Permit CITY OF TIGARD
MECHANICAL PERMIT
0 COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00022
T IGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/14/2008
PARCEL: 2S 112CA - 05900
SITE ADDRESS: 15287 SW THURSTON LN ZONING: R -
SUBDIVISION: ASHFORD OAKS LOT: 013 JURISDICTION: TIG
PROJECT: MOLONEY
Project Description: gas line to range and 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: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 2
> 10000 cfm:
GAS OUTLETS: 2
Owner: FEES
MOLONEY, JOHN D + LESLIE A Description Date Amount
15287 SW THURSTON LANE
TIGARD, OR 97224 [MECH] Permit Fee 1/14/200E $72.50
[TAX] 12% State Surch 1/14/200E $8.70
Total $81.20
Phone:
Contractor:
ROTH HEATING & COOLING
P.O. BOX 1265
CANBY, OR 97013 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 266 -1 249
FAX 503- 266 -3478
Reg #: LIC 14008
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: .ice _ /%� /i , erMo Permittee Signature:
Call 503. • ' • .175 by 7:00 a.m. for inspections that business d. y.
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.
CITY OFTIGARD .. ,
BUILDING Dll
A PERMIT #:
Vi
DATE ISSUED: 11i-14C/220°0°813-
00622
13125 SW Hall Blvd."; Tigard, OR 97223
?- Phone: (503) 639-4171 4 * 01 011410iiii , \
Inspection Requests (24 Hrs.): (503) 639-4175 ...41 -1.1.. /t7CCP-00?-40610 ,2-d
INSPECTION WORKSHEET FOR DATE: 1n6/2008 TIME: 7 PAGE: 23
SITE ADDRESS: 15287 SW THURSTON LN CLASS OF WORK:
SUBDIVISION: ASHFORD OAKS LOT #: 013 TYPE OF USE:
PROJECT NAME: MOLONEY
DESCRIPTION: gas line to range and fireplace
OWNER: MOLONEY, JOHN D + LESLIE A, PHONE #:
CONTRACTOR: ROTH HEATING & COOLING PHONE #: 503
Inspection Request Scheduled For: Date: 1/16/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
Sit) Gas line 063316-01 603-2661249 N
Corrections/Comments/Instructions:
410 _3 e •, .0 „ - - .-7 —rz- -7...-- - 2- ,- -- ,-.. 1.e.. , 'am_
1 ,.....) au. 4,
V
V l , PASS 7 PARTIAL APPROVAL fl CANCEL fl NO ACCESS
0 FAIL E CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: Date: /— /6 —0 A Phone #: (503) 718
_ •
Jan 11 08 03:42p p.2
' ' M Permit App1iCation 'r
F oes oF.rlcEuscoNLY .
City/ of Tigard /
-�" °`� deceived
• Date /13y: 1 c Permit No.'
13125 SW Hall Blvd., Tigard. OR 97223
• ICl/ ' /L c�X:� —
A r Plan Review
Phone. 503.639.4171 Fax: 503.598.1960 ,� f� k I (� t
503.6394175 .+... .T,'.� ' + �q Date /By•
Inspection Line: Other Permit',
Date heady/By.
.^� f s i J. ns El see Page 2 for
Internet: www.ci.tigatd.or -us
�� i 1 �,�.,,_ ii Neti6ed'Methad: Supplemental lnformalion
�F ..DIVISION ll COMMERCIAL TEE* fff
•
FEE SCHEDULE - USE CHECKLIST
Mechanical permit fms* are based on the value of the work
❑ New construction ddit ion /alteration /replacement
performed. Indicate the value ( rounded to the nearest dollar) of all
❑ Demolition Other: P X E mechanical materials, equipment, labor. overhead, and profit.
CATEGORY :OF CONSTRi CT t Value: S 1
dwelling 't.'�i�`"� RESIDENTIAL.EQUIPMENT /SYSTEMS.FEES*
\ F}..1 - and 2-family g ❑ Commercial/industrial gl Acca .
❑ Multi - family ❑ Master builder ❑ Other. For species; information use checklist.
Description Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 1 C$ 24 1 SV� j 'rte y � 1 p U ,�.„ Y ! t �� „ Air conditioning or heat pump
! � (requires site plan showing placement) 14.00
City /State /ZIP: `sr - -'11 (1�� �-Yl� V /, Cr /�- '.7 1 2.4/ Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg. /apt- no.: Project name: heat pump 14.00
Cross street/directions to job site: Duct work 14•00
Hydronic hot 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: Lot no.: Flue / vent for any of above 10
Other. 10.00
Tax map/parcel no.: Other fuel appliances
• :DESCRIPTION OE WORK Water heater 10.00
Gas fireplace 10.00
t Flue vent for water heater or gas
lt,,,,e___. � r p a fl v Loghg ]0.00
l rt 1 1�--" Log iighte er(gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/inset 1 10.00
.. ROPERTY -OWNER El _ Chimney/liner/flue/vent 10.00
Name: a Y lr 1 f 't 1p Other. 10.00
(/ t � Environmental exhaust and ventilation
Range Address: r I r' equipm ent 10.00
oodrotherkitchen
'"') ^� equipment
/ Clothes dryer exhaust 10.00
Phone: ( pi k0C1 ,-005 0 Fax: ( ) to ile t comp o (bathrooms,
toilet eomnattments, utility rooms) 6.80
, APPLICANT ' 121 CONTACT PERSON Attic/crawlspace fans 10.00
Business name.- Other 10.00
Fuel piping
Contact name: S5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
\ t i ,
City /State(ZIP: Wall/suspended/unit heater _
Phone: ( ) F ax:: ( ) Water heater
E -mail: • Fire
, Range 1 C
r.
CONTRACTOR Barbecue
Business name: Roy f��, Clothes dryer ( gas)
. / Other
Address: f f �_ � -CO� MECFI.4NIC 4L PERMIT FEES'
City!StateiZlP: �1'1 r Z0/13 Subtotal �
ph.: (5a3) ) l ( --( 21(41 Fax: ( 5 t 5) 0-6 4 — ( 7e
Minimum permit fee (572.50) '� 7
CCB ]ic.: Plan review (25% of permit fee)
U �� �: State surcharge Y. of permit fee) /
L �i . TOT PERMIT FEE 2, 1 , 2-C C
Authorized signature: ti - �'�- This permit application expires if a permit is not obtained within HO
rrr days after it has teen accepted as complete.
Print name: / ' j /) i[/t Date: ( i 4 . Fee methodology set by TA- County Building Industry Service Board
i:•b uildinii , PmniLS'J.tEC- Pam:tneo.due 12/03 440 -4 6177 (1 IN2 /COM/WEB)