Permit MCITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00124
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 3/11/2008
PARCEL: 25111 CC - 19200
SITE ADDRESS: 10335 SW GREENLEAF TERR ZONING: R - 12
SUBDIVISION: SUMMERFIELD NO.5 LOT: 251 JURISDICTION: TIG
PROJECT: KILKENNY
Project Description: Replace gas log unit with gas fireplace.
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: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
JULIE KILKENNY Description Date Amount
10335 SW GREENLEAF TERR
TIGARD, OR 97224 [MECH] Permit Fee 3/11/2001: $72.50
[TAX] 12% State Surch 3/11/200E $8.70
Total $81.20
Phone: 503 - 624 - 3904
Contractor:
GAS PRO, INC.
7603 SE LOUNSBERRY LN
PORTLAND, OR 97206 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 - 775 -7020
FAX 503 -775 -7014
Reg #: LIC 167493
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 sregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. Y. m. obtain co..es %f these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344. co/ 1
..e
ed By: C Permittee Signature: , `� " Ai ,
Call 503.639.4175 by 7:00 a.m. for inspections that business da■
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 OFFICE LSE
City f Tigard D ',� � Permit No : /7 , f �n /I �� ....
and Date /By:
Pr
it 13125 SW Hall Blvd.. Tigard. OR 97223 Received Plan Review
Phone: X03.639.4171 Fax: 503.98.1960 Date/By: Other Permit:
TIGARD Inspection Line. 503.639.4175 Date Ready /By. luris: El See Page 2 for
Internet: www.tigard- or.gov Notified /Method: ��' Supplemental Information
'' " ": ' ..''': '` ^ TYPE OF WORK COMMERCIAL 'FEE*'SCHEDULEr- USE CHEGKI 1ST
❑ New construction Addition /alteration /replacement Mechanical permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition Other: mechanical materials, equipment, labor, overhead, and profit.
-....Q , ,„ , , � -.. : t ._ _ Value: $
zCATEGORY OF CONSTRUCTION" ` '
' "I
❑ ❑ Oth er: I- and 2- family dwelling ❑ Commercial /industrial I=1 Accessory building "�' RESI DENTIAL EQUIPMENTLSYSTEMS FEES*
Multi-family M aste r builder For special information use checklist.
Description Qty. Ea. Total
' • JOB .SITE INFORMATION AND LOCATION,'•• = 7 , `' Heating /cooling
Air conditioning or heat pump
Job site address: ` 0 33 O % e wv/ � (requires site plan showing placement) 14.00
City /State /ZIP: °% / 6 `/' 4 J 5 �� ell , , y�c�,�_ � �
Furnace 100,000 BTU (ducts /vents) 14.00
l� Furnace 100,000+ BTU (ducts /vents) 17.90
Suite /bldg. /apt. no.: Project name:
Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00 _
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. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
' . ,=DESCRIPTION OF .:WORK 4 -0 7 - °.' ;� Water heater 10.00
n Imo- Gas fireplace 10.00
/
/5 - ,ie F p LA f Flue vent for water heater or gas
llVii fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
r V., PROPERTY. OWNER fl' ;TENANT, n. °4 :
Other: 10.00
Name: t ` k i ke, et r r Environmental exhaust and ventilation
Range hood /other kitchen
Address:
P equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Phone: ( �d y 90 y Fax: ( ) toilet
Single-duct
compartments, utility rooms) 6.80
" t ° : -.�, ace fans 10.00 Attic /crawls
❑ APPLICANT` °'� ' ❑`"CONTACT•• ° 'PCRSON "" >" ` :. p
Business name: Other: 10.00
Fuel piping
Contact name: S5.40 for first four; 51.00 for each additional
Address:
Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
l � h
E -mai i
SpeciA 640 • L. * co v-._. Range
< CONTRACTOR, ^ ': Barbecue •
Clothes dryer (gas)
Business name: 6/ .ICU Other. Address: M ECHANICA,LP E RMITFEES *.
700 r 10�/rs ally Litt
City /State /ZIP: Ai ,i, i d O/ 4/ 'J a t Subtotal 7
Phone: ) ' ! Fax:') Minimum permit fee ($72.50) [/
(� — �� �� (5'03 ) �� � Plan review (25% of permit fee) -lei
CCB lie.: �� State surcharge (12% of permit fee) A . , 70
TOTAL PERMIT FEE g?, ``)
— ..... 'Phis permit a r tlication expires tires if a permit is not obtained within OM
signature: - : — `^
- days after it has been accepted as complete.
Print name: �° y _ A � _ - • p I
'Tan.. ' -- , o , , Date: * Fee methodology set by Tri- County Building Industry Service Board
i A Building VPermits \MEC- PermitApp.doc 01/19/07 440 -4617T (I I /02 /COM /WEB)
CITY OF TIGARD (-yam
BUILDING DIVISION PERMIT #:a pve.-ere, m 4/
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED:
Phone: (503) 639 -4171 A 4��ii� fll Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
SITE ADDRESS: /d 3 3 s p_A- CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 3 - /� — ae Pour Time:
Code # Inspection Description Confirm # Contact # Message CO-u0
,trr i-erict_e 6667_°/ 6 a - 3 ?40 � /l ac � , C.�12, L. L, 771-
Corrections /Comments /Instructions:
I
s.
•
•
4 - pAss ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
n FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
,
Inspector: � /L� C)ti.
D . I Phone #: (503) 718 lc-i?_>"