Permit M CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00214
TIGARD DATE ISSUED: 5/2/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S133DD-12500
SITE ADDRESS: 11945 SW 126TH PL ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT: 162 JURISDICTION: TIG
PROJECT: RAMSDEN
Project Description: Replace range hood in kitchen.
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: 1
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
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:
Owner: FEES
DEBBIE & DANA RAMS DEN Description Date Amount
11945 SW 126TH PL
TIGARD, OR 97223 [MECH] Permit Fee 5/2/2008 $72.50
[TAX] 12% State Surchai 5/2/2008 $8.70
Phone: 503- 691 -6075
Total $81.20
Contractor:
BRIAN R PASCOE CIONSTRUCTION
30950 SW WILLAMETTE WAY WEST
WILSONVILLE, OR 97070 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -522 -8600
FAX 503- 682 -3433
Reg #: LIC 95102
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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
Issued : : ` / j Permittee Signatur g fi r/ •
Call 503.639.4175 by 7:00 a.m. for inspections that bu : ness day.
This permit card shall be kept in a conspicuous place on the job sit ntil completion of the project.
Approved plans are required on the job site at the time of each inspection.
rt , Apr 28 08 11:50a Brian Pascoe 503- 682 -3433 p.3
•
Mechanical Permit Application R-° , ' • FOR OFFICE LE,ONLV
< City of Tigard CE VJ R ue r n y: i P it N. e - , (� evO //
• 1125 SW Hall Blvd., Tigard, OR ' 14 i - y �� �& 7 6
'P I Phone: 503.639.4171 Fax: 503,59 :.1 5.5- Plan Review Oil iii
Pennic
Inspection Line: 175
QOQ n,tcr By
TIGARD specon ne: 503.639.4 (1 `Z O pale tread /By
PR i7
Interne 0 u Scc e Pant t 2 for
t wwvv.tiP,ard- or.gov (� Nori6cdtMethod, �'
n / Spplmenal Infurmaiion
•
n GAIBV) TYPE OF W(�(., �S Q Ni ,. SIGN COMMERCIAL FEE' S(:NEDLILE - USE CHECKLIST
❑ New construction ix Addition alt �� a � ,v � Mechanical permit lees* arc based on the value of the work
. •- (ND ,, ti performed. Indicate the virtue (rounded to the nearest dollar) ofall
❑ Demolition ❑ Other: le17 - mechanical materials, ego i paten l_ labor, overhead, and profit.
CATEGORY OF ('ONSTRUCTI N Value: S
dwelling RESIDENTIAL EQUIPMENT/ SYSTEMS FEES"
1 -and 2 g ❑ Commercial /industrial ❑ Accessory building
For special infnrnrution use checklist.
['Multi ❑ Master builder ❑ Other:
Description Qty. - Total
JOB SITE INFORMATION AND LOCATION Ileating /cooling
Job site address: i J 14 5 5 i a 4,_A- Ep e,� Air conditioning or heat pump
•
1 �/ [ (icquires sue plan shu ing placement _ 14.00
City /State/ZIP: et /'G/ 0 2 Furnace 100,000 B'I 14 00
Suite/bldg. /apt. no.: - 1 Project name: t f �C / ice
Pomace 100.000+ 13TU (duets vows) 17.90
`� Gas heal pump 14.00
Cross street /directions to job site: SC (S � j / S c i j a., Duel work - 111.00
i t ti l - lLe , / Hydranic lint water system 14.00
J �,
/2 / e 7 4 lvY j� S t Z Residential boiler ( radiator or •
6 , /c4c- , hydrunic) 14.00
Unit heaters (fuel -type. not electric),
in -wall, in -duct. suspended. etc. 14.00
Subdivision: Flue /vent fur any or above 6.80
Lot no.: -
Olher: 10 00
Tax map/parcel no.: Other fuel appliances
/�,,
DESCRIPTION Water heater 10.00
TION OF WORK j -
/ICL LE. �, .e-pIie GZCJ l / Q., ,_ F iu e c e nt i / 10.00
T J7 r Flue cent for surer heater or gas
fireplace 10
( Z `� ) /7 l) Lo od s t o 10.00
¢- � ,c.•_ f�y'µ octal) Wood /pelletstovc: 10.00
•
Wood fireplace /insert 10.00
PROPERTY OWNER
I TENANT
Chimi icy /liner /Iluc /vent
Other: 10.00
' N " ,l 10.00
Name: bietrkJt.e ti ...A4 VGt.,,c_ QQ
�n.,.a.SCC@y''- _ Environmental exhaust and ventilation
Address: ' i ci i 5 ! a 6. 4.4, of 0. G equipment hood /other kitchen
1 �� equipment 10.00
City /State /ZIP: 7 «rc Gn Clothes dryer exhaust 10.00
Phone: ()3) 6,,l_ �o75 Fax: ( ) Single-duct ecomp rt uoon
loiter compartments, utility rooms) 6.80
UZI APPLICANT ❑ CONTACT PERSON Ailie/crawlspace fans 10
Business name:
Other: 10.00
6,„,,,,.,-,_ A c ,c (Q
�!', rJ
l Fuel piping
Contact name: • Z 4,4._ ,:;..5`t t)� 55,40 for first four; 51.00 for each additional
Address: _ faware, etc.
