Permit ..
•
) 9' ( !, C ITY OF TIGARD MECHANICAL PERMIT
4 COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00743
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/20/2007
PARCEL: 25111 DB -12200
SITE ADDRESS: 15255 SW 94TH AVE ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.12 LOT: 649 JURISDICTION: TIG
PROJECT: JEWEL
Project Description: Gas line to log lighter for fireplace.
CLASS OF WORK: ALT 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: REPAIR UNITS:
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
FRANCES JEWEL Description Date Amount
15255 SW 94TH AVE
TIGARD, OR 97224 [MECH] Permit Fee 12/20/20C $72.50
[TAX] 8% State Surcha 12/20/20C $5.80
Total $78.30
Phone: 503 -636 -1128
Contractor:
NGCP
19271 SE SUNNYSIDE RD.
DAMASCUS, OR 97089 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 319 -6557
Reg #: LIC 135031
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.
Issued By:" — Permittee Signature:
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.
-'�'-' Dec 20 07 01:51p -Ed Morrison 503 - 675 - 0304 p,1
Mechanical Permit Application ppp FOR OFFICE USE ONLY
n City of Tigard $°° �� Received - ermtt No
13125 SW Hall Blvd., Tigard, OR IY� Date/By � 2 , ' 0 9 It il .0 _....0,4 007 .
51 4 Phone: 503.639.4171 Fax: 503.9 0 Plan Review
Date/By: Other Permit:
:
TIGARD inspe Line: 503,639.4175 DEC 2 0 2001 Date Ready /By: In ® Sec Page 2 for
Internet: www.tigard Notified/Method: Supplemental Information
TYPE OF og \ ®ttIGPt��1 .
�CDIVIStO COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
El New construction ® Addition / i replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
dwelling Commercial/industrial RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ 1 - and 2-family g ❑ ❑ A ccessory building
For special information use checklist.
Z Multi- family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating /cooling _
Job site address: 15255 SW 94 AVE Air conditioning or heat pump
(requires site plan showing placement) 14,00
City /State /ZIP: TIGARD, OR 97224
Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt. no.: Project name:
Furnace 100,000+ BTU (ducts /vents) 17.90
Cross street /directions to job site:
Gas heat pump 14.00
Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
Subdivision: Lot no.: hydronic) 14.00
Tax map /parcel no.: Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
DESCRIPTION OF WORK
EXTEND GAS LINE APPROXIMATELY 10 FEET TO SUPPLY GAS TO FIRE Flue /vent for any of above 10.00
PLACE
Other: 10.00
Other fuel appliances
Water heater 10.00
Gas fireplace 10.00
® PROPERTY OWNER 0 TENANT Flue vent for water heater or gas
Name: FRENCES JEWEL fireplace LL 10.00
ov f.-
Address: 15255 SW 94TH AVE Log lighter (gas) / 10.00
City /State /ZIP: TIGARD, OR Wood /pellet stove 10.00
Phone: (503)636 -1128 Fax: (503)675 -0304 Wood fireplace/insert 10.00
D APPLICANT ® CONTACT PERSON
Chimney /lin c r /flue /vcn t 10.00
Business name:
Contact name: ED MORRISON Other: 10.00
Environmental exhaust and ventilation
Address: 19794 WILDWOOD DR Range hood /other kitchen
equipment 10.00
City /State /ZIP: WEST LINK, OR 97068
Clothes dryer exhaust 10.00
Phone: (503) 636 -1128 Fax: : (503) 675 -0304 Single -duct exhaust (bathrooms,
E -mail: EDMORRISON @TMC- MGMT.COM toilet compartments, utility rooms) 6.80
CONTRACTOR Attic /crawlspace fans 10.00
Business name: NGCP G Other: 10.00
Address: 19271 SE SUNNYSIDE ROAD Fuel piping
City /State /ZIP: DAMASCUS, OREGON 97089 $5.40 for first four; $1,00 for each additional
Phone: (503) 319 -6557 Fax: ( ) Furnace, etc.
CCE tic.. 135031 / . A/. 0 fl Gas heat pump
�� Wall /suspended /unit heater
Authorized signantre
Print name: El) MORRISON Date: A2 -20 -07 Water heater
1: 113uildingTermitstMEC- PermnAppdoc 04/06/00 440.4617T(11102/COM/WEB) ()OE le----- /�/
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CITY OF TIGARD . Aaulmvi
BUILDING DIVISION ).. PERMIT #: MEC2007-00743
13125 SW Hall Blvd., Tigard, OR 97223 e DATE ISSUED: 12n012007
Phone: (503) 639 4171 q 11". imahovie I k.
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 1/3/2008 TIME: 7: OMNI PAGE:
SITE ADDRESS: 15266 SW 94TH AVE CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.12 LOT #: 649 TYPE OF USE:
PROJECT NAME: JEWEL
DESCRIPTION: Gas line to log lighter fix fireplace.
OWNER: JEWEL, FRANCES PHONE #: 603
CONTRACTOR: NGCP PHONE #: 503
Inspection Request Scheduled For: Date: 1/3/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 062464-01 603-598-3419 Y
Corrections /Comments/ Instructions:
3-(9 it ot=t-
1 I I r •
4146,A a
•
PASS L PARTIAL APPROVAL CANCEL n NO ACCESS
I I FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
,
(13 ( 6 S
Inspector: 1-1 Date: i Phone #: (503) 718-