Permit '4'4" CITY TIGARD Y
I!� + ��fi� , 1 MECHANICAL PERMIT
Au COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00667
DATE ISSUED: 11/13/2007
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 2S103BB - 07800
SITE ADDRESS: 12410 SW 124TH AVE ZONING: R -4.5
SUBDIVISION: LAKE TERRACE LOT: 006 JURISDICTION: TIG
PROJECT: SPARWASSER
Project Description: Installation of gas piping for range and (2) gas log sets
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: REPAIR UNITS:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 3
> 10000 cfm:
Owner: FEES
SPARWASSER, RICHARD C Description Date Amount
KAREN M
12410 SW 124TH [MECH] Permit Fee 11/13/20C $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 11/13/20C $5.80
Phone: Total $78.30
Contractor:
NATURAL GAS CUSTOM PIPING INC
19271 SE SUNNYSIDE RD
DAMASCUS, OR 97807 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 335 -9950
FAX 503- 335 -9950
Reg #: LIC 125031
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.
Issu = s By: i h k_ Permittee Signature
Call 503.639.4175 by 7:00 a.m. for inspections that business ay.
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.
Mechanical Permit Application ,.:-., ty � ti 1 !n 1 � 1 � 4 _ ....0A.1,- .
Y *a' Received -t 7
+, ,t'.; ; . ' ; • City of Tigard Date/By: l t ( 3(o7 Permit No.: Otie20o / � �
"' a 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
V. M � . ° ; Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
- a� ...598.1960 Date /By:
F«:iw?7��r it ,t Inspection Line: 503.639.4175 Date Read /B Juris: �� H See Page 2 for
T:- IGi� }h D' P Ready /By:
a`T41?v::: Internet: www.tigard - or.gov Notified/Method: lam(( 1 Supplemental Information
TYPE OF WORK . . ' `COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction ® Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY. OF CONSTRUCTION ` Value: $ S1000
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description I Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump
Job site address: 12410 S.W. 124
(requires site plan showing placement) 14.00
City/State /ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts/vents) 14.00
Fumace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: New Gas Appliance Piping Gas heat pump 14.00
Cross street/directions to job site: Walnut 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: Lake Terrace Lot no.: 6 Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: 2S13BB -07800 Other fuel appliances
. DESCRIPTION OF WORK - . Water heater 10.00
Gas fireplace 10.00
Install additional Natural Gas Line for a new Gas Kitchen Range and two (2) Flue vent for water heater or gas
new Decorative Gas Fireplace Logs sets. fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
. Chimney/liner/flue/vent 10.00
' ® PROPERTY OWNER 0 TENANT Other: 10.00
Name: Richard C. Sparwasser Environmental exhaust and ventilation
Range hood/other kitchen
Address: 12410 S.W. 124 Ave.
equipment 10.00
City/State /ZIP: Tigard, OR 97223 Clothes dryer exhaust 10.00 _
Single -duct exhaust (bathrooms,
Phone: (503)590 7727 Fax: ( ) toilet compartments, utility rooms) 6.80
® APPLICANT - ❑ CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: Richard C. 2Spanvasser 55.40 for first four; 51.00 for each additional
Address: 12410 S >W> 124 Ave Furnace, etc.
Gas heat pump
City/State /ZIP: 97223 WalUsuspended/unit heater
Phone: (503) 590 7727 Fax: : (503) 590 7727 Water heater
Fireplace .
E -mail: rsparwasser@hotmail.com Range 1
- " CONTRACTOR. .. Barbecue
Business name: Natural Gas Custom Piping Inc. Thomas R. Godfrey Clothes dryer (gas)
Other: Gas Log Sets 2
Address: 19272 S.E Sunnyside Rd. MECHANICAL PERMIT. FEES*
City /State /ZIP: Damascus, OR 97081 Subtotal
Minimum permit fee ($72.50) 7X. 50
Phone: (503) 335 9950 Fax: (503) 590 7727 Plan review (25% of permit fee) -1
CCB lic.: 125031 State surcharge (8% of permit fee) D • iD
/ TOTAL PERMIT FEE n . 3v
/ 1°; / This permit application expires if a permit is not obtained within 180
Authorized signature:
/ da af te r it has been accepted as complete.
Print name: Richard . Sparwasser , Date: 11 - 13 - 07
* Fee methodology set by Tri- County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doc 04/06/06 440 -4617T (I I /02JCOM/WEB)
CITY OF TIGARD c ._
BUILDING DIVISION PERMIT #: MEC2007-00667
13125 SW Hall Blvd., Tigard, OR 97223
aiAl; / - DATE ISSUED: 11/13/2007
Phone: (503) 639-4171 „ssimitilielt\ O Cf‘e Abo ? — 0 0 6 C 7
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12117/2007 TIME: 7:0'1AM PAGE: 53
SITE ADDRESS: 12410 SW 124TH AVE CLASS OF WORK:
SUBDIVISION: LAKE TERRACE LOT #: % TYPE OF USE:
PROJECT NAME: SPARWASSER
DESCRIPTION: Installation of gas piping for range and (2) gas log sets
OWNER: SPARWASSER, RICHARD C, PHONE #:
CONTRACTOR: NATURAL GAS CUSTOM PIPING INC PHONE #: 503-335-9950
Inspection Request Scheduled For: Date: 12/17/2007 Pour Time:
1 fr)
Code # Inspection Description Confirm # Contact # Message ■ 11'
V
610 Gas line 061585-01 603-690-7727 N
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Corrections/Comments/Instructions:
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Irii .ASS n PARTIAL APPROVAL El CANCEL fl NO ACCESS
0 FAIL CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: ..'t CA1.-- Date:" -1 / d') Phone #: (503) 718-