Permit 4.. 4
Y.
l CITY OF TIGARD MECHANICAL PERMIT
11 DEVELOPMENT SERVICES PERMIT #: MEC2006-00340
`' I 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 7/25/2006
PARCEL: 2S 110BB -01800
SITE ADDRESS: 12395 SW CORYLUS CT ZONING: R -1
SUBDIVISION: AMES ORCHARD LOT: 007 JURISDICTION: TIG
Project Description: 60' of gas line to pool heater.
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:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
ANDREA ROBERTS Description Date Amount
12395 SW CORYLUS CT
TIGARD, OR 97224 [MECH] Permit Fee 7/25/200E $72.50
[TAX] 8% State Surcha 7/25/200€ $5.80
Total $78.30
Phone: 503- 819 -9499
Contractor:
WOLCOTT PLUMBING /DBA JACK HOWK
1075 W. HISTORICAL COLUMBIA RI
TROUTDALE, OR 97060 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 235 -8784
FAX 503- 491 -2932
Reg #: LIC 23847
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: Z C4.4.,-, _ , Permittee Signature: 5■ f' 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.
1Vii.echtaz:iical Permit Application tteaa,vea �,�/ L / /� 6 z (�
• Q. City of Ti�alyd it Ecblv1.4, , D o26 t aV Pumit' l46e..10 `p — .0 J I `.'
ntc/13y. � Jam/
13125 SW Hall Blvd -. Tigard. OR 97,2. w _), Plan Revic Chher t'enn;t: '
Phone: 503.639.41 Fax: 5113.598.1960 i Dntc /fly
Air' !!•1i Dntc. Rca /hit'. Surfs: ei Scc rage 2 for
Inspection Line: Sl1;i,639.A 175 tiupplrmrntnl Information
JUL 2 4 2006 N
Internet; wtiwi',ci,tigard.ar , us -
' .:I'. ('ON MEW 'I L FEE* ,•C'IIEDI+LE it sr: CHECKLIST
:r T. - ;V i petlnit ikt : ;* trz as,,z1 , , *6",'4 1 :i ': 2'vy.xk
❑ Ncw construction 2,10,r< � r I>crfot7r,ed. Indicate the value (rounded to the nearest dollar) of all
El I.�etttnli'Lion ❑ CJihcf: - - mechanic :a materials. equipment. labor, eve boa and Yo
Value: 5
r (.':\Tr,(::OR \: OF ('ONSTRi!(TiON
r RFhii)EN'rL_+.L EQ1IY1PhLENT / SYSTEMS FEES'
1 and 2 iantily dwelling ❑ Cotnit3txl ia1 /i.ndustrial [7 Accessory building ....
special infnrmal,c >n t +se checklist. _
Master builder ❑ Other: Description Q'ty. Ei. ratnl
JOB SITE INFORMATION - ,tNI) LOCATION Ticatin /cnoltn
/R ^' may _, — ( Air conditioning or heat pump
` �� F •`%^ - ( r uifenl;tlan
c . a'nowin .fnsetncnt 14.b(1
job site address: ea ---
- r , r / ' J ' 7 �J Furnace 100,00013TU (duets/vcnis I 4.00 • _
Cit /Slate /7 TP: '� G �!
Furnace 100,000+ I3T1 "i (ducts/vcnls) 17.90
Prnjce1 nntT,c: ' i' 14.00
Suite /hldR.htpt, no.: Gas h.ont. ump _ ---
"` _
Cross street /diroctians to job site:
Duct work 14.00
� Ii dt hot water s stem 14.00 _
llC/ � Residencn nl boiler (radiator or
hydron ")c) 14.00 -- Unit heaters (fue type. not electri
l c),
in -wall, in - duel. sus ended_ etc. 1(1.00
, Flue /vent for any of above .11
0.00
Subdivision: tot no.: 10.(}0
.. Other; _ � .._
Tax trap /parcel no.: Other fact n Dances
'-4-11-1r. i►I;SC'RTPTION OF WORK i ltd I .00 W
K fir'- ® i & �� OM :�
r '
Flue vent ft . cr r / er . 4 •
tit .lace
_ x.00
l tr,I / , r
Wood/ . o{let. stave
Wood fire .lace /insert 1 0.00
Chimncy /liner /flue /vent 10.00
At 1.'ROPERTi OWNER ❑ TFN.■'f Other 10.00
Name: l 6 .. E Enviroutocntal exhaust irnd venttlntton
_ 574)___-_
� Range Hood /other kl+kitchen
Address: c 10,00 U, UO
City /Staid /ZIP:- �!� //'' Clothes dryer exhaust 10,00
/' �f✓i� - Single -duct exhaust (bathrooms.
