Permit 1
III 'u CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00726
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/13/2007
PARCEL: 25111 CC -13200
SITE ADDRESS: 10295 SW HIGHLAND DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.4 LOT: 183 JURISDICTION: TIG
PROJECT: CARRINGTON
Project Description: Install gas fireplace and gas piping.
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:
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
RENEE CARRINGTON Description Date Amount
10295 SW HIGHLAND DR
TIGARD, OR 97224 [MECH] Permit Fee 12/13/20C $72.50
[TAX] 8% State Surcha 12/13/20C $5.80
Total $78.30
Phone: 971- 645 -2457
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 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.
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By: �,� /S
_ Permittee Signature: if
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Call 503.639.4175 by 7:00 a.m. for inspections th.i. 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.
MechWrnica.l Permit Application FOR OFFICE USE'.ONLY
City of Tl g and Received Date /By: / di "�
Irr
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review Permit No.: /
Phone: 503.639.4171 Fax: 503.598.1960 Date /By' Other Permit: _ �_/
TIGARD Inspection Line: 503.639.4175 Date Ready /By. 0 See Page 2 for
Internet: www.tigard - or.gov Notified /Method: ., Supplemental Information
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❑ 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, e labor, overhead, and profit.
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<'-?°, : ;_ : <,. 3 CATE60RY OF CO 1 „ „.
5 RESIDENTIAL EQUIP TENTS // '§T,EMS FEES *” ; :,'
�.I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building ° " °' "`'° °" �'
1:1 Multi ❑Master builder For special information use checklist.
❑ Other: Description Qty. Ea. Total
;•3; JOB ='SITE INFORMATION- "ANIi LOCATION;.:;."- ' t/ Heating/cooling
�,;. a ..., .,.,, � "fir,.- ^�:.N , �t� .., ,. , ; ., _�,',� .:.
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Job site address: i V 5 4a 4 ,/L , ) J� Air conditioning or heat pump
/ / �q [/ (requires site plan showing placement) 14.00
City /State /ZIP: I f G 4-40/ 74 / °?4 / .) y Furnace 100,000 BTU (ducts /vents) 14.00
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 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: Lot no.:
Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
z ` >' :. E rw a ,,. ., »„ .,r,.F, Water heater I . 00
,, : ) DESCRIPTION; OF: �I ORI{:Iaur ,.: 0
'�, . ' -_ .^ �; �e „�::. . «.. �... � ��,,,,,.. .. . s i���; '; � ice,
Gas fireplace / 10.00
.- • L it 4 Flue vent for water heater or gas
' ^ r )- -2p L A- L L l igh 10.00
/�- Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
, ';.' PR� , , t �,� Chimney /liner /flue /vent 10.00
O ER TYOVVNER`'^ " ® �,�
�,._ „_.. i' .::_ o Other. 10.00
Name: R Fn c / C e , , ) a jJ' Environmental exhaust and ventilation
Address: G 7L, I K Range hood /other kitchen
equipment 10.00
City /State /ZIP: 10.00
( � 5 7 Clothes dryer exhaust
Ph( /7/ ' Y'S- . compartments, utility rooms)
x..° `„ ....., , �:: s ue:,
Single-duct uct ex aust (bathrooms,
Fax: ( ) toilet compart ents of it r ms 6.80
"' , APPLI
„, a. ,, „K..,,,.,.� �; ,.. � 1 craw p ce fans 10.00
.ar�•i > .., TA � � . : At t'c /� Is a
�_..., t ._ .sy ❑.• .. ,.��� .._ . ^,. " CON. .,, ,CT„R ERS Q N ;w ~��3�
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Business name: Other: 10.00
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address:
Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail: Ranee
�: ;CONTRACTOR `iy` Barbecue
Business name: Clothes dryer (gas)
' '� �� — Other:
Address: ) ( O 3 -7 f L' bow C - k 14 y L Ai _ ,. '4' ilkei ANICAL`PERnIIT::FEES* ' • t . � ''' ''
City /State /ZIP: e, �C /1 , 0 4 q '7 ,„20 Subtotal do d
Phone:
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(5 / �f ) 2 ? S Fax: ( C/Jl) f) s ?a Plan review (25% of permit fee)
CCB lic.: / 1 / /2- x/_0 / J • State surcharge (8% of permit fee) J am, Minimum permit fee ($72.50) ��,_ ((�
grr 01110.- T OTAL PERMIT FEE 7 , Authorized signature: T his permit application expires if a permit is not obtaine within ISO
i /ft _— As days after it has been accepted as complete.
