Permit O CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00139
R DATE ISSUED: 3/18/2008
TIGARD• 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S133DD 11300
SITE ADDRESS: 11879 SW 125TH CT ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT: 150 JURISDICTION: TIG
PROJECT: MERCER
Project Description: Gas line for new range.
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:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOERS:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
ERIC & JANINE MERCER Description Date Amount
11879 SW 125TH CT
TIGARD, OR 97223 [MECH] Permit Fee 3/18/200E $72.50
• [TAX] 12% State Surchai 3/18/200E $8.70
Total $81.20
Phone: 503- 265 -6555
Contractor:
KOEHLER CONCEPTS LLC
10772 SE HWY 212
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 650 -9550
FAX 503- 650 -1220
Reg #: LIC 120277
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 dired questions to OUNC by
calling 503.246.6699 or 1.800.332.2344.
Issued By S j f Permittee Sig - - • /�
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.
. 1 . .._
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Mechanical Permit Applicatio : c E. . FOR OFFIC:F, USE ONLY
: ...-- " 13125 SW Hall Blvd , Tigard, OR 97223 Q 1 1 2 °
Ili
,/' City of Tigard
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I: Phone: 503.639.4t71 Fax: 503.598.1960 \\I\ P.,. - c), , , ,,, Rep / 7 o g 7, Permit No.: fe g ..... oci 357
Plan Review Other Permit:
ii l: ate/
1 Inspection Line_ 503 639.4175
. By:
5. 1 GN ,,,. ' . .1 dlik-i-,.... lig See Page 2 :for
Internet: www:tigard-or_gov
Ni 0S \ t , ot .ka '7 ((,,,;, Supplemental Information
CV • , D iN! 1
:::::?...±..- :if 6 ..T.A1..W-. ,,, '?': ""*" 2.:7Eri41 Ir . -_,7,,,..-.7,,, ,Wf--1117.7,„ ., , 71.- i „, • tr.,'" ' .
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D New construction kg Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to thc neatest dollar) of all
0 Demolition 0 Other: mechanical inaterials, equipment, labor, overhead, and profit.
L-PI''',74tAtiNLir-1714.1t,04....i."';:''''']J9Yilt.____31::1",71, Value: $
54 1- and 2 dwelling 0 Commercialiindustrial 0 Accessory building
For special information use checklist.
0 Multi-family 0 Master builder 0 Other:
Description 1 Qty. 1 Ea. J Total
,.'..,,----7-7,0i!!1::;;=....--.l.:..74F.:4,:41iiii--4•1‘,1. -. 7,4 - iihr.rM,
_:: .,., ,,,..=,;,, ,,,,,,, I. ,:, _.,,, i d , r „ ..i ,; j: ,, ,,:, Beating/cooling
Air conditioning or heat pump
Job site address: \\C- '--,....... Nt.....-‘6.-.. (\ re . uires site .lan showin! 'lumen 14.00
City/State/ZIP: .---- N s t--6,- Clc '1-171.7-.. Furnace 100,000 BTU (ductsfvents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suitetbldg./apt. no.: Project name: .. - - t, ke .... f2_
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
_Llydronic hot water system 14.00
Residential boiler (radiator or
hydroni) 14.00
Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended, etc. 10.00
Flue,/vent for any of above 10.00
Subdivision: Lot no.:
- Other: 10.00
Tax map/parcel no.: Other fact appliances
i h.11 . '_----z Water heater 10.00
Gas fireplace 10.00
X ^
- ohs - , -T ta • S ....,..a.\-- Flue vent for water heater or gas
fireplace 10.00
V ‘'" ' L r-- 16. Log lighter (gas) 10.00
Wood/pellet stove 10 00
Wood fireplace/insert 10.00
. __ ., ' •,,,, .....t Chimney/liner/flue/vent 10 00
'...':;:'.-1/..q1AC...0#,M:%01140PAt4),tg:ER4EMOgg.gtitiNALketiega Other: ..
10.00
Name: Environmental exhaust and ventilation
- Range hood/other kitchen
Address: \\b •= \ C,\... equipment 10.00
Clothes dryer exhaust 10.00
City/State/ZIP: --- \ - \c 2 c .A .t.sr_ C...)-C'e‘ Single-duct exhaust (bathrooms,
Phone: (7P c _e-‘ \ Fax: ( ) toilet compartments, utility rooms) 6.80
- 7::::- , g'La;•<'.'j:':. ............................Y"W'r4''''7"''El '= 4W-1-nr7.11:1% Attic/crawlsPace fans 10.00
Other. 10.00
Business name: Fuel piping
Contact name: k....),e,,,S,,, S5.40 for first four; St .00 for each additional
Furnace, etc.
Address: \ -.6 k,,,,,,„_,. ---e\-c_ Gas heatpump
City/State/ZIP: Q...\‘‘,&c.NL,...A.... 4)(1_, CC-10,\c" Wall/suspended/unit heater _
Water heater
Phone: ---5 Us -C\CU Fax: : ( ) .
Fireplace
. ' . III Range
Barbeale
usiness natne:
-.. 'i .,:.:.•,:- ::: :.!1: c:,■,,i.,... -....--.4-_,-.41:',I ,1:,■;,:iii,r,-E.', ; 1!.,!!., _ „,...„ .2, --,-
Clothes dryer (gas)
B \,( .i, Cc X 1,....0 Other:
i-../t4t7.,(1.......e..,-,' '''''''.......■ ' . .. A •' - -..-'''' ' . -:- ' I: ::::P/F..."4,",ff-gjel;,'':-4 .
Address: \Z7\ . ,,,..\ ,,,,,
Subtotal
City/State/ZIP: Q Opt„, OctO€
Minimum permit fee (S72.50) 1-z
Phone: (Se) 1,49:3 ...,\ I Fax: (Scs'y L \
Plan review (25% of permit fee)
WAD State surcharge permit fee) ,Itaiaq
CCB I ic.: \ - "Lt-5L --- v -- 1 ,
' TOTAL PERMIT FEE
_______----------- - This permit application expires if a permit k not obt within 180 1 g
Authorized signature: ---"" days niter it has been accepted as complete.
Date: ..\--x_ob * Fee methodology set by Tri-County Building Industry Service Board
I Print name: \ft \,
-I ■.... 440-461 (11/02/CONUWEB)
I \Building TerrnitAMEC-PernitApp doc 04/0MM
I oaaT-Q9-EOS 311 S1d33W03 N31H3ON Wd92:1 Goo LT Jew
CITY'OF TIGARD
BUILDING DIVISION PERMIT #: MEC200900139
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 3/18/2008
Phone: (503) 639-4171
_ is
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, . Inspection Requests (24 Hrs.): (503) 639-4175 0/3
INSPECTION WORKSHEET FOR DATE: 3/2012008 TIME: 7:02AM PAGE: '14
,
SITE ADDRESS: 11879 SW 125TH CT CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 150 TYPE OF USE:
PROJECT NAME: MERCER
DESCRIPTION: Gas line for new range.
OWNER: MERCER, ERIC & JANINE PHONE #: 503-266-6655
CONTRACTOR: KOEHLER CONCEPTS LLC PHONE #: 50650
Inspection Request Scheduled For: Date: 3120/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 066999-01 503-5049917 N
Corrections/Comments/InstructionS:
-id L.-- 1 N? 7 PC A'
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- PASS I PARTIAL APPROVAL El CANCEL fl NO ACCESS
El FAIL El CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
,
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Inspector: ,i Date: 3.---.26 Phone #: (503) 718-