Permit G'
CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00407
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 7/10/2007
PARCEL: 1 S133DC -17300
SITE ADDRESS: 13236 SW LAURMONT DR ZONING: R -12
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT: 028 JURISDICTION: TIG
PROJECT: ATCHISON
Project Description: Install condenser, furnace and gas line.
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: 1 DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
SUSAN ATCHISON Description Date Amount
13236 SW LAURMONT DR
TIGARD, OR 97223 [MECH] Permit Fee 7/10/2007 $72.50
[TAX] 8% State Surcha 7/10/20W $5.80
Total $78.30
Phone: 503 -590 -4422
Contractor:
RCG SERVICE LLC
11235 SW 83ND AVE.
TIGARD, OR 97223 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 888 -9849
FAX NA
Reg #: LIC 170284
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:- i P_ermittee_Signature: _ Cc4
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.
M hanical Permit Application
FOR Sri ]c i r ov_ ,)
City of Tigard Date/By: / 0 ' ,„i Permit No iii i i. JO v / u
a
u 13125 SW Hall Blvd, Tigar , 1 12 3 Plan Revi:
y 12 ` Phone: 503.639.4171 Fax: 501598.1960 Date/By: Other Permit:
f'I •Gi \':}tb Inspection Line: 503.639.4175 f v 007 Date Ready/By: J H See Page 2 for
w
Internet: ww.tigard or.gov • - • 1 Notified/Method: Supplemental Information
G1 T Y OF TIGARD
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❑ New construction 1th 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 o rhea an -
y�
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J 1- and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building
❑ Multi family For special information use checklist.
❑ Master builder ❑Other: Description I Qty. I Ea. Total
iis1'Q>R: <3�Y!
''. :. � .. Heating/cooling
.............................. > ;;;;;;; ...... or heat pump
Job site address:;:..; .:G:: ::,;:. ✓ conditionin . g P
J (requires site plan showing placement) 14.00
City/State/ZIP: ff f . '' v Gas 100,000 BTU (ducts/vents) / 14.00
Suite/bldg. /apt. no.: Project name: r.(.. .0 yejl as heat 100,000+ BTU ( ducts/vents) 17.90
Gas heat pump 14.00
Cross street/directions to job site: 4 y f (P [A b � pit-- Duct work / 14.00
)refer" - 'w i � i Qr. Hydronic hot water system 14.00
r `4 W Residential boiler (radiator or
(,(a'a hydronic) 14.00
1 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
i :;::::::::::,:;:;:::::::;:::::::::;:;:::::::::::::::::::::::::;:::;:::::::;:::::::::;:iiii:::::::::::::::,::;:ii;:giilrafTW:W04::,::,:,:::::::::::::::::::,:,::,,,:,i:::::::.=:.;:i:.:-;::;:;:::::::ii,::;::::::;:::::iii;iiON Water hea ter 10.00
t,t, W 5 Efe,, W i� Gas fireplace
Flue vent for water heater or gas 10. 00
4 7 i4 D,- fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
Chimne Y
/liner /flue /vent 10.00
z> %>'.C2;Z:; 4;. , N1 ,, its i %' i% i 2' 2?4s ? i4iY z i 1 "i ' <:: T 'N ; _ _ [ r :
.............. ".... _.._.... ..:: �.. �::.:,.::: Other: 10.00
:;:: >:: >:: >::::::; .
Name: 5 cr . 6 j �6 Environmental exhaust and ventilation
� ��
Address: �� 2j� i v Range hood/other kitchen equipment 10.00
City/State/ZIP:, 01_ 4 Clothes dryer exhaust 10.00
Phone: (f -(77t) . Fax: ( )
Single-duct (bathrooms,
et compartments,
toilet rooms) 6.80
Atttc craw space fans
Business name: G ( .....6- �� Other.
S t Fuel piping
Contact name: , - --- 6t., ' . y $5.40 for first four; $1.00 for each additional
Address: l 5-�� Furnace, etc. f ` Cy'
` °' s Gas heat pump
City/ State/ZIP: q J R .,.-PD 6,--- -1-7---t-1- Wall/suspended/unit heater
t
Phone: ._1 C� I Fax: : ( ) Water heater
� �1 J�t¢(rt C e �d - a _ (. Gf p�- Range
E -mail:
Rang
Barbecue
�� ( C..— 1 , - Clothes dryer (gas) /4_
Business name: 1 � � � "/ � der'
Address:
1
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s
Z
I 9
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City/state/ZIP: 1(,44 , G 2 . et '�—�� � px, Subtotal ,1.
Mi nimum permit fee ($72.50)
Phone: (.S - 15 - 8 - - fS ®j � Fax: ( } Plan review (25% of permit fee)
:::: - -- - - " � " - � - i0 - 00___ c____ signature: f� i Y QQQ��� This permit application expires if a'permit is not obtained w art 180
days after it has been accepted as complete.
N
A/C -HEAT PUMP -- -UNIT SITE PLAN
FEET TO BACK OF PROPERTY LINE W 4 VP
FEET TO SIDE PROPERTY LINE
FEET TO FRONT PROPERTY LINE
ADDRES: +/ b
PLEASE REFAX APPLICATIpN WITH SITE PLAN
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CITY OF ��n x m n�`n TIGARD
BUILDING DIVISION PERMIT #: MEC2007-00407
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7V10/2007
Phone: (503) 639-4171
Inspec Requo��o (24 Hrs.): (503) 639'4175 _�h�' «
INSPECTION WORKSHEET FOR DATE: 8/17/2007 , TIME: 7:01AM PAGE: 73
SITE ADDRESS: 13236 EWLAURIV@#NT DR ` ' CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK LOT #:. 028 TYPE OF USE:
PROJECT NAME: Al-CH|SON ` '
DESCRIPTION: Install condenser, furnace and gas line.
OWNER: ATCM|SON, SUSAN PHONE #: 503-690-4422
CONTRACTOR: RCG SERVICE LLC PHONE #: 503-888-9848
Inspection Request Scheduled For: Date: [/17/2]07 Pour Time:
Code # Inspection Description Confirm # Contact # • Message
699 Mechanical final 054024-01 503-754'8778 Y
Corrections/Comments/Instructions:
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F� ��
PASS - - ' _ + RABT/AL/\PPRO\�\L L - _ /' N<]ACCESS
I I FAIL 0 CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: . Date: e 7- m? Phone #: (5O3)718- Zs/q
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