Permit C ITY OF TIGARD MECHANICAL PERMIT
�� I DEVELOPMENT SERVICES PERMIT #: MEC2005 -00541
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/1/2005
PARCEL: 1 S135AA -03705
SITE ADDRESS: 10385 SW 87TH AVE ZONING: R -4.5
SUBDIVISION: ASHBROOK FARM LOT: 012 JURISDICTION: TIG
Project Description: Gas piping to range.
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: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 0
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
MERCEDES GARCIA Description Date Amount
10385 SW 87TH AVE
TIGARD, OR 97223 [MECH] Permit Fee 9/1/2005 $72.50
[TAX] 8% State Surcha 9/1/2005 $5.80
Total $78.30
Phone: 503 - 452 -3198
Contractor:
KOEHLER CONCEPTS LLC
10772 SE HWY 212
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Phone: 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: '7, j m,,, i ,e 4 Permittee Signature: C t
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.
08/30/2005 05 : 45 FAX 5038501220 KOEHLER CONCEPTS a 002/002
. • h
.Mechanical Permit Application mit oFFict: usi:
City of Tigard Received _./ . 6.3 -- ___.,--...., 11:=1===
Date./13y: ki...",
13125 SW Hall Blvd., Tigard. OR 97223
Plan Review
Phone: 503.639.4171 Fax: 503.598,1960 RECEIV 7,N, Date/By: Other Permit:
Inspection Line; 503439.4175 ...114- ' 110 Door Ready/By; MI afl sea Pogo 2 for
Internet: www.ci,tigard,orms
Noed/Method: Suppiemenral informs film
AUG 31 2005 rifi
El New construction 121 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
D Demolition 1:1 Other: mechanical materials. equipment, labor, overhead, and profit,
1 ;i.I .' i:',,:' " idi'l;: ' ',I14Elii;YIR: Val= $
.(.,1( 0 ,,,,: -; al: r 1 :4' aCtk■ 1" Ul . JA , 1 `,. ' . " ' ' • ' " " ' ' ' • '
1 1 /' 1 3 ■ I AO ,,1,,,,, O ,__1 11 "" 10044 '
El
I- and 2-family dwelling fl Commercial/industrial 0 Accessory building S
For special information use checklist.
0 Multi-titmily 0 Master builder 0 Other:
Description I Qty. 1 En. I Total
!'. ' . ' '' I'Ff' i : , : li : j0 i1 40 2 4.440, 7 iitifl0 1 1 4 04 ; i000000,?I'71 ;7 irIM:I.,'I r i : ri l tilA;; Heating/cooling
Job site address: 10385 SW 87" AVENUE Air conditioning or heat pump
, (requires site plan showing placement) 14.00
City/State/ZIP: TIGARD OR 97223 Furnace 100,000 BTU (ducis/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bIdglapt. no,: I Project name:
(Ins heat pump 14.00
Cross Street/directions to job site: Duct work 14,00
.
B dronic hot water sy stem I 1 14,00
Residential boiler (radiator or
hydronic) 14,00
. Unit heaters (fuel-type, not electric),
in-wall, in-duct, suspended. ctc, 10.00
Subdivision: Lot no.:
Flue/vent for any of above_ 10.00
I
Other; 10.00
Tax map/parcel no.: Other fuel appliances
' 'i l : ‘;i' 511 i.14i;:IPII'ri 3 O. 1 bos000****0#44.ii4Figii!IIi',.,'Rlil.1114140,!.'I: Wilt" heater 10.00
- Gas fireplace , 10.00
RUNNING APPROX 25 FEET OF GAS FUEL PIPING TO RANGE LOCATION Flue vent for water heater or gas
fi 10.00
Log lighter (gas) - 10.00
,, Wood/pellet stove 10.00
Wood fireplace/insert 10.00
: Chimney/liner/flue/vent I 0,00
L ': t oth„ 10.00
Name: MERCEDES GARCIA Environmental exhaust and ventilation
Range hood/other kitchen
Address: 10385 SW 87 AVE
equipment . 10.00
City/State/ZIP: TIGARD OR 97223 Clothes dryer exhaust 10.00
Single-duet exhaust (bathrooms.
Phone: (503)452-3198 Fax: ( ) toilet compartments, utility rooms) 6,80
' I T ace
Attie/crawl
51' fans 10.00
Other: 00
Business name: KOEHLER CONCEPTS LLC . 10. _
Fuel piping
Contact name: TODD $5.40 for Brat four; $1.00 for each additional
Address: 10772 SE HIGHWAY 212 Furnace, etc.
Gas heat pump
City/State/ZIP: CLACKAMAS OR 97015 Wall/suspended/unit heater
Phone: (503) 650-9550 Fax: : (503) 650-1220 Water heater
Fireplace
E-Inail: TODDgKOEHLERCONCEPTS.COM Range 1 5.1-6 5 4
' r 114154.1 '
r ffiAii - 511:Tilir.1.,,o,,,,,,,, : .,.,,.,,r, Barbecue
,
Business name: KOEHLER CONCEPTS LLC Clothes dryer (gas)
Other:
Address: 10772 SE HIGHWAY 212 _ lg"g'illi,MOIXCAMItgiliLPERMIT,
City/State/ZIP: CLACKAMAS OR 97015 . Subtotal 5.4-
Minimum permit fee ($72.50) / 1.,.. 0
Phone: (503) 650-9550 Fax: (503) 650-1220
Plan review (25% of permit fee)
CC B lie.: 120277 State surcharge (8% of permit fee) 5 5 D
TOTAL PERMIT FEE . 7 $ . 30 .
The permit •pplicetion expires ire permit is not obtained within 180
Authorized signature: — 7 - '004erge0..° day" after It lute been oecepied its Complcto.
Print name: TODD KOEHELR - Date: 8 • Fee methodology set by Tri-County Building Industry Service Board
iAlkildinaTorminWEC•PeriniiApp.doc 12/03 4 ( 1 1/02/COM/WER)
CITY OF TIGARD ^ ,.
BUILDING DIVISION PERMIT #: MEC200& -001
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 9/1/2005
Phone: (503) 639-4171 / wn� "Hpuy� °��•
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 9/2/2005 TIME: 7:07AM PAGE: 31
SITE ADDRESS: 10385 SW 87TH AVE CLASS OF WORK:
SUBDIVISION: ASHBROOK FARM LOT #: 012 TYPE OF USE:
PROJECT NAME: GARCIA
DESCRIPTION: Gas piping to range.
OWNER: GARCIA, MERCEDES PHONE #: 6603.45 -3198
CONTRACTOR: KOEHLER CONCEPTS LLC PHONE #: 503..650.9550
Inspection Request Scheduled For: Date: 9/212005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 014883 -01 503 -452 -3198 N
' Corrections /Comments /Instructions:
J -
11, Z
I
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: < Date: 9 -- 2 r2� Phone #: (503) 718 -
i`