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Permit l II • i CITY TIGARD MECHANICAL PERMIT i . DEVELOPMENT SERVICES PERMIT #: MEC2005 -00478 `n °�II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 8/4/2005 PARCEL: 1S134DC-07100 SITE ADDRESS: 11675 SW GALLO AVE ZONING: R -4.5 SUBDIVISION: GALLOS VINEYARD LOT: 002 JURISDICTION: TIG • Project Description: Relocate gas line. 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: LPG 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 LEE, RAYMOND E + ARLEEN P Description Date Amount 11675 SW GALLO AVE [MECH] Permit Fee 8/4/2005 $72.50 TIGARD, OR 97223 [TAX] 8% State Surchar€ 8/4/2005 $5.80 Phone: 503- 624 -8238 Total $78.30 Contractor: ACKERMAN PLUMBING 14674 SE SUNNYSIDE RD. #159 REQUIRED ITEMS AND REPORTS CLAc rAPios ©R0 7 0 / 5 Phone: 503- 698 -2211 Reg #: LIC 136601 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: 4.,.. ��C., Permittee Signature:- G � �L�► -ITS 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. ./02/2005 23:03 5036985066 ACKERMAN PLUMBING SE .1 f .. :.i• „, , •,2•1i PAGE 01 ) 09:15 FAX 503598196 T. CITY OF TIGARD 0003 epz,4Nel) , Mechanical PennitiAtiblication FOR OFFICE USE OS LX • \I".' City of Tigard '0. * Received ir I , e , 5 - . Amer 'Permit No.: M # e "'CV ' r 13125 SW Hall Blvd,, Tigard. OR 97213 Phone: 503.639.4171 Fax: 503.598.1960A' 0 Other Pencie Inspection Line; 503.639,4175 0A 4 '6i.",'1'.i.l. 1 Internet wwci.tigarLorm 0 \ Gr'‘ ' .;:-. -1J1. pale Readyflily; Ell See Page 2 far I: w_es NI \S\ - •- 0\ ' t‘t0 V\I Notified/Mean* IM Supplemental Yureentetion 1' ." • : i• • • " • • ', • • ' • • : '• ',, ' , 11^4 i OF 'WORK ' i . ,. , . ,, ' : ' '' co ' : i Y`' ''... • 011)013a); 7, u,sellcus'r Wchanionl permit face* are hoed on the value of the work El New construction Addition/g1toralion/replacement performed. Indicate The value (rounded to the neatest dollin) of all 0 Demolition ID Other: mechanical In lisle ui ,9V_ ALL1pate abot overhead and rem . 'CIA.TE6ORY: EiF COKS • .',:. ..-'• ' - 1 '■ 1 - • •• , 0.040 Kirg ill - and 2 dwelling 0 Commercial/Indust:tint 0 Accessory building For specioi leormation use checklist I: Multi-filMillY 0 Master builder D Other. _ Deecription Fity.1 Ea. 1 Total ,._,. .. ' .1 ; : , ,, 4ott srrE ,t7,4moieroTrox AM) ioca.Tiorc,, ;., . . . . ' ..z.. ', - llengicoolino, , . .. Air conditioning or host pump Job site address: it 6 5" , - CA). ) 1 i i (require; lite plan showing placement) 14.00 City/State/UP; 1 401 - 223 Furnace 100,000 BTU (ducteiventa) 14.00 ' e...,1 t Furnace 100000+ BTUiduetstveorst 17.90 Suite/bldg./apt. gm.; Project name: Ceti_ Gas hot um 14.00 Cross street/dirt:tilting ro job site; Duet work . 