Permit `yk.. .1 CITY OF TIGARD
iii
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00590
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/10/2007
PARCEL: 2S 104AB -05400
SITE ADDRESS: 12235 SW 131ST AVE ZONING: R -4.5
SUBDIVISION: MORNING HILL NO. 4 LOT: 083 JURISDICTION: TIG
PROJECT: ROBINSON
Project Description: Install gas line and range.
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: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
ROBISON, ERIC S + PAMELA R Description Date Amount
- 12235 SW 131ST AVE
TIGARD, OR 97223 [MECH] Permit Fee 10/10/20C $72.50
[TAX] 8% State Surcha 10/10/20( $5.80
Phone: Total $78.30
Contractor: •
A 1 INSTALLATIONS
8116 SW DURHAM RD
TIGARD, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -620 -5657
FAX 503- 620 -1696
Reg #: LIC 150109
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: j/ L �Permittee Signature: 0.k J / fr12 /i ' f -t
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.
Mechanical Permit Application FOR t)TCrf.:l;' c S[: ON l.T'
r . i . ' ' City o f Tigard � a,
,. 1 '. a 'Received 9
II ; '"Date/13y: 1 Q Q Permit No.: A / // r ��� / O
13 SW ball Blvd„ Tigard, oR 7 23 z -, Plan n Review / ��'rrJ
. Pho 503,639,4171 Fax: . 513.508719R t'0 Pl Date/By: other Permit:
t , �
r . A l' D Inspection Linc: 503,639,4I75 t! 2U�1 gc z for
Internet; www.tigard- or OCT y Data Reedy / »y 7u rin: m See 1'n
Notified/ Method: 776' SupplemontalInformation
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❑ Demolition j] Oth
performed, indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit.
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kl 1 and 2 -fami) dwelling Commercial/industrial ❑ Acccssory L ?;j f . .l Z1 1yj j} '"1��J�t" *
2-family it ❑ 1a1 ,• n t;Y,:r u 1 , t�
la' ACCC530 ... ,., I• a ' n r ,.•.,, « ;,r..,...,.,; : ..
0 Multi -family Master builder For special information uve checklist.
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Job site address: 1' - 3 S S'C Air conditioning or heat pump
(requires site plan showing placement) 14,00
City /State /ZIP: 1lalt:,�' Q.lI '" d ) . Furnace I00,000 BTU (duels /vents) T4,00
Suite/bldg. /apt, no 1: Project name: ` � 0� Furnace 1.00,000+ BTU (duets/vents) I 7.90
D LK Gas heat om 14,00
Cross street/directions to job site; Duct work 14,00
Hydronie hot water system 14.00
Residential boiler (radiator or
I hydronic) 14.00
Unit heaters (fuel -type, not electric), •
— • in -wall, in -duct, suspended, etc. 10.00
Subdivision: J Lot no.; Flue /vent for an of above 10.00
Other; 10,00
Tax map /parcel no.,
r; Y;; no.: , i � Other fuel appliances •
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1 , .i' 1 , ) � t1' ! ,,1~;� LV14317;'1!!,r� t-1 �, ti I' 1 ou s rr. ', • i. hector
- , � $ + iabi: . i'•tS ,,� f�. ,tptili� !� N:, Iii �� C'i, A SA��' tt :' (d
''tor i u ,. � ,,� . u '•e�wu�i�ryw•,1 "-��nrcauu,l�rt +K li$�i 1'aiSi',,;'k,'71 tl }�'�nleY,;IS? '' l 1 '�`.�� 1 O.Of)
;i
I ei,;i,�i�. _
[' JL. # Gas Water fireplace 10,00
E P ltl Flue vent for water heater or gas
VVV fireplace 10.00
Log light ( gas) 1 0.00
Wood/pclict stove _ I0.00
•
Wood fireplace/insert 10.00
i. "''' S:Y• I ;1R.1'IC:i:. �y;;;��q I , "nN; 'i' , 2 1; ' +;'.I;E S+i? E� ' . "i "l. "-;17r:' ; :;;, Chimnc /liner /flue/vent
': , ba °'l:�:. :'��V",'- I ;P.*.. ri{ ., '� . i, f,'ly 1 1 t , l n C t,r,,,, y 10.00
d . .
Ea:tE,a Other. J J 10.00
Name:
d `b Sot' - .. Environmental exhaust and ventilation
Address: (7'.35 SW 13 / s Range hood /other kitchen
— equipment 10.00
City /Stake /ZIP: \ , • Cs Oft 9-1-3a 3 Clothes dryer exhaust 10.00
Phone: Y S Q Pax: ( ) exhaust (bathrooms,
( m3) 1 Single-duct roc
ms) 6.80
compartments, utility roo
.. '.:Iri 1 :ii! i '!1 "e'i IF, } ' y iG• ''ATrik��- ti: ulil' ` ila :� t 1'� :11 :6 ;�;; i ,f„ „ „ p„ ' loiter compartments,
.+. ..,:, .,f!tf ' : r .;#httaG∎c,�sli,,!;'ii;.11 y ' tl`S 1i'T, 1,1,,4 ,, tt' ,. 'd. , 1( �,,„1/ "• ;(iFt; k y, Attia/ctawlspacefans 1000
„s� 11, t i i,
Business name: A • _ Other;
• 10,00
e. • r F ` Fuel piping
Contact name: _
✓v - 1'4r1 1 ti,‘ $5.40 for first four; $1.00 for each additiona
Address; an l L Sy-) r N1 it.,1 Furnnrc, cte.