Print name: 1 /lfi T i" )" ��ll s Date: NC * Fee methodology set by Tri- County Building industry Service Board
I: \Building \Permits \MEC- PermitApp.doc 04/06/06 440- 617T 1/02/ •M/WEB)
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BUILDING K�U, ��U U��U��0� PERMIT #: k4 7 OO72G
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| 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/73/2007
Phone: (503) 639-4171
Inspection Requests (24Hmj:(503)830'4175 ~% :col V
INSPECTION WORKSHEET FOR DATE: 2/15/2008 TIME: 7:01AM PAGE: 54
SITE ADDRESS: 1O29GSVV HIGHLAND DN CLASS OF WORK:
SUBDIVISION: SUKHh0E]RF|ELDNAA LOT #: 183 TYPE OF USE:
PROJECT NAME: CARR|NG'T()M
DESCRIPTION: Install gas fireplace and gas pi inQ.
OWNER: CARNINGTON.RENEE PHONE #: 971'E45-2467
CONTRACTOR: GAS PRO, INC. PHONE #: 503775'7820
Inspection Request Scheduled For: Date: 2Y1312008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
G99 Mechanical final 064919-01 971-6452457 Y
Corrections/Comments/Instructions:
_.____. =„. _
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.
PASS | | PARTIAL APPROVAL 0 CANCEL ri NO ACCESS
CALL FOR INSPECTION 7 ADDITIONAL FEES ASSESSED
Inspector: �]-� � Date: 2 ~ /3' Phone #: (503) 718-
CITY OF TIGARD
BUILDING DIVISION 4 . PERMIT #: 1Fc2007 - 00726
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/130007
Phone: (503) 639 -4171 n' ew ,
Inspection Requests (24 Hrs.): (503) 639 -4175
I
INSPECTION WORKSHEET FOR DATE: 11!17/1007 TIME: 7.01AM PAGE: 17
SITE ADDRESS: 10295 SW HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD N0 LOT #: 1B3 TYPE OF USE:
PROJECT NAME: CARRINGTON
DESCRIPTION: Install gas fireplace and gas piping..
OWNER:. CARRINOTON, RENEE PHONE #: 971 - 646.2467
CONTRACTOR: GAS PRO, INC. PHONE #: 503 - 776 -7020
Inspection Request Scheduled For: Date: 12/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 001862 -03 971-646.2467 N
Corrections /Comments / Instructions:
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CS � - i - 6• 1 S)
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❑ - %1 PARTIAL APPROVAL El CANCEL • El NO ACCESS
�r ., n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: _ ■ / _C . .IIIENEMINI Date: /2 7/ `? Phone #: (503) 718- ''Z 679
CITY OF TIGARD
BUILDING DIVISION PERMIT #: 4EC2007-00726
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13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/13/2007
Phone: (503) 639-4171 . 1 , 0,„401V\
Inspection Requests (24 Hrs.): (503) 639-4175 ,,...........„ ......
INSPECTION WORKSHEET FOR DATE: 12/17/2007 TIME: 7:01AM PAGE: 18
SITE ADDRESS: 102% SW HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO .4 LOT #: 183 TYPE OF USE:
PROJECT NAME: CARRINGTON
DESCRIPTION: 'w gas fi an d gas piping
OWNER: CARRINGTON, RENEE PHONE #: 971-645-2457
CONTRACTOR: GAS PRO, INC. PHONE #: 503-7754020
Inspection Request Scheduled For: Date: 12117/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
6 IS htiochanical rough-in 061652-02 971-64fr 2467 N
Corrections/Comments/Instructions:
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PASS , = IAL APPROVAL L j CANCEL n NO ACCESS
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CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
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Inspector: - Date: 0 Phone #: (503) 718-
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CITY OF TIGARD
BUILDI DIVISION PERMIT #: MF03007 .
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 121/3/2007
Phone: (503) 639 -4171 ed4v�A��illi
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 12/17/2007 TIME: .7_01AMvi PAGE: 19
S un h� 6ti _ /r)
SITE ADDRESS: 10295 SW HIGHLAND DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NOR LOT #: 18:3 TYPE OF USE:
PROJECT NAME: CARRIN'NGTON
DESCRIPTION: Install gas fireplace and gas piping. •
OWNER: CARRINt3TON, RENEE PHONE #: 971 - 645.2457
CONTRACTOR: GAS PRO, INC PHONE #: 503- 775 -7Q2Q
Inspection Request Scheduled For: Date: 12/17/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Messa e
6I0 Gas line 061652-01 971-645-24157 Y (Z -- I
Corrections /Comments/ Instructions:
•
) %i PARTIAL APPROVAL ❑ CANCEL (l NO ACCESS
(l FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
/ ■...„.
Inspector: Ii�� Date: iZ___/42 6 Phone #: (503) 718- ZZy,
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