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Permit
4 CITY TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2006 -00500 fit 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 10/18/2006 PARCEL: 2S104CA -03000 SITE ADDRESS: 13552 SW LAUREN LN ZONING: R -7 SUBDIVISION: HILLSHIRE LOT: 030 JURISDICTION: TIG Project Description: loft. gas line and outlet for range. 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: > 10000 cfm: GAS OUTLETS: 1 Owner: FEES GREG JACKSON Description Date Amount 13552 SW LAUREN LANE TIGARD, OR 97223 [MECH] Permit Fee 10/18/20C $72.50 [TAX] 8% State Surcha 10/18/20C $5.80 Total $78.30 Phone: 503 -579 -6364 Contractor: KOEHLER CONCEPTS LLC 10772 SE HWY 212 CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS 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 - 332 -2344. Issued By: Sl A r Permittee Signature: C) . L / i ( TYV CA S 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 Application I'Oli I► r ru tu': (' 4I ()NIA Re�ei yd la /? o b 1ST EL3�19 —vo 00 13125 SW Hell Blvd., Tigard, OR 97223 City of Tigard ly Dnr / Permit No: (] Plan Review Other Permit; Phone: 503.639.4171 Fax: 503.598.1960 n, , Dateaty: Inspection Lino: 503.639.4175 ^,�p d9ta Rc /Dy, ruin: '.ice P. 2 for Internet: www.ci.tigard.or.us 0 C Notified/Method: Supplemeami information , ^�.�Pa, y: . I.. "fit 1r?'r�J " y . 190' , NH'r EA'' "• 15L'•'vy r „. rr , ..�� +„a, ngi(iiry •1. s r;r,'y.:ar. - „,-- .p., .; q r Iii °U l. . ry 'Mon. ,'' '' W,V41, "Ar.,4, ,1 ,n. , n ; - 1: l ;.1f:9' { �,�,r�� . 'Y ;:c i i , , . p't� :t ni.h.� ,:.V., J • �.7 < 4 1 � 3Pi. I I M l.b E S 41,.. u f � I,,i'i - . • ° T v' . 1, y p� rc :,,' , r jfa,t ',, Ii,. ', , a `-" i` La' •,,�q mmGill:YRi�r�r vii 1i11,1�,,,,,„:&, A IIIN,4,,.1��uM �4, tt11a�v�CII l , > t er I 0 , • P4 11 i *R. IM'1Mintl11 Rc, ArS '1a�i11,SiI'jA.,..,. tr tk„wrl` ”' - Mechanical permit foes* arc based on the value of the work El [off New construction ddLtion - lterationieplacement performed. Indicate the value (rounded to the naves[ dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment. labor. ovencevd. and profit. ::!4:• Y Nit"' , : a ' 4 r ;'°".rs .,r417: ;I:7,f 't7, , :17.?7i. ' • 7,;':Nrr : " 'f,1l t� Value: $ . """"T N c r`o 4 n C,gL ,p q ml P �' f ' r r , + 4 t _ ul. . -.'t91 • c�i,.:` LL1PS Sl :�uL;�fwfYolN�v:a1�r.,,R.,..:7. - :l: I +r ;4V�i lr�e'•,�, .OFrl ftr ,0(I(i ! 'a,� I,'�, �I. 1 , 7 • I ry r . t .rl h I .91 , L, I , n;'':a r ^c -s.cn, ,r�0 a':-�rc ^ r•:1 *, . , , cnr n l wrtu. , , ,,, and 2 - family dwelling El Commercial /lttdusuial ❑ ' 1 ').1! .1 , 1; 1 1 , +,I; �� p 11 I r :i c`` 1,• 1�+5'ti, 11 . 