Permit ..'j • CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00604
; TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/11/2008
PARCEL: 2S110BB - 02300
SITE ADDRESS: 14300 SW HAZELHILL DR ZONING: R -
SUBDIVISION: AMES ORCHARD LOT: 023 JURISDICTION: TIG
PROJECT: SCHRUPP
Project Description: Installing gas insert and gas line.
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:
OTHER UNITS: 2
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
RICHARD SCHRUPP Description Date Amount
14300 SW HAZELHILL DR
TIGARD, OR 97224 [MECH] Permit Fee 12/11/20C $72.50
[TAX] 12% State Surch 12/11/20C $8.70
Total $81.20
Phone: 503- 968 -6287
Contractor:
LUDEMANS INC
12675 SW BEAVERDAM RD
BEAVERTON, OR 97005 -2129 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 646 -6409
FAX 503- 646 -8034
Reg #: LIC 51469
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: 41E _ A , 1/4, I, Permittee Signature: fe LCe (C)r\
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.
DEC.10.2008 4 :02PM NO.379 P.2/3
Mechanical n it A �licati �} ,; .'' .,y
uical Pei" 1 o) ' �� '.� r , ;', x `ri • I_'(+)It (') 115t (IN ;gl r - t it bi " k',
ip': City of 1 i : and I% CE D Received "
h Dt4eBv: • o • o ; _a PcmritNc. V .7.008 • 40 .4
13125 SW Hall Blvd., Tigard, OR 9'7223
• , Phone; 503.63•.4171 Fax; •503.595,19 Plan Review o ther Pennh:
rvit t L C 1 200 nute/Byr Pl See Pa ge 08 • c362 4 •
TI Gn it.f) Ins Lint; • 639 4175
Date Ready/By; 61 See Pa e 2
manta
I ntcmeC www.l gard- or.gov /B a for
CITY OFTIGARD Notified/Method: Supplemental Information
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Mechanical pen fees"' are based On the value oldie work
❑ New construction r. Addition/alteration/replacement
t-�I performed, Indicate the value (rounded to the nearest dollar) of all
u Demolition ❑ Other: mechanical materials. e•ui merit, labor overhead, and prdfit.
■. I,•Y_,1, :eg ,itl 1 1J °' liri I ♦� "�';u�Z a l I . ' i .
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1118101,1111.21705623.10.1& ° t� o- &' . lt' R
X 1 - and 2- family duellint ❑ Commercial /industrial ❑ Accessory building �til• ! +rt
El For speclal information use checklist.
❑ Multi - family ❑ Master builder
Dcscr don
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Job site address J.5/ �, Air conditioning or heat pump l
�2a (requires sitcJilat= showingplacement 1 14.00
M • Q
r
7 Furnace 100 000 BTU (ducts/vents 14.00 ,
Suite/bldg./apt. tie.: Project name: e Furnace 100,000+ BTU (ducts/vents) 17.90
- 0.7 4.., A r /� Q Gas heat pump 14.00
Cross street/directions to job :ite; ! Duct work I _ 10.00
H dronie hot waters stein 14.00
Residential boiler (radiator Or
hydronic) 14,00 ,
Unit heaters (fuel - type, not electric),
in -wall, in -duet, su- .ended, etc. 14.00
Subdivision; Lot no.: Flue /vent for any of above 620
- • . . . Other: _
Tax map /parcel no.:
Othor fuel appliances
