef d / " 1 Er l lr$ Xi /- Fuel I in
PP t',
Contact name: / p 33 6 j ( ' A) .'> $5.40 for first four, 51.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/ State/ZIP: 1- /�
(/,d 1_,4,--r-- /iv `P 2- Wall/suspended/unit heater
Phone: ( .fD, 3 ) 6 9 , z , . , - - / S I Fax:: (S / ? / ..., / p ,' Water heater
E-mail:
�9 , q Fireplace
r' i 'f:' resr -, " "' is i tk.�. -,1 uw" "i'�?rkr¢, 'ajs,c�; - '7• x7"`z'�.,,,:�5'•"` Range
x; ' r`f`ti"�" .,, . �` '� a ' `+ fi„p s.S ".c;�GC r.� b, s�, �rt>Y =:c Barbecue
...g- t:.,,5, .,.. - -.1g :. ai t: 1..s.e.1,4tu+. s.z;: .u, ts 's. e ,,....
Business name: A b W J�� Clothes dryer (gas)
d � Other
Address: tie a iy c rs u S a c t° f S 7 r
City/State/ZIP: T 1. _ Subtotal
' • , Minimum permit fee ($72.50) 7� . 5U
( )
Phone: ( ) Fax: Plan review (25% of permit fee)
CCB lie.: SL 3 /-1 State surcharge (8% of permit fee) 50
/ TOTAL PERMIT FEE '��;
Authorized signature: ,l )72-y6 This permit application expires Ira penult Is not obtained within 180
days after k has been accepted T complete
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BUILDING DIVISION ~°~°,~~~~""°~� ~°"",~,,~~,° PERM|T#: K8EC2006-005Z2
13125SVV Hall Bhd.. Tigard, OR97223 DATE ISSUED: 1[V]7/2006
Phone: (503) 639-4171 Ott
Inspection Requests (24 Hrs.): (503) 639-4175 ".
INSPECTION WORKSHEET FOR DATE: 10/30/2006 TIME: 7:O5AM PAGE: 64
SITE ADDRESS: QS81USVV VENTURA C[ CLASS OF WORK:
SUBDIVISION: WASHNGTON SQUARE ESTATES NO LOT #: 061 TYPE OF USE:
PROJECT NAME: ALLEN
DESCRIPTION: Install gas line to range.
OWNER: ALLEN. PHONE #: 503
CONTRACTOR: ARROW MECHANICAL PHONE #: 503'692-1565
Inspection Request Scheduled For: Date: 10130/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 038982-01 503-692-1565 Y
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Corrections/Comments/Instructions:
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~�PASS / / PARTIAL APPROVAL �� CANCEL NO ACCESS
FAIL CALL FOR INSPECTION ADDITIONAL F S ASSESSED
Inspector '��� ' • O ate� � � �� �N�'���N~hone #: /503A 718'Z~,
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