Permit - CITY OF T
171 CITY O 1 TIGARD GARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00695
TiGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/28/2007
PARCEL: 1 S 134BD -04000
SITE ADDRESS: 11930 SW HAZELWOOD LP ZONING: R -4.5
SUBDIVISION: ENGLEWOOD NO.2 LOT: 128 JURISDICTION: TIG
PROJECT: SOWER
Project Description: Gas line to range, garage. Range exhaust .
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:
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: 1
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
KEN& CHRISTY SOWER Description Date Amount
11930 SW HAZELWOOD LOOP
TIGARD, OR 97223 [MECH] Permit Fee 11/28/20C $72.50
[TAX] 8% State Surcha 11/28/20C $5.80
Total $78.30
Phone: 503 -579 -5424
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact #:
Reg #:
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: / - Permittee Signature;, 4.
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 A s di ,!..„, ;LI
EIRE® Received s .OR :OFFICE USE ONLY
City of Tigard y / �!o Permit Notf�/� ` . 0a ... , �
IN �
13125 SW Hall Blvd., Tigard, OR 97223 '• xG
Plan Review
. 11 : -: - Phone: 503.639.4171 Fax: 503.598.1'1 v V�6 2007
Date/By: Other Permit
1 Y
Inspection Line: 503.639.4175 L' Date Read /B El Se Page 2 for
TIGARD Ready /By. g
Internet: www.tigard- or.gov � OF rrGARo Notified /Method: Supplemental Information
R V l /Mf NG DIVISION
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
El New construction Af 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.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
0.1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: • Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
� Air conditioning or heat pump
Job site address:
1? 34) Si/ /44 a /UDdd G� (requires site plan showing placement) 14.00
City /State /ZIP: T f 4/n/ 4 .??-22,3 Furnace 100,000 BTU (ducts /vents) 14.00
9 ) Furnace 100,000+ BTU (ducts /vents) 17.90
Suite /bldg- /apt- no.: Project name: Fe.� e„/ /
,die e /
�t Gas heat pump 14.00
Cross street/directions to job site. SG) S O Duct work 14.00
/ fie- '44
1 Wale / Hydronic hot water system 14.00
<t) /a / s/ 7 S(J S , "l ev 7v 41/Vid Residential boiler (radiator or
/ hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
/ j Gas fireplace 10.00
re, bfre e)( n / g e f ec -t/-,c r1�N5'e !J /(eJ�YW/ D!/M/ ; cad / .( k,t 4t Flue vent for water heater or gas
/ j fireplace 10.00
7-15 C o n te- IT 't ex /1 ALiS7 At' a 1,_ !yye 5'I /e e - v ter - r,l Log lighter (gas) 10.00
/ MI/ � rari e-e5 ivet✓ . r / /ye t't ,-' �'+ e-- la � e kAe Wood /pellet stove 10.00
-4" �X ti 2✓J't VeA/I 7 % (,,/7 /l Wood fireplace /insert 10.00
f Chimney /liner /flue /vent 10.00
54PROPERTY OWNER ❑ TENANT
Other: 10.00
Name: / l&j i v i.. r,3, fy SOej f" Environmental exhaust and ventilation
Address: V q j Range hood /other kitchen
/ [ ! 3D S6) /rje /✓�dB al !iD equipment 10.00
City /State /ZIP: - 7 — / / , , ,, v -,...) e0 / /`j y7� / Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: s 3 ) 52 � ._ j 'Z re Fax: ( ) toilet compartments, utility rooms) 6.80
0 APP LICANT / El CONTACT PERSON Attic /crawlspace fans 10.00
Other: 10.00
/ /
Business name: /y
� T d e/l y file. /A/[' ' Fuel piping
Contact name: / S $5.40 for first four; $1.00 for each additional
Address: l it Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended /unit heater
Phone: ( ) Fax: : ( )
Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: LP WO" e,.' Clothes dryer (gas)
Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE � 3o
This p ermit application expires if a permit is not obtained within 180
Authorized signature:
days after it has been accepted as complete.
Print name: ' / k .S`J6.)i2 Date: y . 2 , 7 * Fee methodology set by Tri- County Building Industry Service Board
1. \Budding \Permits \MEC PernntApp doc 04/06/06 440 -46t7T (I1 /02 /COM/WEB)
CITY OF TIGARD
BUILDING DIVISION
Alk PERMIT #: iViEC2007-00695
13125 S D ATE tV Hall 'Blvd., Tigard, OR 97223 E ISSUED: 11/28/2007
Phone: (503) 639-4171 hoinigmA i Inspection Requests Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 5/30/2008 TIME: 7:01AM PAGE: 59
SITE ADDRESS: 11930 SW FIAZELWOOD LP CLASS OF WORK:
SUBDIVISION: ENGLEWOOD I\10.2 LOT #: 128 TYPE OF USE:
PROJECT NAME: SOWER
DESCRIPTION: Gas line to range, garage. Range exhaust .
OWNER: SOWER, KEN& CHRIST PHONE #: 503-579-5424
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 5/30/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 070541-01 503-579-5424 N
Corrections/Comments/Instructions:
PARTIAL APPROVAL El CANCEL n NO ACCESS
n FAIL El CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: IP Date: 8 Phone #: (503) 718- ti-4-15----
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00695
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11129/2007
Phone: (503) 639 -4171 - 4 2t#04111`r.
Inspection Requests (24 Hrs.): (503) 639 -4175 __..
INSPECTION WORKSHEET FOR DATE: 5/30/2008 TIME: 7:01AM PAGE: 68
•
SITE ADDRESS: 11930 SW HAZEL WOOD LP CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.2 LOT #: 128 TYPE OF USE:
PROJECT NAME: SOWER
DESCRIPTION: Gas line to range, garage. Range exhaust .
OWNER: SOWER, KEN& CHRISTY PHONE #: 503- 579 -5424
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 5/3012008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
GAO Exhaust. hood 070541 -02 503 -679 -5424 hJ
Corrections /Comments /Instructions:
•
•
•
PASS n PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL n CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date: ��"° �' Phone #: (503) 718- Z4-
CITY OF TIGARD .
BUILDING DIVISION PERMIT #: MEC2007- 00535
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/28/2007
Phone: (503) 639 - 4171 °�piigliliiI'�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 5/30/2008 TIME: 7 :01AM PAGE: 57
SITE ADDRESS: 11930 SW HAZELWOOD LP CLASS OF WORK:
SUBDIVISION: ENGLEWSOD NO.2 LOT #: 128 TYPE OF USE:
:
PROJECT NAME. SOWER
DESCRIPTION: Gas line to range, garage. Range exhaust .
OWNER: SOWER, KEN& CHRISTY PHONE #: 503 - 579 -5424
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 6/3W2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 070541 -03 503.579 - 5424 N
Corrections /Comments/ Instructions:
M PASS n PARTIAL APPROVAL ❑ CANCEL I NO ACCESS
n FAIL I CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: S �. — e;' , ` Phone #: (503) 718- .25-J