Permit CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00721
TIGAARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/12/2007
PARCEL: 1 S134DC -11300
SITE ADDRESS: 11530 SW GALLO AVE ZONING: R-4.5
SUBDIVISION: CASCADIAN PLACE LOT: 002 JURISDICTION: TIG
PROJECT: MERCER
Project Description: Install gas line to generator.
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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
SCOTT MERCER Description Date Amount
11530 SW GALLO AVE
TIGARD, OR 97223 [MECH] Permit Fee 12/12/20( $72.50
[TAX] 8% State Surcha 12/12/20C $5.80
Total $78.30
Phone:
Contractor:
SERVICE NOW OF OREGON INC
621 SE 7TH
PORTLAND, OR 97214 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 445 -2440
FAX 503- 445 -2443
Reg #: LIC 161582
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.
/ . n
Issue• : /1 /Jj / / Permittee Signature: w � /iCAI i f-r)
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.
• RECEIVED i . r s 1 i c
i ' i t er Tt s` .? , :vn r. K , .e 7r. r C r •�
Mechanical Permit Application r -Y « , r § , : ; .'�f ' Fo ROFHICE; ;4, U S r ~ -
....b. ._sa.s5c..tr-. y: r •tit.c,a.i..,.ut-.r.,k-�i4- •s
, 's t Iia: +-A
t �'I ;r 7 City of Tigard CC 1 2001 Received
/ , l Pernit No.: �r� Z
. 2L 1 Date By: �2 / /Z /�� ��N He 7 //� �! ��
13121 SW' Halt Blvd., Tigard, OR 9.223 Plan Review { {/
,
III
Pho 50 3.639.4171 Fax: 503.5
j OF fIGARU Date /By: Other Pamir
T 1 GA R D Inspection Line: 503.639.4175 BUILDING DIVISION Date Ready /By, tun E! See Page 2 for
*int i Brett Internet: www.tigard- or.gov Notified/method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE" SCHEDULE - USE CHECKLIST
❑ Ncw construction Addition /alteration /replacement Mechanical permit fees" are based on the value of the work
performed. Indicate the value (rounded to the ncanxt dollar) of all 1
❑ Demolition ❑ Other mechanical materials, equipment, labor. overhead. and profit.
CATEGORY OF CONSTRUCTION Value: $
e gi-1. and 2- family dwelling El Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description Qty. Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Ilenting ;cooliog
Job site address: / j S 3 D S / . Q i 7 //47 �J - Alt conditioning or heat pump
(requires site plan showing placement) 14. 00
City/State/ZIP: I 4, / . - -7Z Z 3 Furnace 100,000 BTU (ducts:vents) 14.00
Furnace 100,000+ BTU (duets/vents) 17,90
Suite/bldg. /apt. no.: Project name:
���� Gas heat pump 14.00 __
Cross street /directions to job site: Duct work [4.00
I- lydronic hot water system 14.00
Residential boiler (radiator or
jydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.:
Flue /vent for am of above 10,00 1
Other. 10.00 1
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
/ -- ) / - Gas fireplace 10.00
6 5 L ( �1 e___ --/---) 4z�/' / ,e ]� r Flue veto for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert _ 10.00
J PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 10.00
Other: 1 0.00
y..--/-- 1�y� }
Name: ,�Q �" / t�
�� Environmental exhaust and ventilation
Address: / J Range hood /other kitchen
- ///2 A- I/ c equipment 10.00
City/State /•LIP: / / // J,e /� .17 a a 3 Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments. utility rooms) 6.80
Fr APPLICANT ❑ CONTACT PERSON Attic /crawl space fans 10.00 -_
Business name: cal,,/(e_ /vf� / ., / / I G Other: 10.00 I
Fuel piping
Contact name: 4 11- t, �•' J S5.40 for first four; $1.00 for each additional
Address: �� ! Q.�� Furnace, etc.
/ , Gas heat pump
City/State/ZIP: it , 2I D4 '70- Wall /suspendcd/unit heater
•
Phone: ( "5D3 ) 4i'q _. 4I41 Fax:: (.o ( ,./ 3) (' S _ qv ? Water heater
E -mail: ti q.5-. Fireplace
Range _
CONTRACTOR Barbecue
Business name: / I Clothes dryer (gas)
L AT - 5 G DU C Other: I
Address:
MECHANICAL PERMIT FEES*
City /State/ZIP: Subto
Phone: ( ) Fax: ( )
Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB Iic.: /6/6s a State surcharge (8% of permit fee) 7X, 3O
TOTAL PERMIT FEE
Authorized signature i This permit application expires if a permit is not obtained within 1h0
I days after it has been accepted as complete.
Print name: - /, / /r Date: / L/i / /,., • Fee methodology set by Tr-County Building Industry Service Board
I.l Building `Petmilsl\1EC- PermitApp. doc 04 !/" 440 - 4617r (11Po2•COMPI' BI
i £ Z . out MON aoIAJaS 0 69 :Z6 LO 14 080
1 - .
CITY OF TIGARD
BUILDINd DIVISION
A. PERMIT #: MFC2007-00721
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/12/2007
I Phone: (503) 639-4171 111-11"011141#
Inspection Requests (24 Hrs.): (503) 639-4175 IL fiE 0 7 - 00 7-
INSPECTION WORKSHEET FOR DATE: 12/13/2007 TIME: 7:00AM PAGE: 21
SITE ADDRESS: 11630 SW GALLO AVE CLASS OF WORK:
SUBDIVISION: CASCADIAN PLACE LOT #: 002 TYPE OF USE:
PROJECT NAME: MERGER
DESCRIPTION: Install gas Iine:to generator,
OWNER: MERGER, SCOTT PHONE #:
CONTRACTOR: SERVICE NOW OF OREGON INC PHONE #: 503-445-2440
Inspection Request Scheduled For: Date: 12/13/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 061459-01 603.445-2440 Y
Corrections/Comments/Instructions:
1 g
... 4
Di A vl
\ot
.
o p
,
_....„-
7 PARTIAL APPROVAL El CANCEL fl NO ACCESS
0 FAIL E CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
Inspector: Ir • Date: / f-:-- - — 0 ? Phone #: (503) 718-