14,00 l4ydrooic hot water t stem 14. Residential bailer (radiator or hydronic) 14.00 Unit heater, (fhel not electric). inewall, invduct sum n,ded. etc. 10_00 Flue/ vent for ay of above 1040 Subdivisicrn; I Lot no.: other: i 0,00 _ Tax map/parcel no.: Other fuel appliances 9,rater heater 10.00 DESCRIFtION OF WORK ; ' • ,. , • . . --- , 10.00 20-Ligi&Jeadlet. 02-.. ? CO Jitti G rructt la f; water beater or gas firoJace . 10.00 ,... ■••■ 1)214 lighter WO 1 0 ,0 0 - Wood/pellet stove _ 10,00 - --._.„.., Wood firsplace/inscit 10.00 5 7 •. APAOPER1* OWNER •:-. , .'. ; : 1 : ,, ,. . '. _ - , : . . , Cothhin;cy/linargluclvait 7.1 . — Environmental exhaust and ' ventilation 1—''--'-' Range hood/other kitchen 61A equipMent 1 10 O. . 00 °° _.., City/Slate/Z1P: Clothea r c•___hc, si exhaust (bathrooms, Phone: 42, ) k , •:g A 3 •, Fax! ( ) toilet c ompute:tem is, utility room) 6_80 t . La ;AO1t4cAiNt ' .: • , ,. 'i . ' ' ! Li. Col4tAcrortnsoN : ,.:1.-" ' Artiocraympaceam 10.00 Other: 10.00 Business name: ■■■•-•••••■■•• . Fuelpping C,ontact name; $5,40 ar first fbari21.00 for_eistLadditignu - - Furnace. etc. Adttot$: ' — — Gas heat pump City/Stutc/ZIP: 'Wall/trespeuded/unit heater .... Pb ane: ( ) 7 Fax: : ( ) Water heater -- — -- Fireplace E-tnail: Ran — _ • ' ' ' • • • •• ' • ' 'COriRACTOlti" s * .., ! . - . i Clceites d VVA,__ at1 ram k : a . / ... R , A . .41.1I.P. AA a Other M Atift Address: . .. t o / / iii 9 I • ' :,;.'.i , l';'IVTI;#41\711.04,PERMIT: FEES,' ......!../.....4.1. , .- ......', City/State/ZIP: Cbt Subtotal `.4. .1 • lvIlnimum porrnIt fce ($12.,50) 272, 6 77 Phow_Lp) ) i 9 I ,23.11 Fax; ( CO ) 69T- p .6 Plan review (25% apart fee) •"-- -----.. CCB 110-: f '? 4 .e — sp State surcharge (8% of' • • it fee . , o "DOTAL l'ERIMIT 1711Z18, 7? 3 Title pxi permit oprfollentlan umpires Ira permit 4 not tit:414MA within 180 AutttegiZed SigrAnlre! .. 5"/"Z u e .0 AIA days after a Ma been wowed 22 complei iit name: 5fejg,44 0 #16/1 Date:N.3_0s- • Per methodology set by VI /tackling Indury Service 3t4ird i CITY OF TIGARD -- .-. BUILDING DIVISION PERMIT #: MEC2005- 00478 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 8/4/2005 Phone: (503) 639 -4171 A ' /N pntAi'I Inspection Requests (24 Hrs.): (503) 639 -4175 °`__.. INSPECTION WORKSHEET FOR DATE: 8/19/2005 TIME: 7:07AM PAGE: 22 SITE ADDRESS: 11675 SW GALL O AVE CLASS OF WORK: SUBDIVISION: GALLOS VINEYARD LOT #: 002 TYPE OF -USE: PROJECT NAME: LEE DESCRIPTION: Relocate gas line. OWNER: LEE, RAYMOND E + ARLEEN P, PHONE #: 503.624 -8238 CONTRACTOR: ACKERMAN PLUMBING PHONE #: 503 - 698 -2211 Inspection Request Scheduled For: Date: 8/19/2005 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 013928 -01 503 - 698 -2211 N C /Comments /Instructions: • "'VI) L L crL /•GS ( s ) ' / G_ /7-- / , _ '- 5:9;r" P ,._3.14 , 1/4.,...„*(.441-.._ & --- /11- 7 p 57 ¢z. i. • PASS PARTIAL APPROVAL ❑ CANCEL NO ACCESS I I FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED I Inspector: i Date: — /F---6J Phone #: (503) 718- •