9 ,n. , al f,l :� 1 „. n •fT � f t" p t Accessory building '�� „q,,il,i� �nlliyr9;l.i�;,rl'vf jVi•" „ .,, ' r I] g y�l: IuiU ,•i. ?t” l ❑ Multi ❑ Master builder ❑Other: For special information use checklist. 'G;:i:,:, i'A'� ^:'FV. r' "k� '1i .IM', ,:1'4:3;:5 "`Wuo; +! , ",ri;'r.!; Description I Qty. i Ear I Total .,J•- - Frif "1 li nip' �r,:'' lk i:. 0 Vi y, 15sr If �1; iS11G7Niil ;';•y�'�'.�ii4- '1;�0. ,�1,#,' ',,:'., m 8a f`, :rf7�� l,.tri_.,..,- ^.IR� '0,14!i.,1,, : i; r.1,[1,y.iy4:"ri,�1 Fielding/cooling _�,.. - ,:Ili }Yuh"k..,r..Sr �.' �, �: 1z�lK�a;.. �ct�sf�c��, acxa�. ixu+=`, cn_ r.{ i-".,,: r:�: x,. c. x^ 1�Ittr.. r., bfit�.'.. c11 [.:,:i::_ai:r''.:�fi�.,lu�l �::a., Job site address: \ -2 jj 'Z - � �Cl..�`- `P1'r1 \_ � Air conditioning or bent pump (requires site plan showing placement) 14.00 City /Statr/Z1P: 6, r _ ��- Furnace 100,000 BTU (duets/vents) 14.00 Suite/bldg. /apt. no.: Project name: Furnace 100,000+ BTU (ducts/vents) 17.90 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 Flue/vent for any of above 10.00 Subdivision: Lot no.: Other: 10.00 _ Tax map /parcel no.: Other fuel appliances 'fi(' r,7:F i1;7 ,.. + t ' r .7 :•r F err :17,3 gs, ,i;71 t:' :...:L:,,,. 0 .t' ;g : .t u 'o 'RB'.17 r :; r,,::f: r r: , ,. 1 1 , 1 : . .rr. .Ir,,,f,:,,,.,,� [ ' 'lr .I 1. 1 ;.. [ i , ,.�a,.,.n: �y r :u',_ . ; r { I ,,, %'`I;l;' 'al:,! I� " ",�'TI _ Water heater 10.00 . - 11 4i fi ' A , ltll try 9 (,'l f k to+ • I :,...., ��l 5 4 , I J s y . , . , y �: .�.L ' :�.av��,.slt� _. �.tClLL11L i�'ijlu� l _ . . .0 „tr l- �c��:9 _ 1 _ -- Gas fireplace 10.00 „ - Flue vont for water heater or gas fireplace 10.00 1 Es �� - Log lighter (gas) 10.00 Wood/pellet stove 10.00 Wood fireplace/insert 10.00 ;1 ��''!( 7:::k ; ' f ' grah, r, ;ll i:4::,.. :.;r, ;•¢r:.. ^,r. ; ^r,7 7-rc ,,,r7 - - °--r!. - Ch n n I' .,1...,.,:: r . �r, �„� L,y. i, ; :L• - a.,, ..i ;i. n f;f' : - , r � /li Cf/1.1llC/Vant 10.00 ati u4,k,,..,r, ..; I :: r I, r : :. : :i h , l q ' I ., : , 1 h : '1.1 I: G ”. ' U .. if: ,1', . ,j 1.. ,f ,,.�,� t ,,..,.,.I , ,.�..., . s:;.' �i..:c,,._... L. ............ �ct .: .�Mc,r; '� �..:: . °o J ; 1 i �' Y: u, f: �nu: z , ,�,,li..i.u, rn :t..:: ' "',i • I ,i,. 1 ,, r .... i :::': I .. . ether' 10.00 ame• . .. - .5" it _ St) Environmental eahauat and ventilation \�G.c� ��.. w..vn`� �"�., Range hood /other kitchen Address: _ �'1 equipment 10.00 City /State/ZIP: 0 .,$-6, C ti 'c-■Z•Z� Clothes dryer mamma 10,00 1, Singlc -duct exhaust (bathrooms, Phone: (_ Z_) S` -- LiSLo Fax: ( ) toilet compartments, utility moms) 6,80 ! , ...I. I.