Permit ra
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CITY TIGARD MECHANICAL PERMIT
,� DEVELOPMENT SERVICES PERMIT #: MEC2006 -00335
,;��I DATE ISSUED: 7/21/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S111CC 00800
SITE ADDRESS: 10115 SW CENTURY OAK DR ZONING: R -7
SUBDIVISION: SUMMERFIELD LOT: 005 JURISDICTION: TIG
Project Description: Gas piping to range.
CLASS OF WORK: OTR 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:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
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FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
SANDRA NYLEEN Description Date Amount
10115 SW CENTURY OAK DR
- TIGARD, OR 97224 [MECH] Permit Fee 7/21/200E $72.50
[TAX] 8% State Surcha 7/21/200E $5.80
Total $78.30
Phone: 503- 314 -4899
Contractor:
SUBURBAN @ HOME
6014 NE 112TH AVE.
PORTLAND, OR 97220 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 257 -5438
FAX 503- 257 -5430
Reg #: LIC 143335
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.
7. Signature:
Issued By: _� Permittee e — %l
Call 503 - 639 -4175 by 7:00 a.m. for inspectio that business
This permit card shall be kept in a conspicuous place on thb site until co • - ion of the project.
Approved plans are required on the job site at a time of each i spection.
•
..4,1 21 06 12: 20p p. 1
Mechanical Permit Application FOR OFFICE USE ONLY
Cllr Of a fJl Received
Date/By' (1 7-, -O ! I ' t. 4 P emilt N° V% ti �^'► V 1
13125 SW Hall il Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598,1960 PlanRwiew
:pi�' +j > DatelBy Other Permit:
Inspection Line: 503.639.4175 1 Date Read /D
Internet: www.ci.tigard.or.us ^� ` - -�+ y r E1 See Page 1 for
Notified/Method: Egla Supplemental Information
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❑ New construction L4f' Addition/alteration/reptacement Mechanical permit fees* are based on the value of the work 4
//����"` performed. Indicate the value (rounded to the nearest dollar
D Demolition Other: h ( dollar) of all
mechanical materials, labor, overhead,
si .,... 1.. 1.f }.y l �Y 1.^ �It":t:..: �::� „ ♦,` _
and profit
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Value. $
and 2 -famil dwelling t ' - ' JME _ ;-":W - „ . TE ' *? ` '; ?` c
Y �' B ❑Commercial /industrial ❑ Accessory building _ '+ .�. ...,.., t:« �,-•.. i � '
For special information use checklist.
❑ Multi - family ❑ Master builder El
st;Ei7� i! ;!;,,. Description I Qty Ea. Total
..i. i;' ii -
. i• : 4013: pt,,,;;;,
iii' 'A.,li ►�`L'r; � i'v : `: r4i..... ,t - iii �''., r-�..
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_!:.,,.-��:_.,.......... .;, - . :.:;, Heating/ cooling ,
Job site address: i 0115 S C e t / dot V lb l'. Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: e�c,,,t`c& r 0e-- q �ZZL/ Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bld / aP no.: JJ t. I Furnace 100,000+ BTU (ducts/vents) 17,90
g• Project name:
Gas heat pump 14.00
Cross street/directions to job site: Ductwork 14.00
Hydronic 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
Subdivision: f Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map/parcel no.: Other fuel appliances
..4,.:., , , : - . .. ... ,,,•,.,. .
,-,.. ,. ...,:.,,- , is yii;ia- heat" 10.00
:::�ti+'::': 61;?:':i` � � ` +i!aS.:f; -'t.::;::. Wa ter he la
,,. ... , . .., ,, ,.r, ..,, .. -.•1 .....,...,., ' e t li u is� ! gi " ^::i�? �'
C9-(&5 Gas fireplace 10.00
C Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove _ 10.00 '
Wood fireplace/insert 10.00
!i ` �
�tI�r,, Chimney/liner/flue/vent Yy ,,�_,. ,.., ii � �• � S : iFr,i'r.- Cyn 10.00
• :riF::: .: . 1. OPE T :: .,.'.rY �E ":I '..,. - .;!!-
c c :...:........... . r.:::'i •i °i t1s: + ..: and ventilation
' Other: .
