Permit ` 0.
I N II CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
PERMIT #: MEC2006 -00546
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/7/2006
PARCEL: 25111 DB -05000
SITE ADDRESS: 15227 SW ALDERBROOK PL ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.7 LOT: 410 JURISDICTION: TIG
Project Description: Install gas line, vent & new gas insert.
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: 1
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
JAN GOULD Description Date Amount
15227 SWALDERBROOK PL
TIGARD, OR 97224 [MECH] Permit Fee 11/7/200€ $72.50
[TAX] 8% State Surchar€ 11/7/200€ $5.80
Total $78.30
Phone: 503- 624 -1687
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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
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Issued I �/ / . r Permittee Signa ) 1f , ,p �C��
-al AL Call 503.639.4175 by 7:00 a.m. for inspections that business
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.
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2006 -11- 0319:5, » 5035981960 P 2/3
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Mechanical Permit Application i t ii 01. 1,1( Lt_ , t'. ()NI 1
� i/' 5-�(
i Received
C
ty of Tigard Received � / 4 O 6 , lo Permit No.: )`'li ft = xie_ tiV/1
€' a 13125 SW Hall Blvd,, figard 972 ���IVE Plan Revie over/
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Phone; 503.639,4171 Fax: 503.598,1 1 Date/By: Other Permit
I I i . A R I) Inspection Line: 503.639.4175 6 Date Ready /Hy: Luria. ®S Pane 2 for
Internet: www.tigardar.guv NOV 2��0 Notified/Method: SupplenrentalInformatioa
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CITY OF TICARD _
TYPE OF %MOLDING DIVISION COMMERCIAL FEE° SCHEDULE - USE CHECKLIST
❑ New construction Addition/alleration/replaccmcnl Mechanical permit fees' arc based on the value of the work
performed, Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other; mechanical materials,_ equipment, luhor, overhead, and profit.
CATEGORY OF CONSTRUCTION _ Value: S
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
. 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
Multi -family ❑ Master builder ❑ Other: For special irijormation use checklist.
Description Qty. i Ea. i Total —
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 1 '� /� Air conditioning or heat pump
. r� { . �� !"11�'e � ruo �' _ (requ site plan showing placement) I4,00
City /State /ZIP: --"\--. 54 r 0 r, 6 11 ?‘'it Furnace 100,000 BTU (ducts /vents) 14.00
Suite/bldg. /apt. no.: 1 Project name: Furnace 100,000+ BTU (ducts /vents) 17.90
Gas heat pump 14,00
Cross street/directions to job site: Duct work 14.00
- ---T— Hydronic hot water system 14.00
Residential boiler (radiator or .
hydrunic) 14.00
Unit heaters (fuel -type, not electric).
in -wall, in -duct, suspended, etc. 10.00
Subdivision; ^T l..ai no.: Flue /vent for any of above 10.00
— Other: 10.00
Tax map /parcel rxi Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00 _-
r Gas fireplace _ l 1 0.00 t Q. 00
- A. 1 1 SAKI) 9 (IS `; AP U th i 4 ► n \ t 9 4 s 1 l c,o(T Flue vent for water heater or as
I / fireplace _ I . 10.00 14, to
----.- 1.0g lighter (gas) 10.00 ,
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
el PROPERTY OWNER ! ❑ TENANT Chimney /liner /flue /vent 10,00 }fit gr)
Other __ 10.00
4 C,, Name: J t) vs:1 a Environmental exhaust and ventilation
Address: 15 J W A 1 l t) e T tvoo r Mil( p e hood /other kitchen
� e equ quipment 10.00
City /State/Z1P: --- q ti f 0 r . M -4 Clothes dryer exhaust 10,(x1
/ Single-duct exhaust (bathrooms.
Phone; (sp ) ( a ti. l (DST. Fax: ( ) toilet compartments, utility rooms) 6,8(1
❑ APPLICANT ❑ CONTACT PERSON Attic /crawlspaee fans 10.00
Other: 10.00
Business name: _ Fuel piping
Contact name: S5.40 for first four; 51.00 for each additional
-
Address: Furnace etc.
... Gas heat pump _ .
City /State /ZIP: Wall /suspended /unit heater
Phone: ( ) I Fax: : ( ) Water heater
- - Fireplace 1 5'. 1 1.JZ
E -mail; Range „—
C:ONTRACI'OR Barbecue - -
Business name: 4- \ \ N 5� A' 1 01� () r l' t V C('
Clothes r: dryer (gas)
Other:
Address: i ° R t6 (P _ I MECHANICAL PERMIT FEES*
City /State /ZIP: `cf Q iA j c ) u 1 a 0 r 61 1 0 100 _ _, Subtotal 2q . •
Mini mum permit tc '50 c 072,50) 1 �
Phone: (' ) 1:3 ) ( `-. - X3' j ) Fax: (jti3) ( i t 1 .. L943 Plan review (25% of permit fee)
CCB lie.: `( Ct S Qs State surcharge (tl' of permit fee) S' . V
'I'O't'AL PERMIT FEE - Ns. .
Authorized signature! Thin permit application expires if o permit is nut obtsitied within /do
�� days after it has been accepted as complete.
t1^ �. (' , \f 3f ob
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CITY ���� ^. , t , ��nu n m��o
! BUILDING DUNG D PERMIT #: K4 D0[ �
' 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/7/2006
Phone: (5O3)G3Q-4171 A A 1
|napeo�nRequae�C24Hmj:�08)6304�17G A 1 Er 2006 -~00-53
INSPECTION WORKSHEET FOR DATE: 11/8y2006 TIME: 7:03Alv) PAGE:" 35
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SITE ADDRESS: 16227SyVALDERBRO{)NpL CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.7 LOT #: 410 TYPE OF USE: '
PROJECT NAME: GOULD
DESCRIPTION: InII gas line, veal & new gas insert.
OWNER: GOULD, JAN PHONE #: 503-624'1687 '
CONTRACTOR: ALL FUEL INSTALLATION & SERVICE LLC PHONE #: 503
Inspection Request Scheduled For: Date: 11/812006 Pour Time: '
Code # Inspection Description Confirm # Contact # Message
610 Gas line 039418-01 503-674'2360 Y
Corrections/Comments/Instructions:
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- PASS ri PARTIAL APPROVAL 0 CANCEL n NO ACCESS
I | FAIL 11 CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
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Inspector' , Date: ii-- F Phone #: 8503\ 718-
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