Permit .1 1s
r' CITY OF TIGARD MECHANICAL PERMIT
4"'i,4 ' DEVELOPMENT SERVICES PERMIT #: MEC2006 -00301
14,
"-" 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/3/2006
PARCEL: 2S104BA -01600
SITE ADDRESS: 13892 SW HINDON CT ZONING: R -25
SUBDIVISION: COTSWALD MEADOWS NO.3 LOT: 097 JURISDICTION: TIG
Project Description: Install approximately 25' of gas line to range location.
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:
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:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
JAMES KEMP Description Date Amount
13892 SW HINDON CT [MECH] Permit Fee 7/3/2006 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 7/3/2006 $5.80
Phone: 503 - 579 - 5676 Total $78.30
Contractor:
KOEHLER CONCEPTS LLC
10772 SE HWY 212 REQUIRED ITEMS AND REPORTS
CLACKAMAS, OR 97015
Contact #: FAX 503- 650 -1220
PRI 503- 650 -9550
Reg #: LIC 120277
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 -33
Issued By: �- SIG ✓.f Permittee Signatu `�
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business ay.
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.
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..., . 4-11 aic mit sil Permit Application cm t: uu: ()NIA
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Received .,..." Z7 . A
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City at, igard = cEN ED Date/By: I X, 0 c A Permit No.
e :NE e 96 - 4/6--a:75o
13125 SW gall Blvd., Tigard, OR 97
Plan Rcview
Phone: 503,639.4171 Fax: 503.5981 Other Pcrmit;
Inspection Lint; 503,639.4175 JU 0 3 2006 :44. Pate R 1-)ohif3y; eady/gy; WI RI See Page 2 for
Internet; www.ci,tigard,or.us NotillecVMethod: Supplemental information
y oF TIGARD
'i..." '''F'j!!!! :ji: :i'' i i , r' , PSIt • CtIECKL"T
Mechanical permit fees* arc based on the value of the work
0 New construction 4 Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
0 Demolition Ei Other: mechanical materials,esuipment, labor, overhead. and profit.
" '',',.' ' ...'.. 'J I.1:”,. ; ,i'. 1 ■ : ,i 4 !`: ':" .4. ' 'Zi'; ' 04 63,1 4 1 /i i itWe i *StL*0 16 1 4; 1+ 1 11Ti';; ; iAI, : ili ' P, : Pi.;! ; !'i:. 1: ,:: . 1 , , . Vnluc; $
ik •!."..!
14 I- and 2-family dwelling El Commercial/industrial 0 Accessory building
Far special Wormaiion use checklist
0 Multi-family 0 Master builder 0 Other: Description I Qty, 1 ea. 1 Total
61 're' liWOLOto Hentinicir' _
Air conditioning or heat pump
Job sitc address; \ ....iD \-Vetzsi-.6zv, CA (matins' 'die plan showina placement) 14.00
City/State/ZIP: --6 \\ agl,r C,79_ C\-11-7-C\ Furnace 100,000 BTU (ducts/vents) 14.00
t.
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg./apt. no.: Project name:
Gas heatpump 14,00
Cross strect/direetions to job site: Duct work 14,00
Hydronic hot water system 14.00
Residentiut boiler (radiator or
hydronic) 14.00
Unit heaters (fuel-type, not electric),
in-wall, in suspended, etc. 10.00
Flue/vent for any of above 10,00
Subdivision; Lot no.:
Other 10,00
Tax map/parcel no.: Other fuel appliances
. :' '' : l '' ';''i ' ; :•!,:` l', i.I111',01ill'Algkilq, Water heater 10.00
Gos fireplace 10,00
\R-Ps`4\V■A‘ 13'u( D- "Sas erS- eta, ...,...a.) Flue vent for water heater or gas
fireplace 10.00
` ciNc■q„,:W1 ‘ \CIC-Ntz*LIt1 Log lighter (gas)
'
10,00
Wood/pellet stove
10.00 _
Wood fireplace/insert 10.00
Chimney/liner/flue/vent 10,00
POOTIO`Y.:9# —
Other: 10,00
Name. - - - Z, . \ (.. j z 4? Environmental exhaust and ventilation
Range hood/other kitchen
Address: \ •t,.. ' \,...\.c.,6--, Cr\ , equipment 10,00
City/State/ZIP:—%7NTtc-6, CSZ._ C3022-C\ Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: °•,:t, ) Cs°14‘.._ Fax: ( ) toilet compartments, utility rooms) 6,80
'.i . i 3.a : ',": • :,L 1 . l' ' I ' ' it ..1 ■" itilejtg4 ^ l' ' AttiCkrilWISpaCC fans 10,00
Other
Business name: \‘..06. Cr‘ceil U C . 10,00
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
- '
L__
Address: \UN N.._
ZZ. Furnace, etc.
_Gas heat pump
City/State/ZIP: C.....4chi.,,,04.4,4-- C c10\c- WalUsuspended/unit heater
Pil " e `r=da ) (os.CN - Fax: ".8 2L
)C07)--AZZO Water heater
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9locc
E-mail=pe la \ (....60e■No.tc" Ilebor■Ge,,,e■zu •C.13v• Range I
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.';!.r:11'.1:11! A: !':1 : 'i'i l titiStWeitiWi r . ,.. . ,, iliimvi - 1„, , „ rro 13arbecuo
- ,, ..'? , :r
Business name: N ik6.6,-,,N.Q . 1.0 C.:1ZcCe, \I„C, Clothes dryer (gas)
--
Other
Address: < \I js. 7.A.7._ — 11 74 i .4 1 `! 1 i■MO4it a N Yi t*:**0:41. : **Yi : 'i. l' . ':i: ''''':
City/Statc/ZIP: C ck_ Ck Subtotal
Minimum permit fee ($72,50) 11. -So
Phone: lU k ,-CkS0 Fax: CSZS ) L _17213
Plan review (25% of permit fee) .. '
CCB lie.; ls-LO-ryt State surcharge (8% of permit foe) 6
TOTAL PERMIT FEE - it ,•sz
Authorized signature - Thhi permit application expires If n permit is not obtained within IN
days after it has been accepted as complete,
Print rme, LN ' . . _ Date: A — ° Fee methodology Re by Tri.County Doilding industry Service Hoard 4 ,
i IBuildineennice\MEC-Per1M4P " Ca 440.4617T (11/02/CONOVED)
ZO 0/1.0 0 Sid33NO3 831H30A ()NU:199E09 XVJ VL:LO 9003/L0/L0
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CITY OF TIGARD . . .._
BUILDING DIVISION PERMIT #: r EC20? 6 00301
1 13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED:
Phone: (503) 639 -4171
A ui iipl �i
Inspection Requests (24 Hrs.): (503) 639 -4175 :_..
INSPECTION WORKSHEET FOR DATE: 7/1012006 TIME: 7:05AM PAGE: 47
SITE ADDRESS: 13892 SW HINDON CT CLASS OF WORK:
SUBDIVISION: COTSWALD MEADOWS NO.3 LOT #: 097 TYPE OF USE:
PROJECT NAME: KEMP •
DESCRIPTION: Install approximately 25' of gas line to range location.
OWNER: KEMP, JAMES PHONE #: 603- 579'5676 1
CONTRACTOR: KOEHLER CONCEPTS LLC PHONE #: 503'650 -9550
Inspection Request Scheduled For: Date: 7/10/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 032700 -01 503- 579 -5676 N
Corrections/Comments/Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: '2 — /0 -- Q& Phone #: (503) 718- Z4-4-