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Permit
` V CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00609 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/19/2007 PARCEL: 1S134 DC-01400 SITE ADDRESS: 11735 SW 114TH PL ZONING: R -4.5 SUBDIVISION: 114TH PLACE LOT: 007 JURISDICTION: TIG PROJECT: KLUEMPKE Project Description: Install gas line, vent and new insert. 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: 1 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: 1 > 10000 cfm: GAS OUTLETS: 1 Owner: FEES KLUEMPKE, PETER JOSEPH AND Description Date Amount KIMBERLEE ANN 11735 SW 114TH PL [MECH] Permit Fee 10/19/20C $72.50 TIGARD, OR 97223 [TAX] 8% State Surcha 10/19/20C $5.80 Phone: Total $78.30 Contractor: ALL FUEL INSTALLATION & SERVICE LLC PO BOX 69 TROUTDALE, OR 97060 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 674 -2350 FAX 503- 674 -2693 Reg #: LIC 169503 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 -001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. Issued = k: // Lj. / n I Permittee Signature: (/ / ? (i f 6)1 r WY Call 503.639.4175 by 7:00 a.m. for inspections that business day. • - • ermit card shall be kept in a conspicuous place on the job site until completion of the project. Approved plans are required on the job site at the time of each inspection. 2007- 10, -19 09:12 » P 2/2 Mechanical • X,f -;o, �' -� r ° ,. ir,T itlr , . y y 6 4 �:. , E tw, .i -- � w ,s :. echanical Permit Applien r pi,EcElvE" t � k� w; �r :$ ` I l. ,1 t (ti rl N I 1 � 1 �∎ I a � , ^` r , , r ' .' `' .. y 4r' City of Tigard ` . p t eBy /O / / 5 r'�mmt No. fIEC Zc/ -fet , , , v 13125 SW Hall Blvd., Tigard, OR 97223 Review i V, Phone: 503.639A171 Fax: 503 598.19600 C T 1 9 200 y: Other Permit: ',. \ i i i Inspection Line: 503.639.4175 Date/By: - 1 . .:.':',/,'; a C OF TIGARD D: R: tun. 0 See Page 2 for Internet; www.tigard or.Fpv Noti6edlMethod: ` 76,/ Supplemenlil Information BUILDINGOIVISION / -- ----- TYPE OF WORK COMMERCIAL FEE* SCHF.DUI•E - USE CHECKLIST Mechanical permit Ices' are based on the value of the work New Construction ❑ 0 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; $ $672.00 1- and 2-family dwelling RF.SIDENTIAI. EQUIPM / SYSTEMS FEES* El y g ❑ Commercial /industrial ❑ Accessory building For special information u se checklist. ❑ Multi- family ❑ Mastcr builder ❑ Other: Description 1 Qty. I Ea. 1 rotul JOB SITE INFORMATION AND 14.)CA`I'ION Heating/cooling Job site address; 11735 SW 1 t4 Place Air conditioning or heat pump (requn'e¢ sae plea showing placement) 14.00 City/State /ZIP: Tigard, OR 97223 Furnace 100.000 BTU(ducts /vents) _ 14.00 Furnace 100,0004 BTU (ducts/vents) 17.90 Suite/bldg. /apt. no.: Project name: "' -- Gas heat pump 14.00 (Crass street/directions to job site: Duct work 14.00 Ilydrunic but water system 14.00 . Residential boiler (radiator or hydronic) 14.00 • --- -- Unit heaters (fuel -type, nut electric), in -wall, in -duct, suspended. etc. 10,00 Fiuc/vcnt for any of above 10,00 Subdivision: lot no.: Other. 10.00 'Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Install gas line, vent and new insert Gas fireplace entfor 1 10.00 10,00 Flue vent for water heater or gas fireplace ,....... 10.00 �. Log lighter (gas) 10.00 Wood /pellet stove 10,00 wood tircptacc /insert 10,00 ® PROPERTY OWNER ❑ TENANT Chimney/liner/flue/vent 1 10.00 10.00 - Other: 10.00 Name: Pete Kluempke Environmental exhaust and ventilation Address: Same as shave Range hood /other kitchen equipment 10.00 City /State /'LIP: Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: (503)6134 -2732 Fax: ( ) toilet compartments. utility rooms) . ® APPLICANT ❑ CONTACT PERSON Attic /crawlspacc fans 10.00 Business name: See Below Other: 10.00 Fuel piping Contact name: $5.411 for first four! $1.00 for each additional , Address: Furnace etc. .. Gas . heat pump_ City/Slate/ZIP: _ _ _Wall /suspended/unit heater Phone: ( ) F'ax:: ( ) Water heate - _ . — ., _..... - _. Fireplace .._ 1 5.40 E-mail; - - - Rend �. w .. CONTRACTOR Barbecue Business name: All Fuel Installation and Service Clothes dryer (gas) Other Address: PO Box 69 MECHANICAL PERMIT FEES* r City /State /LIP; Troutdale, OR 97060 - _ Subtotal 25.40 Phone: (503) 674 -23,50 Fax: (503) 674 -2693 ___ M Minimum permit fee ($72,50) 72.50 Plan review (25 of permit fee) CC.rt lit.. 169503 State surcharge (R% of permit fcc) 5.80 �/ -- TOTAL PERMIT FEE 78,30 Authorized signature: I / _ ' I (,% - 1 j - 0 7 This perrnit application expires if a permit is nut obtained within 140 LI- C days after it has been accepted as complete. CITY CAF TIGARD BUILDING DIVISION PERMIT #: MEC2007 -00609 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/X9/2007 Phone: (503) 639 -4171 "NVlt'i/ti Inspection Requests. (24 Hrs.): (503) 639 -4175 „ I_.. /t1E 9©O 7- 00 ‘C INSPECTION WORKSHEET FOR DATE: 101250007 TIME: 7.01Atvi PAGE: 29 SITE ADDRESS: 11 735 SW 114TH PL CLASS OF WORK: SUBDIVISION: 114TH PLACE LOT #: 007 TYPE OF USE: PROJECT NAME: KLUEIPKE t DESCRIPTION: Install gas line, vent and new insert. 1 OWNER: KLUEMPKE, PETER JOSEPH AND, PHONE #: CONTRACTOR: ALL FUEL INSTALLATION & SERVICE LLC PHONE #: 503 - 6742350 Inspection Request Scheduled For: Date: 10/255/2007 Pour Time:. Code # Inspection Description Confirm # Contact # Message 610 Gas lino 058341 -01 503.684 -2732 N Corrections/Comments/Instructions: ASS I I PARTIAL APPROVAL CANCEL n NO ACCESS n FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: Date:/e --s Phone #: (503) 718- —z-'