City/State/ZIP: �`[ ■ / , Gas heat pump
`� ∎ ` C � 2 t _Wall /suspended/unit heater
Phone: ( 5C3 ) (o) S6 5 1 Fax: ; ( )c ;x 41 4 Water heater_
E -mail: 1 10 G , , CANS — Fireplace
y',' ; cl; u;r ,t q' , ; „ v , 101' I Range 1 —
?iU ,;},, (, ..... i' . i'kl'rS't;titi ,11 i itfd,l f , „a;«.: tope II :'.i ` „r
jigs:, i;: ry ? 11ft,.,, ., I •;;;, A t -.... `NI 1,; E'3'r}„t,,.,.. Barbecue
Business name :
t r �'��, s'. t..;,�,t;ii� 1: Vii. �:'t: •. �,
” Clothes dryer (gas)
Addrcss; — ` Other: —
City/Statc/Z1P: d,, t±C`y��f`['s5..
S°`i' ' 1:f; }i:rl �• cart: y. r n � '• t ,71nc•+ -t r.l.. • I: },:�
-- Subtotal
Phone: ( ) Fax: ( ) Minimum
inimum permit fee ($72,50) _
r l . / Plan review (25% of permit fee)
CCI3 iic.
SO 4 /�"f State surcharge (8% of permit fee) S
• + TOTAL PER IT FEE 78 3a
Authorized signatures This permit application expires if a permit is not obtained within ISO
!- days After it has been accepted as complete.
print name: fi ' ` _._ . j pate; to/ Q / 7 ' Fcc mcthodobgy act by Tri- County Building Industry Service Board
1 : \BuiIdinR \Permits \ME;C- 06rmitApp,dpc 04 /06/06 440-4617T /o2/COM/tvg.B)
CITY O D ``"
BUILDING DIVISION PERMIT #: MEC2007-00590
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 10/10/2007
Phone: (503) 639 -4171 .s telli �
Inspection Requests (24 Hrs.): (503) 639 -4175 ! ° =__..
INSPECTION WORKSHEET FOR DATE: 11/15/2007 TIME: 7701AM PAGE: 53
SITE ADDRESS: 12235 SW 131ST AVE CLASS OF WORK:
SUBDIVISION: MORNING HILL NO, 4 LOT #: 083 TYPE OF USE:
PROJECT NAME: ROBINSON
DESCRIPTION: Install gas line and range.
OWNER: ROBISON, ERIC S 4. PAMELA R, PHONE #:
CONTRACTOR: A 1 INSTALLATIONS PHONE #: 503-620-5657
Inspection Request Scheduled For: Date: /1/1512007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 059684 -01 503.709.4702 V
Corrections/Comments/Instructions:
iU or /Comments /Instructions: P
E;11 1 SMA. L. 4 i ? - �` ; -4et16- 7 S C •GS
.../
PAS ❑ PARTIAL APPROVAL n CANCEL 421 ACCESS
FAIL r CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: I f 7 Phone #: (503) 718- .. -4- -f-5�
� ' , . '`
CITY OF ~ ' ` r
��n n m n��u TIGARD `'
BUILDING DIVISION PERMIT #: WM007'00690
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/10/2007
Phone: (503) 639-4171 -4 , 0 1141i i
Inspection Requests (24 Hrs.): (503) 639-4175 a�@�~ "�1..
INSPECTION WORKSHEET FOR DATE: 1/14/2009 TIME: 7:04AM PAGE: 24
SITE ADDRESS: 1 7Z35EWj318TAVE CLASS OF WORK:
SUBDIVISION: MORNING HILL NO. 4 LOT #: 083 TYPE OF USE:
PROJECT NAME: ROBINSON
DESCRIPTION: Install gas line and range.
OWNER: ROEQB0N. ERIC S+ PAMELA R. PHONE #:
CONTRACTOR: A 1 INSTALLATIONS PHONE #: 503-620-5657
Inspection Request Scheduled For: Date: 1/14y2008 Pour Time:
{}ode # Inspection Description Confirm # Contact # Message
699 Mechanical final 060150-01 503-524-786 N
Corrections/Comments/Instructions:
=° `'~ �v-^^^�L� m�7 � —' �� ^" ���^ ' \
� — '~^~� `'~~~^�"^ �°� --, ^� w �"°-^ ' ` ^~° '" ° ' ' "~'--~~~--
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/~ k r......./L-A 9/1.—)
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��
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PASS PARTIAL CANCEL ri NC]ACCESS
--` __
| I FAIL ri CALL FOR INSPECTION [I ADDITIONAL FEES ASSESSED
Inspector: 67 ■ VU-- Date: / l /U''~q) Phone #: /503\ 718-
CITY i . D . • __ .
BUILDING DIVISION PERMIT #: MFC2007 -00590 •
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10/10/2007
Phone: (503) 639 -4171 4
Inspection Requests (24 Hrs.): (503) 639 -4175 4.' W ' LL ■
INSPECTION WORKSHEET FOR DATE: 10/23/2007 TIME: 7:00AM PAGE: 69
SITE ADDRESS: 12235 SW 131ST AVE CLASS OF WORK:
SUBDIVISION: MORNING HILL NO. 4 LOT #: 083 TYPE OF USE:
PROJECT NAME: ROBINSON
DESCRIPTION: Install gas line and range.
OWNER: ROBISON, ERIC S .1- PAMELA R, PHONE #:
CONTRACTOR: A 1 INSTALLATIONS PHONE #: 503 - 620 -5657
Inspection Request Scheduled For: Date: 10/23/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
• 699 Mo hanical final 058091 -01 503- 524-7859 N
10 qa 621. el -A-a >
I orrections /Comments /Instructions:
A :I/. i.e/a • I' s.
-4 - a 1 le e''. ::
7 ,,es. ;: i . ?„-;,- e, . - - ...a.,_,
ASS III PARTIAL APPROVAL El CANCEL n NO ACCESS
I F AIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date:/b- '�-- .. Phone #: (503) 718 - f'4-