Permit CITY TIGARD MECHANICAL PERMIT
l COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00170
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/28/2007
PARCEL: 25111 BC -00200
SITE ADDRESS: 14445 SW 100TH AVE ZONING: R -3.5
SUBDIVISION: TIGARDVILLE HEIGHTS LOT: 018 JURISDICTION: TIG
PROJECT: BOGERT
Project Description: Gas line to range.
CLASS OF WORK: ADD 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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
BOGERT, MARK H AND Description Date Amount
MARY E
14445 SW 100TH [MECH] Permit Fee 3/28/2007 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 3/28/2007 $5.80
Total $78.30
Phone: 503- 639 -3270
Contractor:
ALL FUEL INSTALLATION & SERVICE LLC
PO BOX 69
TROUTDALE, OR 97060 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 674 -2350
FAX 503- 674 -2693
Reg #: LIC 169503
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: ,��ied Permittee Signature: 8---3,-, , ,2i�, �'e ��
y v � /
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.
2007-03-27 13:57 » 5035981960 P 2/2
- IV ha al Permit Application FOR t 11 T 1( I 1 Nt t l \l \
City of ga Received „ �./
i FT i r = p ! ,'Diite%BV:3 s' 3 / * r Permit No iS r MU/ -- d 0� /
i r 1312fSW Halt Ti Blvd. , Tigard, OR 9722 � �'
• Phone: 503.639.4171 Fax: 503.598.19 A < _ _ k� I ' "r'! Other Permit:
I 1 �, r. 11 Inspectio Line: 503 - 639.4175 Date Ready/By: 11111 Si See Page 2 for
Interact: www.tigard Notified/Method: Notified/Method: Supplemental Information
I`1AR r., i. 200
TYPE OF WORK o ,t : ,,,r , COMMERCIAL. FEE* SCHEDULE - USE CHECKLIST
�s ors i .5A-D` "-g- Mechan permit fees" arc based on the value of the work
❑ New construction ® Addition /altcr ?nhrpl.(tc
1. Pt -- TTe t , Tr}p: performed- Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit -
CATEGORY OF CONSTRUCTION Value: $
Commercial /industrial
® I - and 2- family dwelling [] RESIDENTIAL EQUIPMENT / SYSTEMS FEES"
❑ Accessory building
For special information use checklist. -
El Multi - family ❑ Master builder ❑ Other: Description I 0119, I l a. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 14445 SW 100 Avenue Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State/ZTP: Tigard, Oregon 97224 Furnace 100.000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17,90
Suite/bldg. /apt. no,: Project name: Gas heat pump 14.00
Cross street/directions to job site: T)uct work 14.00
Hydronic hot water system I4,(1(1
Residential boiler (radiator or
hydronic) 14.00
-- -- Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.0(1
Flue /vent for any of titans 10.00
Subdivision: Lot no.:
r......-..._, Other: 10,00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater — M_ 10.00
Gas fireplace 10,00
Invtnll gas line to new gas range J
Flue vent fbr water heater or gets
fireplace 10 - 00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00 _
® PROPERTY OWNER I ❑ TENANT _Chimney/liner /l]ue/vent 10.00
Other: 10.00
Name: Mary Bogart Environmental exhaust and ventilation _ _
Range htxtd/other kitchen
Address: Same as Above equipment 1 10.00 10.00
City /State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
- Phone: 3270 Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans _ 10.00
Business name: Other: 10.00
Fuel piping_
Contact name: 55.40 for first four; 51.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State/ZIP: Wall/suspended /unit heater
Phone: ( ) Fax:. ( ) Water heater . --
Fireplace
E -mail: Range 1 5,40
CONTRACTOR Barbecue _
Business name: All Fuel Installation and Service Clothes dryer (gas)
Other:
Address: PO Box 69 MECHANICAL PERMIT FEES"
City /State /ZIP: Troutdale. OR 97060 Subtotal 15,40
Phone: (503) 674 Fax: (503) 64 -2693 Minimum permit (cc ($72,50) 72.50
Plan review (25% of permit fee)
CCB lie.: 169503 (NA( p • 116 ] _. State surehtvgo (8' %u of permit fee) 5.R0
TOTAL PERMIT FEE 78.30
T Authorized signature: ' ( 1 - _ ^ - I This permit appitcatioo expires if • permit is not obtained .pit ui . 180
day, after it bas been accepted as complete.
Er -., 1 • 4— _ .� o..1
CITY OFTI - _ ` •
BUILDING DIVISION PERMIT #: MEC2007- 00170
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/28 /2007
Phone: (503) 639 -4171 u °d4p i,� ili
Inspection Requests (24 Hrs.): (503) 639 -4175 .. ' W ':..
INSPECTION WORKSHEET FOR DATE: 3/30/2007 TIME: 7:00AM PAGE: 11
SITE ADDRESS: 14445 SW 100TH AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE HEIGHTS LOT #: 018 TYPE OF USE:
PROJECT NAME: BOGERT
DESCRIPTION: Gas line to range.
OWNER: BOGERT, MARK H AND, PHONE #: 503-639-3270
CONTRACTOR: ALL FUEL INSTALLATION & SERVICE LLC PHONE #: 503 - 6742350
Inspection Request Scheduled For: Date: 3/30/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 045776.01 503-6742350 N
Corrections /Comments /Instructions:
I PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 3c - "'" Phone #: (503) 718- Z