• r . '•':'s.' �'; ; I I;; q, •::. � ° �'. , Attic /crawls ace fans .. .. k .: : .. ^..._....... l i , .:, a. ' P 10.00 ��, r .t, . : , . .. .�.i ,,..,,�.,� „I f. l I. I ..i ::.. i�: 4:: .': :. ):rF� ......., �. .... ,I:.. Business [tame: 'iLoe_�� \,._\1_,,,. Other: 10.00 Fuel piping Contact name: — A. , $5.40 for first four; $1,00 for each addltlonal Address: \p - 7.,\1.. Furnace, etc, City /State/ZIP: C3a9 hoat�ump _...-.4.- _,-,► _ Qr,Q • Wall/suspended/unit heater Phone: fir,) . 0 • S Fax: per) , \.ru Water heater Rage E -mai l � l. _ s 7.A. ( ., II Range .11:: I • 1 '1 , - I } ,f I r. r i VI 1 Barbecue Business name: Q Clothes dryer (gas) Address: C� Other. :dt; : ^�;, -..:; ; ti:r I : A 110:: : Z �\ • .-.3;q:' : ;.;,,,; ; :, , ,',. it it ' t,, n r2.,.._, 9 ' i . fNl1 4U.1 City /State /ZIP� (1(.1 : .1:,,, t. i L..,.I ` • S '`C' ,�� 17� Subtotal Phone: "S) zi p _r_„\SS© Fox: I _XQ Minimum permit fee ($72,50) ,'Z �a� Pl an review (25% of permit fee) CCB tic,: �'Zt State surcharge (8% of permit foc) _ l TOTAL PERMIT FEE 10 e N Authorized signature: ■ This permit applies' don ecplrea Ira permit hi not obtained within 180 1 .� days after It ham boon accepted as complete. [ nt name: �r�7 �� \� I Date: "\0 N•Th ! • Fee methodology set by Tri- County Building Indushy Service Board I:\BulldingWarmiti oe C•PornitApp,d 12/03 440.46I7T (I I /OVCOM1WEB) 300 /L00 S1d33N00 831H3051 OZZL099C09 XHd LC ZZ 900Z /9L /OL CITY OF TIGARD ,0000 BUILDING DIVISION PERMIT #: 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: Phone: (503) 639 -4171 ttipa" Inspection Requests (24 Hrs.): (503) 639 -4175 111. INSPECTION WORKSHEET FOR DATE: t Oh/5 /0 1' TIME: PAGE: SITE ADDRESS: 1 "b66 L- L-kk y26- L\1 • CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: DESCRIPTION: OWNER: PHONE #: CONTRACTOR: PHONE #: Inspection Request Scheduled For: Date: Pour Time: at �/(� Code # Inspection Description Confirm # Contact # Message 1 LO I b Coo, S °`' l orrections /Comments /Instructions: ,„4\--„,..,ukijt,..,,„) --rh7; 5 ee--(ZvY) O e S 0 b 1 1 0 - p„.04- U/In 4.•\ lA C ` 2, l/lAi 6LA ce 0 c Cs (26-11 eAR . I ' e--e4 ''' ' _ ■ ■ 11 - , , ■visiaa • l/�J • L-rI I • . J... P-A,r-c k r.„,_ L___,...- A 611 43 j ± 4- L� cN A .,...„k k•••--,,,‘• s t---,..Jzi _a_43L.,,,k T--.4.___ 4._ r e....te„...,.....4 , • ' PASS U PARTIAL APPROVAL 0 CANCEL I NO ACCESS FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED r� /�, � Inspector: V (/ Date: Z � / / 7 Phone #: (503) 718 - -2 ' / zy