Permit ���U���U�� !VISION PERMIT | — ~^2=8-0==
| 13125 SW Hall Blvd., Tigar . OR 97223 DATE ISSUED: l/14/2008
Phone: (503) 639-4171 4474,00,1A ^���r�° � �� �
Inspection Requests (24 Hrs.): (503) 639-4175 m�y�~ r�� ^- �. ^. � = �»V^M `~ w ' ° u^~'^' -�)���� ~~_� ��
INSPECTION WORKSHEET FOR DATE: 1/22/2008 TIME: 7:01AhX PAGE: 75
SITE ADDRESS: 122468W SUMMER 8T CLASS OF WORK:
SUBDIVISION: SUMMER HILLS PARK LOT #: OW TYPE OF USE:
PROJECT NAME: DEFFERD8NG
DESCRIPTION: InsaII as line, vent and new gas stove
OWNER: DEPFFR0NE). CHRIS FAND, PHONE #:
CONTRACTOR: ALL FUEL INSTALLATION & SERVICE LLC PHONE #: 503
Inspection Request Scheduled For: Date: 1/22'2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 063526.01 603'590-3735 N
Corrections/Comments/Instructions:
.`
7,4 fl PARTIAL APPROVAL 0 CANCEL ri NO ACCESS
7 FA|L | | FOR|N8PB3|ON ADDITIONAL FEES ASSESSED
^^
Inspector: ./ )" �� � Date: u'-- Phone #: K503\ 718
- • ~~
CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00023
" DATE ISSUED: 1/14/2008
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
PARCEL: 1 S134CB -00700
SITE ADDRESS: 12245 SW SUMMER ST ZONING: R -4.5
SUBDIVISION: SUMMER HILLS PARK LOT: 005 JURISDICTION: TIG
PROJECT: DEFFERDING
Project Description: Install gas line, vent and new gas stove
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: WOODSTYERS:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 2
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
DEFFERDING, CHRIS F AND Description Date Amount
VICTORIA L
12245 SW SUMMER [MECH] Permit Fee 1/14/200E $72.50
TIGARD, OR 97223 [TAX] 12% State Surch 1/14/200E $8.70
Phone: Total $81.20
Contractor:
ALL FUEL INSTALLATION & SERVICE LLC
PO BOX 69
TROUTDALE, OR 97060 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 674 -2350
FAX 503- 674 -2693
Reg #: LIC 169503
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: � ' / , 411 110 Permittee Signature: iiee A/
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.
2008 -01- 1113•32 » P 1/2
OR 97223
ard
• • • Tf�' -yi s "' -- Tr 1 ,• e k r c.[ tT p, 'a i +
Mechanical Permit Applica ik �r 11, t 11 ( N, 1 t 1 t t
9 x; i keusved
Cit of Tigard N a n Re w / U P " Penult No.. y)2 r�- c1�in��
'7.::=: 13125 SW Hall Blvd., Ti ,
P' Plan Review
® Phone; 503. 639.4171 Fax: 503.598.1960
Other Permit:
-, J AN 1 1 2008 tJigc/A _
: i ?i`i., > , Inspection Line: 503.639.4175 Date Ready/By: lurk ® Sec Pace 2 for
,... , =: Internet: www.tlgard•or,gov CITY OF TIGARD Notiticd/Mcthod. Supplemental Information
. __•li . l_ a _
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - IJSE CHECKLIST
[] New construction ® Addition /attention /feplaeement Mechanical permit Pecs• arc based on the value ol'the work
performed. Indicate the value (rounded to the nearest dollar) of u11
❑ Demolition ❑ Other: mechanical materials, equipment, labor, m erhead, and profit.
CATEGORY OF C:ONSTRUCFION
Value: $ S1,207.26
RESIDEN'FIAL EQUIPMENT NT /!SYSTEMS FEES*
® I- and 2- family dwelling 0 Commercial /industrial 0 Accessory building
1-or special information use checklist,
❑ Multi - family C] Master builder ❑ Other: Dew:ription ..•.. 'Qty. T Ea. I 'total
JOB SITE INFORMATION AND LOCATION !leafing/cooling
Job site address: 12245 SW Sommer St Air conditioning or heat pump
(requires site plus aluiwmq placement) 14,00
City /State /LIP: Tigard, OR 97223 Furnace 100,000 BTU tduetarvemq____ 14.00
Furnace 100,0004 BTU (duets/vents) 17.9(1
Suite/bldg. /apt. no.: Pmjcct name: Gas heat pump 00 _
Cross street/directions to job site: Duct work 14,00
- __ l y dnntic hest water stem 14.00
Residential boiler (radiator or
_hxdrunic T 14.00 ,
Unit heaters (fuel-type, not electric),
in - waft, in - duce, suspended, etc. 10.00
Subdivision: Lul nu.: Flue /vent for any of above 4 10.0(1 _.
,. ^ Other: 10.00 ,
Tax map /parcel no.: Other fuel appliances •_
DFSCRIP'1'ION OF WORK Water heater 10.00
Install gab hoe, vent and new �,gS stove
Gas fireplace for 1 10.00 10.00
Hue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00 •
M
Wood/pellet stove V 10.00
Wood fireplace /insert 10.00
® PROPERTY OWNER 1_ ❑ TENANT Chimney /liner /flue /vent
Other 1 10.00 10.00
10.00
Name; Chris Deferding Environmental exhaust and ventilation M
Address: Same as above Runge houd/uther kitchen
equipment 10.00
City /State /7.,1P: Clothes d ry cr cxhaasl - 10.00
— • Single -duct exhaust (bathrooms.
Phone: (503)590 -3735 Fax: ( ) toilet compartments, utility rooms) 6,80
0 APPLICANT 0 CONTACT PERSON Attic/crnwIspace fans _ 10.0U
-- other: 10.00
Ruttiness name: See Below
,• „• -_ Fnrl piEin13.
Contact name: 55.40 for first four; 51.00 for each additional
Address: Wf Furnace. etc. —
_ (,as heat pump ,,,
('ily /S!aleflll': Wall /suspended/unit h catcr ..
Phone: ( ) Fax: : ( )
Water heater
-• - - - Fire lace 1 5.40
E -mail: Rung,c .m
CONTRACTOR 14arbec e
Business name: All Fuel Installation and Service, 1 -L('• Clothes dryer (gas)
- — Other
Address; PO Box 69 _ MECHANICAL PERMIT FEES
City /State / /.IP: Troutdale, OR 97060 Subtotal 25.40
• Minimum permit fee (S72.50) 72.50
Phone: (503) 674 -2350 Fax: (503) 674 -2693 plan review (25 "/ of permit ten)
CC13 tic.: 169503 State surcharge (12% of permit fee) 8.70
. 77 - . - TOTAL PERMIT PEE 81.20
•
�_ C� This permit application etpirea if n permit 14 not obtained within IRO
Authorized signature: days after it has been accepted tie complete.
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