Permit r .
ill : . `` CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT
PERMIT #: MEC2007 -00749
TIGARD DATE ISSUED: 12/28/2007
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 1S 125DD-07800
SITE ADDRESS: 09685 SW VENTURA CT ZONING: R-4.5
SUBDIVISION: WASHINGTON SQUARE ESTATES NO.3 LOT: 086 JURISDICTION: TIG
PROJECT: BRAICH
Project Description: Install gas insert into existing fireplace, chimney liner 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:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
REPAIR
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
ROSEMARY BRAICH Description Date Amount
9685 SW VENTURA CT
TIGARD, OR 97223 [MECH] Permit Fee 12/28/200 $72.50
[TAX] 8% State Surchart 12/28/200 $5.80
Phone: 503- 244 -7123
Total $78.30
Contractor:
G P & W SYSTEMS INC
732 MARBLE RD
WASHOUGAL, WA 98671 -9601 REQUIRED ITEMS AND REPORTS
Contact #: PRI 360 - 835 -3516
FAX 360 - 835 -5716
Reg #: LIC 108176
This permit is issued subject to the regulations contained in the Tigard Muniapal 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.
i
Issued y: Permitt Sig • ature: / , , , / o /� ---1.
Call 503.639.4175 by 7:00 a.m. for inspections at b m day. /
This permit card shall be kept in a conspicuous place on the job s itzs until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Dec 28 07 11:02a GP &W Systems, Inc. 360 -835 -5716 p.1
h- nica1 Permit �1 i4 , ri���E'� -- - - - -
F OR OFFICE USE ONLY
City of Tigard Received
13125 SW Hall Blvd., Tigard, OR 97223 Dateatr la R D permit No.. Nf e 7 ,, aQ 7 y 4
Phone: 503 639.4171 Fax 503598 1960 DEC ` 2U� Plan Review
'z.Ty r
Inspection Line: 503.639.4175 Date/By: Other Permit. Tlr • t, ! V 1 _ i
Internee www.ci.itgard.or.us CI� H Q 1 lit r; __,. Date Ready/By. El See Page 2 for
' Notified/Method: Supplemental fnformrtion
BU'LOI
•
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
New construction ❑ Addition!altcrat ion /replacement Mechanical permit fees• are based on the value of the work
❑ Demolition performed. Indicate the value (rounded to the nearest dollar) of all
❑ Other: mechanical materials,
equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: S CI45 Ce
1,Q 1- and 2- family dwelling ❑ Commercial/industrial E] Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
❑ Multi- family ❑ Master builder ❑ Other:
For specia/ information use checklist
Description I Qty Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 9 i06 e_.,, 1 I c Air conditioning or heat pump
v (requires site plan showing placement) 14.00
City/State/ZIP- - --; „ e j t !fi . Z2 Furnace 100,000 BTU(duets/vents) 14.00
Suite/bldg. /apt no.. "u `^ � ` ` P rojectt name: Furnace 100,0()0+ BTU (duets/vents) 17 90
Gas heat pump 14.00
Cross street/directions to job site Duct work 14
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: I Lot no.: Flue vent for any of above 10.00
Other:
Tax map!parcel no.: Other fuel appliances 10.00
DESCRIPTION OF WORK Water heater 1000
1 �e�-C � / S s T 1 Gas fireplace X 10.00
9 , l.Jl IO - 11Af .) Flue vent for water heater or gas
RuN c pv2 !NC/ - '� fireplace 1000
Log lighter (gas) 10.00
Wood/pollet stove 10.00
Wood fireplaceJinsert 10.00
PROPERTY OWNER I ❑ TENANT _Chimneylliner /Ilue/vent x 10.00
Other. / 10.00
Name. CrSt(n A'RLi Po P.-MCA- t
Environmental exhaust and ventilation
Address: q (01)5 CD �J \fe. t _ — /Q Range hood /other kitchen
`�lJ -(0. /1 equipment 10.00
City/State/ZIP: ' ) t C V . 4 - � - Z3 Clothes dryer exhaust 10
Phone: {S p_L 7 ,... t . 23 Fax . ( ) Single -duct exhaust (bathrooms,
toilet compartments. utility rooms) 6.80
�4.PPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 1000
Business name: ,4 P f IL S 'f sTE ins Zivc. Other: 10.00
,, Fuel piping
Contact name: /4t � +. it A A) 0 p
a . F-C� Vl F C fir $5.40 for first four; $7.00 for each a ddiliooal
Address: 73 2. / „f t a ed Furnace, etc. 1
,, j,4- � Gas heat pump
CitCity/State/UP: /111151441/0 L [r V 7/ Wall/suspended/unit heater
Phone. (3( `i ' • 3sa Fax:: Q $ ,C • �- �' / / Water heater
i E -mail: � ?� Fireplace \/
_ Range �
CONTRACTOR Barbecue r
Business name, G p jJ Sy s4e S • Ong_ Clolhcsdryer(gas)
7 3� )14 _ _ `L a /1 Other:
Address: ! �C���I
MECHANICAL PERMIT FEES*
City/State/ZIP' w u 6 4-L i� ¶fl 7 J '2t . 'C'
Phone: S36 g3s„ 35i� Fax f� ms` t � P ! Subtotal ' 5710= Minimum permit fee ($72.50)
CC 1r gyp.♦.,`- J ,a -3sfa' State surcharge (8% of permit fee) Plan review (25 % of permit fee)
Vo e�fo 39%-- State •�d
0 TOTAL PERMIT FEE '-4, %O
Aut orized sign �.��� This permit application expires ifa permit u not obtained within 180
days after it has been accepted as complete.
Print name �I/V ' Date: 2 • Fcc methodology set Tri -Coup Building In
• "L.J .,t, 8Y by b' g dustry Service Board
CITY OF TIGARD
BUILDING DIVISION PERMIT #: tv1FC2007 -00749
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 12/28/2007
Phone: (503) 639 -4171 +
Inspection Requests (24 Hrs.): (503) 639 -4175 ...jll..
INSPECTION WORKSHEET FOR DATE: 2112/2008 TIME: 7:05AM PAGE: 40
SITE ADDRESS: 00.,85 SW VENTURA CT CLASS OF WORK:
SUBDIVISION: WASHINGTON SQUARE ESTATES NO LOT #: 086 TYPE OF USE:
PROJECT NAME: BRAICH
DESCRIPTION: InsialI gas insert into existing fireplace, chimney liner and gas piping.
OWNER: BRAICH, ROSEMARY PHONE #: 503 -244 -7123
CONTRACTOR: G P & W SYSTEMS INC PHONE #: 360
Inspection Request Scheduled For: Date: 112/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 064866-01 360.836 -3516 N `
c q-p Vt P,►.ay
Corrections /Comments /Instructions:
•
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION - ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: 1_ -i 2- --o g— Phone #: (503) 718 - Z.4-4-C--