Permit I r• 4+
C ITY OF TIGARD MECHANICAL PERMIT
" ' A ., COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00470
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/30/2007
PARCEL: 2S104AA -11500
SITE ADDRESS: 12415 SW 129TH AVE ZONING: R -4.5
SUBDIVISION: BELLWOOD NO. 3 LOT: 134 JURISDICTION: TIG
PROJECT: PHAM
Project Description: Install gas fireplace and flue vent, gas line already in place.
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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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 2
GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
PHAM, HOI BA AND Description Date Amount
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VU, KIM M X
12415 SW 129TH [MECH] Permit Fee 7/30/2007 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 7/30/2007 $5.80
Total $78.30
Phone:
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.
i
Issued By: J i /f/ .II. / / � // Permittee Signature: /440// � ( 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.
FRlOC : 'Hal F I REPLACE PHONE NO. : 15036269130 Jul . 30 2007 09: 00A1 P1
d
Mechanical Perni•i �
nr p : : :' FOR OFFICE USE ONLY • • : :
City of Tigard 11 �J 1 P m , i l No.:
13 ! 25 SW Hall Blvd., Ttgaid, OR y7 , - ,l 0 a' �JAIal
Plan Review
Phone: 503.639.4 171 Fax: 503.598.1960IL 1007 k,r a •A I) Other Permit
Inspection Line; 503,639.4175 J% �� 1);i uc:,d nt fv rix
",� %: Y Y: esPuke2
Intci net www.eiripsrd.oi.us t i ,i - fT r � ` S 4 ® � nodtie4/MfelhOd nr I 0 Su Supplerocnt,ll la(ormalias;
t�.>�'F"� ,��;s£" (',,� is �.�. ti / A, '}i "'!wi +' �_ �,.':„ cay�,'} � t + �. f r, : �;.r._ gy��t
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Mechanical permit fees• are based on the value of work
❑ New construction NI Addition /alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Denloliti (, ❑ Other ^ mechanical materials, eguiprnent, Tabor, overhead, and profit.
MT I N 1- arid 2- tfrnily dwelling ❑ Cpntrnerciul /industrial ❑ Accessory building • : ' • , >ar a . "` , `,' •
[II ❑ Master builder ❑ Other: For special itljorrxalivn use checklist.
Description 1 Qty. I La.. I Total
. ° h "1 . ', " rA t d ' ' 1 ',t Ta T 0 d c" ' Hearn' cooliu:
Job site address: i o0 tae /a J ^, Alt conditioning or heat pump
(requiras site eaa showi ace lent) 14.00
City / State/ZI t q at, t (), flac2 �V^ Furnace 100 000 BTU (duets/vents) 14,00
Furnace 100,000+ BTU (d,wts/vents)• 27,90
Suite/bldg. /apt. no.: • Project name: (jay heatpurnP 14.00
• ,. ' Cross streetldireotions do job:-aitc: Ductwork...
— ----'— FIydronic hot water system 14.00
Residential boiler (radiator or .
• hydrurl it,) 14.00
Unit heaters (firel - type, not cicetric)'
in- wpll,.in -duel, suspended, etc. ' ' 10,00
• Subdivision: Lot no.:
^" Flue/vent for an of above 10.00
Other: 10:00 '
Tax map /parcel no.: Other (feel a,Is lianccs
•
•
^.'4r yV• r .- , .LA Y V.1, Y jakfr4si 1 r' Water heater 10.00'
Gas fireplace A 10.00 0 %t'
Noluv n : Gut C vep\4L2 — ' O6 k tv\_ Lam-. Flue vent for water heater or gas • 6 0
u fireplaec f 10.00. 1a
. Log lighter ragas) 10.00
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Wood /pellet stove 10.00
• Wood fire .lace/insert 10.00 .
V w•r m'� r X55 ` z" Chi /
, y mne Itncr /fl u &vent 'LL
•r,, . e ther s ^ .t o A w a �u a. 1 � f9 ' y . J O "00
`` __ Other: 10.00 1
Name: r • Plant 1 Environmental exhaust and ventilation 1
Address: 1,(.1 iS • Q_ J g ,� � Range hood/other kitchen
a 10
Ciry/State/ZIP: T iaC1 e O j e 7aa3 Clothes dr r exhaust . i0.00 .
y G Single-duct exhaust (bathrooms,
Phone; ( ) 391,— lOO c� / Fax; ( ) toilet compartments, utility rooms) 6. 80
• I `MAIR z'M•y ' a !i a Atti(*raw's ace fans 10.00
tt.
d, . .
IIusiness name: Other; 10.00
i • a s ■ Yt` . Q.C. C 2
Fuel + ing
Contact name: �c
Q 1 A. --e. $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
116 S �.� e„ Gas heat urn.
City /State/ZIP: a. / v - v 776oS' W &Il /suspended/unit
Phone: (GO & (,,, ^ a __ _ Fax: : a3)� — I / 8 Water heater
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E -mail: ' f Range
�a T�� F�v cy Rang
t ., t> ,.cr., • 4 ga'. i ,'' Barbecue
. Business name: ,¢.. i..{� C� Clothes dr er ,as Ern=
�� ll _ Other �� �
. Address: c �1 La (1101, __ • i; a 5 a r°2 lM ' .
G ity /State /ZIT'{ ve d VY �� Subtotal p?O
// ,— / . / Mintinnurn er fee ($72.50) t 7
P■hone: ) 6 — `� a " ' Fax: (, Z (..
) ... 7/ ) r
.
Plan review (25% of pertnit fee)
!
CCB lie.: L e� ' i State surcharge (S% of permit fee) , g
TOTAL PERMIT C FEE 7 ;3:,
/• -� - This permit app8cativa expires If n permit Is not obtained within i $0
Authorized signature /
� .� �'i /� .
days after It has been accepted as complete.
a7 /it,�1 i I 5 4 e : 7 3 ' • 7 _ • Fee methodology sot by Tri -County Building Industry Scrvicc Boa,'d \
• :4 An; Mine \pwnniealMxc- Prm,ieA ,lnr. 11/ni 44e.4et7T C1t /ONCO 4,wPn1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 0Oi70
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/30/2007
Phone: (503) 639 -4171 iak
Inspection Requests (24 Hrs.): (503) 639 -4175 004.
INSPECTION WORKSHEET FOR DATE: 8/14/2007 TIME: 7:00AM PAGE:
SITE ADDRESS: 124166 SW 129TH AVE CLASS OF WORK:
SUBDIVISION: BELLWOOD NO. 3 LOT #: 134 TYPE OF USE:
PROJECT NAME: PHAM
DESCRIPTION: Install gas fireplace and flue vent, gas line already in place.
OWNER: PHAM, HOI BA AND, PHONE #:
CONTRACTOR: T & K MECHANICAL PHONE #: 503 - 626.4652
Inspection Request Scheduled For: Date: 8/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 053969 -01 503.844 -9173 Y
Corrections /Comments /Instructions:
P� ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
FAIL CALL FOR INSPECTION Li ADDITIONAL FEES ASSESSED
Inspector: /. Date: g 11 7 Phone #: (503) 718- 2-9'44'1