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Permit I7 CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2007 - 00613 DATE ISSUED: 10/22/2007 TIGARD; 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1 S133DA -00500 SITE ADDRESS: 11040 SW SUMMER LAKE DR ZONING: R -7 SUBDIVISION: AMART SUMMERLAKE LOT: 027 JURISDICTION: TIG PROJECT: GERARDS Project Description: Gas line extension for 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: WOODSTOVES: FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: 1 Owner: FEES JERRY GERARDS Description Date Amount 11040 SW SUMMER LAKE DR TIGARD, OR 97223 [MECH] Permit Fee 10/22/20C $72.50 [TAX] 8% State Surcha 10/22/20C $5.80 Total $78.30 Phone: Contractor: HEAT RELIEF CO 13122 NE DAVID CIR # 800 PORTLAND, OR 97230 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 261 -9915 FAX 503- 261 -9814 Reg #: LIC 122424 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 callin. 2 3.246.6699 or 1.800.332.2344. Issue • = �� /��/ / Permittee Signature.: bppkathpo /) Call 503.639.4175 by 7:00 a.m. for inspections that business day. • - it 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. t. _Oct 22 2007 9:14RM HEAT RELIEF Heating & Coo 503 261 9814 p.1 Mechanical Permit Applicatio FOR l►I• FI('IF, USE ONLY Ci of Ti and --� 'QCeived 1 tY g to a 0 -- 5 Permit N o.: /�.l f�/` N......_. 13125 SW flail Blvd., Tigard, OR 97223 D ateBy: / HOC/ Plan Revi f " Phone; 503.639.4171 Fax: 503.598.1960 OCT 2 2 1001 Date/By: eW Other Permit TWA n ti 0 inspection Line: 503.639 �a �6 > , . No )tom Date Rea /B thod : Juri4 j Internet: www.tigard- or.gov • E/l t 1 t �{Zy tified Me: Supplemental inturmntinn i BUWLDINGDRR9lSIONt . , , : (5 r '}: r " r;: .7 "MSar._ , 000*:0 t " 1 SE tit. - USF CFIECKLIS r New construction dAddition /alteration /replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest (Jolla!) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit ,, E� . at �t r`": # t . r ,j� Value • $ T f 1- and 2-family dwellin Commercial /industrial cw - ? 1 TEMS`FEES• • L Y g ❑ 0 Accessory building For special information use checklist. E Multi- family ❑ Master builder 0 Other ! t Description Qty Ea. Total Ji3 '., lPi? 4g1 Y- r " " „ , S : t 4i a <.. . Hea ling /tooling Job site address: //042) 54) SSternme r Lai, u r • Air condi tioning heat pump (requires site plan sho wmq plarclnent) 14.00 City /.State /ZIP: Ti's 6,,,d, o Q 97,225 Furnace 100,000 BTU (ducts /vents) I f4 00 Suite/bldg./apt. no.: Project name: Furnace 100,000+ BT1J (duets/vents) I 17.90 I Gas heat pump 1 4.00 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 -walI, 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 ., z r x �. r c a 'Srtr k {.. __. - 000 ' <<f, Rti 4 a �- l iji r ; Water heater Gas a � fireplace 10.00 LI A 5 .H 1 % A A . 0 rt , Flue vent for water heater or gas fireplace 1 /0.00 Log lighter (gas) ' 10.00 Woad /pellet stove 1 10.00 Wood fireplace /insert 1 . I> 1:40.0 ' r 1::`',0 :'w: Chimney /liner /flue /vent 10.00 1000 Name: 5e / rf d Other. 10.00 �e rar (� Environmental exhaust and ventilation Add1 mss: Q �O u� _Environmental hood /other kitchen (' SL�rr] tr 45 equipment 10.00 City /State /ZIP • Clothes dryer exhaust 10,00 Single -duct exhaust (bathrooms, Phone: ( ) Fax: ( ) toilet comparunents, utility rooms) 6.80 Q +B00,(9 T : ..' I ( eN.. c.is .. 