Permit Er CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00630
TIGARD DATE ISSUED: 10/30/2007
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103AA -01908
SITE ADDRESS: 12355 SW 106TH DR ZONING: R -4.5
SUBDIVISION: COTTONWOOD PLACE LOT: 011 JURISDICTION: TIG
PROJECT: BRUGGER
Project Description: Gas line and fireplace install.
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
BRUGGER, JUDITH C AND Description Date Amount
JOHN A
12355 SW 106TH [MECH] Permit Fee 10/30/20C $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 10/30/20C $5.80
Total $78.30
Phone: 503 - 639 -3360
Contractor:
T & K MECHANICAL
11525 SW CANYON RD
BEAVERTON, OR 97005 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 626 -4652
FAX 503- 626 -9138
Reg #: LIC 121165
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: /` Permittee Signature: 97.7 ai4 .
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.
FRQM : FRX NO. :503629138 Oct. 29 2007 11:53RM P1
46.,. .�
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Mechanical Permit Ap l' 1
Mechanical ; rint OFFICE USE ONLY
City of Tigard Received /2
13125 SW Ball Blvd., Tigard, OR 97223 OCT 29 201
Date/By. o d 7 130 Permit N, ar,G30 •
Phone: 503 - 639.4171 Fax: 503,598,1 Plan Review
p � 9- r i 44 , 1
w , Date /By. Other Permit:
Inspection Line: 503.639,4175 g Ur 11 c , ` 1 i
Internet: www.ci,tigard.or.us . :`� � ~. , ` _..., ' Date Ready /Dy lath: ® SeeYggeZfor
7 T i DrI G rr Not fiad/Mathvd; Su trmentgl in qY
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❑ New construction P: Addition /alteration/replacement Mechanical permit fees* are based on the value of the work Y
performed_ Indicate the value (rounded to the nearest dollar) of al
❑ Demolition ❑ Other; mechanical materials, equipment, labor, overhead, and profit.
' t. T 8 n - M O s l ROMP N Value $
y g 0 Commercial /industrial building
Y 2 ~� je 3 „ r r >l a ,, t
t �1 - and 2-family dwelling El building ����ef . �
❑ multi-famil ❑ Master builder For.special lrFformertiorr use checklist.
�, ❑ Other:
„ MT , ,_ t` - K`i r ' R ! ti a fi` k ;P, ".�a3�n :"f it a t w . �l + Yyls, Head g /cooling •
Qty. i Ea. � Total
Job site address: I 'o 3 5$ S l c .t 1 �
�1� Ai r conditioning or heat pump 1
W LJ • uiree site • en sbowin. • acement 14.00 I _
j�
Furnace 100,000 BTU (ducts/vents) 14,00 - Suite/bldg./apt, no.: . Project name: Furnace 200,000+ BTU (duets/vonts ^ 17,90
as heat pump 14,00
Groan street /directions to job site: • • - • •
1•lydronic hot water system 14.00
Residential boiler (radiator or
dronic) 14.00
Unit heaters (fuel -type, not electric),
- in wall,.in -duct, suspended cm. • • 10:00
Subdivision: Lot no,; Flue/vent for any of above 10.00
Other: 10.00 1
Tax � /parcel no.: ?� Other fuel appliances
.::3a �+'a�- 1,'•i.�''%�, m RF M81 hW x N o �' S a"�r ' RR Mw t i?n ' eg Water hstet' 10.00
/
Gas fireplace / 10.00 /0
i .c h ' A • _ Q 1 A P V • Flue vent for water h eater or gas
fireplace — I 10.00 - i
L og lighter (gas) 10.00
Woodl 10.00
Wood fireplace /insert 10,00
" V ^yl4it�l` ?( +y mr �e�igtj p s: y r /liner /flue/ vent
dS ', '',, � titeg ;6tY 1
3 W � r Chimne y 1 0.00
t tka sit Other: 10.00
Name: J olntn �-- -
u ti ! o • • Environmental exhaust and ventilation
.Address: i a3 5 � s l • r xange hood/other kitchen •
equi�ttl9nt • .: 10.00
City /$talc /Zll':7 —
1 „„ co, - 0 e �17 . a3 Clothes dryer exhaust 10.00
Phone: ( -*+ 4 . g c ltaust arooms,
�i, �,, ,� „ .� •7 ,r� to le -duct compartments, (b utili th ty rooms) 6.80
tl: L ',.�„ Re. 5'4{Ol�'z �h 1 'a~'�`:�i,iPIS4i °• �.� �' a ` , t ''.: � A tt i c / craw l space fans -
,' *� ,
r) a • t i _10.00
Other: 10.00
Business name:
x F . 9.1- ac - w Q.