11 Gas heat pump
City /State /ZIP: 5 1 L
C -;_.(e- .- WalFsuspended /unit healer
Phone: ( ) .1 Fax: : ( ) Water heater
' E - mail: /,
I ircplace
: / get S d:ue (a: v / 36210 n.. `_
Range
CONTRACTOR Bart x:tie
Business name: /
Clothes dryer (psi BYcc4.ti. u „.vL C v ,,si,✓�/ -cci?t
Other:
Address: (6s 5.4 L - ,, E le/c, 1 '-- A 1 1tF :('IAv1C :CI. PERMIT FEES=
City /State/ZIP: 4.- y /State/ZIP: ca4.--).1 0 ( c rz ,76 7 U Subtotal
Phone: ( 5 5 Li- 8� Cc: Fax: (5,.;3) ( 2- -,3'r ., > Minimum permit fee (S72.50) '72
Plan review (25 %ter permit fee) - ; 7
CCB lie.: Y SLL �� /5/06/09 State surcharge (12 %of permit li:c) .
j/ /� 1 J TOTAL, PERMIT FEET
Authorized signature Z% This permit application espi res if a penal) is nil obtain within I80
I r '' . - dads after it has been accepted as complete.
Prim ^ ° • .0 / A 4 - e I n 4/2_,,,,._ `. , I • p mcthoduloev set by TO-County Nuilaine Industry Service 11o00
l
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008 -00214
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/2/2008
Phone: (503) 639- 4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 6/20/2008 TIME: 7:02AM PAGE: 13
SITE ADDRESS: 119!15 SW 126TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 162 TYPE OF USE:
PROJECT NAME: RAMSDEN
DESCRIPTION: Replace range hood in kitchen.
OWNER: RAMSDk.N„ DEBBIE & DANA PHONE #: 503-691-6075
CONTRACTOR: BRIAN R PASCOE CIONSTRUCTION PHONE #: 503. 522 -8600
Inspection Request Scheduled For: Date: 6/2012008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 071658 -01 503. 522 - 8600 Y
Corrections /Comments /Instructions:
L PASS ❑ PARTIAL APPROVAL ❑ CANCEL NO ACCESS
❑ FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: 6 ° ' O 2 Phone #: (503) 718- '2-(P1 1/
,, CITY; OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008-00214
p. 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 5/2/2008
Phone: (503) 639 -4171 / u ulpiq�l lilt`
Inspection Requests (24 Hrs.): (503) 639 -4175 =�1
INSPECTION WORKSHEET FOR DATE: 6.212008 TIME: 7:02AM PAGE: 1
SITE ADDRESS: 11945 SW 126TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 162 TYPE OF USE:
PROJECT NAME: RAMSDEN
DESCRIPTION: Replace range hood in kitchen.
OWNER: RAMSDEN, DEBBIE & DANA PHONE #: 503691 -6075
CONTRACTOR: BRIAN R PASCOE CIONSTRUCTION PHONE #: 503 -522 -8600
Inspection Request Scheduled For: Date: 6!712000 Pour Time:
Code # Inspection Description Confirm # Contact # Message
599 Mechanical final 070659 -01 503-522 -8600 Y
Corrections /Comments/ Instructions:
•
n PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: A Date: Z--.= s Phone #: (503) 718-