Permit Er CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00745
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/21/2007
PARCEL: 2S103DC -00500
SITE ADDRESS: 13705 SW 110TH AVE ZONING: R -3.5
SUBDIVISION: FAIRHAVEN COURT LOT: 004 JURISDICTION: TIG
PROJECT: ROGERS
Project Description: Gas fireplace, gas line install.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: 1
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
MARK ROGERS Description Date Amount
13705 SW 110TH AVE
TIGARD, OR 97223 [TAX] 8% State Surcha 12/21/20C $5.80
[MECH] Permit Fee 12/21/20( $72.50
Total $78.30
Phone: 503- 624 -6493
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.
4 ae l ed...„ A rl
Issued By: Permittee Signature: d 4ila ' 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.
4 ..
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Mechanical PermitAnplic - tr
City of Tigard Received ,. /�� Permit Nu,:M,, //
QEC I)nla,nv �n� Metcp� ! .....0076z6
13125 SW Hatt Blvd., Tigard, UK 972222333 r!(j111 Platt Review !!
Phone; 503.639,4171 Fax: 503•S9Q Other Penal
DatclBy:
'f I i., 1„, &i .., Inspection Line: 503.639.4175 �e 11 Dale Rcady/By: hvi ®a Nice 2 Air
Internet: www,ligard -orgov QDi � I _ Notitied/Method: Supplemental information
TYPE OF WORK �trl COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ® Addition/alteration/replacement Mechanical permit fees` arc based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition . ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONS'T'RUCTION Value: $
1 -and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial /industrial ❑ Accessory building
For special rnrorrnalion use Checklist.
0 Multi- family Q Master builder ❑ Other:
-- .- Description Chy, 1:a. total
JOB SITE INFORMATION AND LOCATION Heating/cooling „-
,n Air conditioning or heat pump
Job site address: 13705 SW 110 Ave
, (reuith . ate plop allowing placement) 14.00
City /State /ZIP: Tigard, OR 97223 Furnace 100,000 BTU (duets/vents) 14,00
Furnace 100,000+ BTU U (duets /vents) 17 90
Suite/bldg. /apt. no.; Project name: µ
Gas heat pump 14.00
Cross street/directions to job site: _Duct work_ 14.00
'Mimic 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
Flue /vent for arty ... of above 10.00
Subdivision: . �. I Di no.: .,
- I4F ,t Other: 10.00
Tax map /parcel no.: Other bet appliances _
DESCRIPTION OF WORK - Water heater 10,00
Install gas line, vent and insert Flue fireplace I 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 tireplacc /insert 10.00
-
PROPERTY OWNER Chimney /liner /flue /vent 1 10.00 10.00
El
_- ❑ 'I'w;NANT 10.00
Name; Mark Rogers Environmental exhaust and ventilation
Address; Same all above Range hood /other kitchen T
equipment i 0.00
City /State/ZIP: Clothes dryer exhaust 10.00
-^ Single -duct exhaust (bathrooms,
Phone: (503)624 -6493 Fax: ( ) toilet compartments. utility roams) 6.80
® APPLICANT ❑ CONTACT PERSON Attic /crawlspacc fans 10.00
Other: 10.00
Business name: See Below _ ^ Fuel pi pin g
Contact name: 55.40 for first four; $1.00 for each additional
Furnace, etc.
Address: •• -- -
" "' -• •• . Gas heat pump _ ., . „...___
City /Stale /ZIP: Wall /suspended /unit heater
Phone: ( 1 LFax: ; ( 1 y - Water heater
Fireplace I 5.40
F,-mail: Range ..
CONTRACTOR Barbecue
Business name; All Fuel Installation and Service, LLC. Clothes dryer (gas)
Other:
Address: Pt) Box 69 MECHANICAL PERMIT FEES*
City /Stare /7,IP; 'Troutdale, OR 97060 Subtotal 25.40
Phone; (503) 674 -2350 Fax; (503) 674 -2693 Minimum permit fee ($72.50) 72.50
- Plan review (25% of permit fee)
CCB tic.: 169503 State surcharge (8 %ol'permit fee) 5.80
-" TOTAL PERMIT FEE 78.30
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Authorized signature ) - A_ I - t'J This permit application bas expires its permit if, nat obtained within 180
days a (ter it a beat accepted as complete.
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CITY ��`������������� _ _ —
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BUILDING DIVISION PERMIT #: AAEC2007-00745
13125 SW Hall Blvd., Tigar , OR 97223 DATE ISSUED: 1201/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 AS 1J1.
INSPECTION WORKSHEET FOR DATE: 12131/2007 TIME: 7:00AM PAGE: 27
SITE ADDRESS: 13705 SW 110TH AVE CLASS OF WORK:
SUBDIVISION: FAIRHAVEN COURT LOT #: DM TYPE OF USE:
PROJECT NAME: RoGERs
DESCRIPTION: G fireplace as line install.
OWNER: ROGERS, MARK PHONE #: 503-024-6499
CONTRACTOR: ALL FUEL INSTALLATION & SERVICE LLC PHONE #: 503-674-2350
Inspection Request Scheduled For: Date: 12/31/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 06234701 503-6742350 N
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Corrections/Comments/Instructions:
Covirsc./f-4)-
��
�� PASS El PARTIAL APPROVAL 0 CANCEL ri NO ACCESS
I FAIL | I CALL FOR INSPECTION pl ADDITIONAL FEES ASSESSED
Inspector: (-T�'L`��^^ L� Oate:17_131 / 0 - 7 Phone #: (503) 718-