Phone: ( - F/q ggig," Fax; ( ) . ^ - toilet compartments, utiii rooms) 6,R0 ,
Attic /crawlspacc .fans 10,00
El : \rri : I('.AN'1' c3 C' <:)NT.a PERSON
other: 1 0.00
Business name; Wolcott Plumbing fibs .JACK idOWK I,IIMBING & DRAIN _ nel i ttg --
Con1aL'tname; $ _5 . 40 for first four, 51.00 for cacti additional
(`rJrC" -- de.
Address; 1075 W HISTORIC COLUMBIA RIVER, HWY HWY G aet c.
City /Slate / "LIP'. TROUTDALE, OR 97060
wall/suspended/unit heater - -,_
Phone: (503) 235 -8784 Fax: : (503) 491 - 2932 Walcr heater
— . - -• Fir lace
E-mail: Ran ,c —
"
C'oNTR.- >,CToR Barbecue
��►
Business name; Wolcott Plumbing dba JACK IIUWK PLUMBING BTNPLUMBING & DRAIN clothes d cr ,: as r ter, /t�� �
iv
:% � � 1O
Address: 1075 W HISTORIC COLUMBIA RIVER. HWY Nli:(7i,: \Nic . &i. £ERI ID' FEES' �
City/Stato /'ZIP: TROUTDALE, OR 97060 - Subtotal
-- Minimum permit: foe ($72.50) 42 ,`
Phone: (503) 235 -8784 Fax: (503) 491 -2932 Plan review (25% of permit fee) _
CCB lie.: 23847 State surcharge (R% of permit fee) .
� " �" TOTAL PERMT.T y J�
( � �� �/� This permit application expires It n (,qr is not btu_ i li „3IRV
Authorized signature: `L <� �� �� / days aferIt has been accepted as card .
l name: `-! /�� / _)ate: t ,,, * Fee methodology set by Tri- Cnunty Building industry Service Board
J /llAj/ "X ma-.. i' % g)3._. 4 . :?
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MFC2806-0040
AR 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/20/2006 mr
Phone: (503) 639 -4171 / mpi
Inspection Requests (24 Hrs.): (503) 639 -4175 - ri 6 a2co 6 - on 3
INSPECTION WORKSHEET FOR DATE: LI/2/2006 TIME: 7:06AM PAGE: 2
SITE ADDRESS: 12385 SW CORYLUS CT CLASS OF WORK:
SUBDIVISION: AMES ORCHARD LOT #: 007 TYPE OF USE:
PROJECT NAME: ROBERTS
DESCRIPTION: 60' of gas line to pool heater.
OWNER: ROBERTS, ANDREA PHONE #: 503 - 819.949
C ONTRACTOR: WOLCOTT PLUMBING /DBA JACK HOVVK PHONE #: 503. 235.8704
Inspection Request Scheduled For: Date: 8f/2006 Pour Time: •
Code # Inspection Description Confirm # Contact # I) -ssa.e
610 Gas line 034261 -01 503- 235.8781 Y
Corrections /Comments /Instructions: .
G UAJC 4 70 r f R $C "'LS
pr l
Z,, PASS PARTIAL APPROVAL I I CANCEL I I NO ACCESS
FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: oh F Date: ' e9, Phone #: (503) 718 -Z-6 Y