Name:
L' ✓I Environmental exhaust ' atio n
Address: 1 G 0 Range hood/other kitchen
i I 1 S 9 i� j u'n C _ LJ equipment 10.00
City/State/ZIP: „,--e..A l OR_ - - 4 --ZZLJ Clothes dryer exhaust 10.00
JJJJ 7 Single - duct exhaust (bathrooms,
Phone: (503 ) 31 Li _. 1.1 ,cfCi Fax: ( ) toilet compartments, utility rooms) 6.80
. .
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„ ..1....,.}......_.. ., ..._ ,• ............. '` ,.Q �!:i;:'i Attic/crawlspace fans 10,00
Business Warn -
lik -C
`- C L1 Other: 10.00
Fuel piping
Contact name t� Vtr k �V,, $5.40 for first four; $1.00 for each additional
Address: C - )lX-.\ 1 e) \ 1a \Y1 n 1 r _ 1 /� t (� , Furnace, etc,
d -{ l 0,--L, �J�Y .
i>sz C ) Gas heat us pump
City/State/Z11 \
V`-� Wall/suspended/unit heater
Phone: 5 L- I Fax: ; �. c7� , b1 .- C � ]Z r1 Water heater
E-mail: `"'t °fJ�F C) ►Vt-J Fireplace
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_ ,.., . - .,,,,... :•..:- .... ............ ............ 111:.,. ! ,. :- t. Barbecue
Business name: - �� Clothes dryer (gas)
Address_ (. Other:
city /State/Z - ��!`( `� OR 5:..) ....,t!- ;tt,:i,..,.. ME ::.,..:.:ICAI i p I Nl iii *S 7: <:c ,:
G ���JV Fax ($72,50) 4 ,
Subtotal S �L).0 Phone 1C �� Mini permit fee 'J�
Plan review (25% of permit fee)
CCB tic.: � �� - 7 - )S State surcharge (8% of permit fee) 4 S• cb 7
TOTAL PERMIT FEE 1
Authorized signatur 4,...____ This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: 1 pe (lam Om. !`t s° Date: ,...1,..{i I LI 2 19(96 * Fcc methodology set by Tri•Couoty Building Industry Service Board
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CITY OFI IGARD .` ' , .
BUILDING DIVISION PERMIT #: MEC2006 -00335
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/21/2006
• Phone: (503) 639 -4171 / a i r g 4�uy����'J i II�,
Inspection Requests (24 Hrs.): (503) 639 -4175 J
INSPECTION WORKSHEET FOR DATE: 7/24/2006 TIME: 7 : 01AM PAGE: 25
SITE ADDRESS: 10115 SW CENTURY OAK DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: 005 TYPE OF USE:
PROJECT NAME: NYLEEN
DESCRIPTION: Gas piping to range.
OWNER: NYLEEN, SANDRA PHONE #: 503 - 314-4899
CONTRACTOR: SUBURBAN @ HOME PHONE #: 503. 257 - 5438
Inspection Request Scheduled For: Date: 7t2412006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 033573.01 503257 -5438 Y
Corrections /Comments /Instructions:
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❑ PASS I PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
AIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
i
Inspector: fi Date: `7- -24—p,b Phone #: (503) 718- Z`��-
• CITY-OFTIGARD
BUILDING DIVISION
PERMIT #: MEC2006-00335
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED.: 7/21/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 7/26/2006 TIME: 7:07AM PAGE: 84
SITE ADDRESS: 10115 SW CENTURY OAK DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: 005 TYPE OF USE:
PROJECT NAME: NYLEEN
DESCRIPTION: Gas piping to range.
OWNER: NYLEEN, SANDRA PHONE #: 503-3144899
CONTRACTOR: SUBURBAN @) HOME PHONE #: 503
Inspection Request Scheduled For: Date: 7/26/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 033717-01 503-314-4899
Corrections/Comments/Instructions:
•
p -ASS fl PARTIAL APPROVAL L1 CANCEL pi NO ACCESS
I I FAIL El CALL FOR INSPECTION pi ADDITIONAL FEES ASSESSED
Inspector: Date: 7. Phone #: (503) 718-