1 ' :1, ,. S g0•.i'.}it�y P�� i�' , •� y , t I LID , "rr� F��"'A},j � ' Water healer 10.00
Gas fireplace h G ,5e-r 2 . " MI 10.00 0.6
_/-- ' U ^ fie✓ 71-- _ ��¢ Flue vent for water heater or gas
0 4- �� a fireplace 1000
r Los lighter (Ras) 10.00
- L. Wood/pellet stove 10.00
-
Wood fireplace/insert 10.00
::u! 1
t,•l;l x,< @y �?� t r,. . r Chin /liner /flue/v
, "�. i t;'," '� t E ' 1ld+` r �) i 4t D:' Clic . T U O racy cat I0.00 /d. ade' 1. � t• ��� - )}l i �'� � .1, , t 'l, �, � other: 10.00
Name: C ■ , -.. Environmental exhaust and ventilation
Address: _ da O oSC1 = /' `/ Rage hoed /other kitchen T
I c ui.ment 10.00
1.-". 0 /Z 9 7 ,78 V Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone. (5 03 6 ' _ , c 2,7 Fax: ( ) toilet compartments, utility rooms) 6.80
18 , 1 k��,f' g Yfil''�lw ' �'� i �� d G 11 d ! L` 7i 94 �� ;V r
s';, i� wr'�I; M. tla h s Y i i 7 .'� 1 t" , s a d �;ii,,¢ Attic/crawlspace fans 10.00
o £ AI Other: 10.00
- - -• Fuel piping
Contact name; 4/1... A, I. C 1ct 55A0 for first four; 51.00 for each additional
Address; Furnace. etc,
I _ it e i o' Gas heat pump
City /State/ IP: e _ Q ` ( 70OS Wa11/su5. /unit heater
Fboee: Le' _ ' 90 Fax:: (5 Q l�� • �s� Water heater `
E -mail
Fireplace je
O w A Ai A. eie'., S Rangy
) t f Ilrl`t J D4if' l i P 1� }lL4 � �J { � � 1 r�x j } h
,. 1 .i , :��. 1 v 1i . , h(1r ,1 +, ;'u tt,,.. a NISI „ ��i' ,c;1';��G 1'� {ItifvJ��, i � ';' ;, Barbecue
Business name: y e .4p Clothes dryer (gas)
Address: Othet ppp. y�,�pt� y ��y
:a r} i 1 T5 .'.w ]Y+?aY� rn�r 'W. I u t6 1,h1 i t
-
a , 1¢;
City/State /ZIP:
_ Subtotal , I
Phone; ( ) Fax ( )
Minimum permit Fee (572.50) 7,. p
Plan review (25% of pcnnit fee)
CC8 1ic,; State surcharge (12% of permit fee)
TOTAL PERMIT FEE ./42O
Authorized signatur � Thly permit application uxpirej Ira permit Is not obtained within 180
days after (t has been accepted as complete.
Print name: .. " . ; 1111 12/1 ..•.: 9 e & Date: /0_ /0 - O ri " Fee methodology set by Trt•County Building Industry Service Foard
1 1 awI01ng∎PamrvtMEC•P AUp.40c 01 IS /07 440 (11 /02 /COMlW100)
CITY OF TIGARD .. , ...
L• ,
BUILDING DIVISION PERMIT #: 1Ec2000_00E
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/11/2000
Phone: (503) 639-4171 i .474P. ,PIA■ji
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: •2/Antis TIME: 7 PAGE: i 1
Z ot.Z... MT.
SITE ADDRESS: 14300 SW HAZELHILL DR CLASS OF WORK:
SUBDIVISION: AMFS ORCHARD LOT #: 023 TYPE OF USE:
PROJECT NAME: SCHRUPP
DESCRIPTION: Installing gas insert and gas line.
OWNER: SCHRUPP, RICHARD PHONE #: 503-968-6287
CONTRACTOR: LUDEIVIANS INC . PHONE #: 503,646.6409
Inspection Request Scheduled For: Date: 12/300008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 079260 603-968-6287
Corrections/Comments/Instructions:
6 9 - 1 7 - - -7 iki Ill
(--- 4 L- i
c,.. •
/MIMI ,
4...
P1 PARTIAL APPROVAL n CANCEL n NO ACCESS
FAIL CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
Inspector: Date: q Phone #: (503) 718- Z‘YY