Fuel pipits
• + ,Vim. A. $5.40 for first four; $1.00 for each additional
IIIIIIII
Address: •
.. _ l (�.Vk es ,.. Furnace, eta
4 City /State/ZIP: 2 , �• is 4 76as Gas heat pump
Walllsus.
Phone: (SO . _ .....2.a._ Fax:: 6 3) • ' 38 Water heater INIMMINIIIII
Fireplace
y ,c'77 f �^ti i U�.m0.��ro -xr . Milk �i�A t '"' tvl' a �x t a� Ba
` rb
'' 'N` t t •�nr °, 4.3ra'. ,,ra(r id Y Ba c rbcu e ' Mini°
Business name: , J H ee- Clothes dryer (gall
�'/ . 3 p Other:
Address:
/ — c/( -{_,) 4. Q. y ak �� y �
w!' r N�. h4, y r Ya k ^,siv,, 4 t `, y A
_Gs vev • Qv :.,. subtotal
Phone: ) R - < � - F ax: (t 1 , „• . C''/ �Ca� Minimum permit fee ($72.50)
`�2.� GC�'�' �,1 Plan review (25% of permit fcc)
ir A State surcharge (8% of permit fee) IMMO
TOTAL_PERMIT 1~ EE '7
Authorized signatur • = � ���_ ��/�� •n us permit appl expires if . permit is not obtained within 180 I. PTA �^'"" days After It h been acccptad
�71�r/L / x frt ' " Fee methodology set by Tri County Building Industry Service Board
;Akt.i ..doe 12/03
CITY OF TIGARD 4,
BUILDING DIVISION PERMIT #: MEC2007 -00630
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/30/2007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11//612007 TIME: 7 :01AM PAGE: 4
i44' °T - o,PAA?d
SITE ADDRESS: 12355 SW 106TH DR CLASS OF WORK:
SUBDIVISION: COTTONWOOD PLACE LOT #: 011 TYPE OF USE: .
PROJECT NAME: E RUGGER
DESCRIPTION: Gas line and fireplace install.
OWNER: BRUGGER, JUDITH C AND, PHONE #: 503"639 -3360
CONTRACTOR: T & K MECHANICAL PHONE #: 503-626-4652
Inspection Request Scheduled For: Date: 11/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final O59t 40-02 503-844-9173 4k--t&
Corrections/Comments/Instructions:
PASS PARTIAL APPROVAL n CANCEL ❑ NO ACCESS
❑ FAIL LL FOR INSPECTION n ADDITIONAL FEES ASSESSED
r
Inspector: Date: / 74 bPhone #: (503) 718 - L C /f
. ,
CITY OF TIGARD
BUILDING DIVISION ,. PERMIT #: MEC2007-00630
13125 SW Hall Blvd., Tigard, OR 97223
A DATE ISSUED: 10130/2007
Phone: (503) 639-4171 Aliiillilt
• Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 11/16/2007 TIME: 7:01AM PAGE: r
J
SITE ADDRESS: 12355 SW 1061H DR CLASS OF WORK:
SUBDIVISION: COTTONWOOD PLACE LOT #: 011 TYPE OF USE:
PROJECT NAME: BRUGGE}Z
DESCRIPTION: Gas line and fireplace install.
OWNER: BRUGGETZ, JUDITH C AND, PHONE #: 503-639-3360
CONTRACTOR: T & K MECHANICAL PHONE #: 503-626-4652
Inspection Request Scheduled For: Date: 11/16/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 059840-01 503-8449173 Y , 1
Corrections/Comments/Instructions:
Z— C34---- 10&_
liall. i 0, —
,
1\
ASS) 11! !'ARTIAL APPROVAL E CANCEL pi NO ACCESS
0 FAIL TA CiLL FOR INSPECTION fl ADDITI NAL FEES ASSESSED
Inspector: Date: I 1 ) (5 Phone #: (503) 718-
Mr &-
. .
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