1 A ttic / crawlspace tans I 1000 Business name: 1 a 4, -ve 1 t T e 0 Other: 10 00 Fuel piping 1 � ^ Contact name: ill air i n ec D 1 »t 1 55.40 for first four; $1.00 for each additional _ Furnace, etc 1 3 i a s NE E- Dct rl'�' Cc.,z. C�, • irbd Gas eat pump h � — Address: City/State/ZIP: a p j _- F. e) 723 a Walh$uspended /unit heater 1 Phone: (p3) a4, /_ 4,9 Fax:: (pj) a6 / 9 tit? Water heater 1 -mail: J a 1 re P p Fireplace 3' r r •► P , eLoYl j Range ' ' ' . .. ,vei .4 ,... 11 ; 1 { �_._. ... u1..M s,� Y & Barbecue Business name: ‘...\ e c. e \ ,,,,,c.- Other Clothes dryer (gas) --‘),Q. (Other: ` 1 -11 a-k Y , c., .�t�v.`. Q_ t c, v._ ` OC', i . - it Address: rouvlucAtteR n FEE s• --I City/State/TIP: hoc kl. 0+r1c1 l C ? --). C> Subtotal . Phone: ( rte ",,) / n Fax: (�.) c rs . ( i f Minimum permit fee ($7250) l LV�" "1 l t CCQ tic.: 1 a � a , Plan review (25% of perm,! lee) ` 4 / State surcharge (8% of permit fee) �_ TOTAL PERMIT FEE Authorized signature: /�� This permit application empire. if a permit is not obtained A, ith,n 15(1 " .44-'v z` ' days after it has been accepted as complete. i I ' rintname: �'{� R}�L e.6- l/G_tlC.13Ce, Date: * Fee methodology set by Tit - County Building tritium Set viceBoard R�l t, , O'era,itriMEG1'cmnt 4111 (lac 04/06.+01, 440 -41, 7T 11 i/e2/CObiN/EB) I \ CITY OF,TIGARD BUILDING (VISION PERMIT #: MEC2007-00613 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: /0/2212007 Phone: (503) 639 -4171 �o'0 �0ii ilii' Inspection Requests (24 Hrs.): (503) 639 -4175 , te a o ? - Oa&' /2 1 INSPECTION WORKSHEET FOR DATE: 11/2/2007 TIME: 7 :01AM PAGE: 72 SITE ADDRESS: 11040 SW SUMMER LAKE DR CLASS OF WORK: SUBDIVISION: AMART S(JMMERLAKE LOT #: 027 TYPE OF USE: PROJECT NAME: GERARDS DESCRIPTION: Gas line extension for range. OWNER: GERARDS, JERRY PHONE #: CONTRACTOR: HEAT RELIEF CO PHONE #: 503- 261 -9915 Inspection Request Scheduled For: Date: 11/2/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 058869 -01 503.524 -4453 N Corrections/Comments/Instructions: � G� _Or/ -`/ s/ X7 - -..0 s G NOS I AP S ! / y� I-t 1. L. V - ' s <'T ,2-z -- J y I I PAS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED A _______ Inspector: Date: ii— Z— © 7 Phone #: (503) 718 - �� CITY OF TIGARD BUILDING D IVISION PERMIT #: MFC2007- 004513 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/22/2007 Phone: (503) 639 -4171 A ruu�W , Inspection Requests (24 Hrs.): (503) 639 -4175 ...' ' L /1�� v� D6 `7 d to l INSPECTION WORKSHEET FOR DATE: 11/212007 TIME: 7 :01AM PAGE: 71 SITE ADDRESS: 11040 SW SUMMER LAKE DR CLASS OF WORK: SUBDIVISION: AMART SUMMERLAKE LOT #: 027 TYPE OF USE: PROJECT NAME: GERARDS DESCRIPTION: Gas line extension for- grange. OWNER: (ERARD'S, JERRY PHONE #: CONTRACTOR: HEAT RELIEF CO PHONE #: 503-261 -9915 Inspection Request Scheduled For: Date: 11/2/2007 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 058869.02 503 - 524 -4153 N Corrections /Comments/ Instructions: i . / /PARTIAL APPROVAL CANCEL ❑ NO ACCESS IL CALL FOR INSPECTION L] ADDITIONAL FEES ASSESSED Inspector: Date: /r - -�— 0'7 Phone #: (503) 718- Z