Permit irioxr CITY I MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00633
Aar l5 ISSUED: 12/12/2006
T;tGARD 13125 SW Hall Blvd., Ti ard, OR 97223 503.639.4171
Tigard, PARCEL: 2S104AA -14100
SITE ADDRESS: 12200 SW 128TH AVE ZONING: R -4.5
SUBDIVISION: BELLWOOD NO. 3 LOT: 160 JURISDICTION: TIG
Project Description: Gas line to stove and bbq, vent 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP:
GAS PRESSURE: 50 + HP: WOODSTOVES:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 2
Owner: FEES
MULLIGAN, PATRICK J AND Description Date Amount
SUSAN M
12200 SW 128TH [MECH] Permit Fee 12/12/20( $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 12/12/20( $5.80
Phone: Total $78.30
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: /V,/ Permittee Signature: nv7 ����"
Call 503.639.4175 by 7:00 a.m. for inspections that busines
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.
2006- 12- 1108:OB p„in » 5035981960 P 212
, 7' 1. ,1; " , f 'l 11) II I M 'I M y I , 0, 1�� a w .
rechanical Permit A lication ,, • Y °.u,. . _. ,.1 . �1. . &. 6 .,, ,- 3.> . 4,,„
' u ' City of Tigard r R Ce 1 VC d ` / Permit No. DD 62
/
r 13125 SW H Blvd., Tigard, OR 972 k , � �� DYteBy: / � 1 t /0fo' �� .�� ��
/ � d Phone: 503.639.4171 Fax: 503,598.1 `6(1 pc U
paw Rev 1C`v Other Perm;(:
i91 4\1 /, Inspection l.ina 503,639.4175 DEC 1. 2U Y Date Ready/By: •�f� IB See Page 2 for
lfv Internet: www,tigard•tr.gov Notified/Method: ( Suppkmentat Information
Gu t) A - 1
TYPE OF wdi}liILD1N C DIV SI
COMMERCIAL FEE" SCHEDULE – USE CHECKLIST
❑ New construction ® 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
❑ Demolition Q Other: mechanical mutrr_ials equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
I3 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For .special information use checklist.
❑ Multi family ❑ Master builder ❑ Other:
Description Qty. I Ea. J Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 12200 SW 128tb Air ctmditioning 111 heat pump
('requires site plan showing placement) 14.00
City /State /ZIP: Tigard, Oregon 97223 Furnace 100.000 BTU (duds/vente) _ 14.00
Furnace 100,0004- RTU Owe/vents) 17.90
Suite/bldg. /apt. no.: Project name: Gas heal pump 14.00
Cross street/directions to job sitc: Duct work 14.00 ,
Hydronic hot water system 14.00
Residential boiler (radiator or
hydrunic) 14.00
Unit heaters (heel -type, not electric),
in -wall, in - duct, suspended, etc. _ 10.00
Subdivision; I tit nu.: Flue/vent for any or above 10.00
Other: 10,00
Tax map /parcel no.: Other fuel appliances __
DESCRIPTION OF WORK Water heater - I0,00
Gas fire .lace I ' 10.00 10
Install gas line to stove and bbq, vent new gas stove Flue vent for water heater or gas
fireplace 1 10.00 10
Log lighter (gas) 10.00
— _ Wood/pellet stove 10.00 — —
Wood fireplace/insert 10.00
® PROPERTY OWNER 1 ❑ TENANT ChimncyAtner /flue /vent 10.0 ��
Other: 10.00
Name: Pat Mulligan Environmental exhaust and ventilation
Address: Same as Above Range hood/other kitchen
equipment 10.0(1
City /State /LIP: Clothes dryer exhaust 10.00 -...-
- / Single -duct exhaust (bathrooms,
Phone: ( s.4Q — 1 Lf- Fax: ( ) toilet c mpartments utility rooms) - 6.80
® APPLICANT li ❑ CONTACT PERSON Attic /crawlspacc fans 10.00
Other: 10.00
Business name: See Below _ ......
Fuelrj _
Contact name: $5.40 for first four; 51.00 for each additional
Address: Furnace. etc.
— Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: 1 ) Water heats
Fireplace 1 •
E -mail: Range
CONTRACTOR Barbecue 1 5.40
Business name: All Fuel Installation and Service, LL(. Clothes dryer (gas) -
Other: _
Address: PO Boa 69 MECHANICAL PERMIT FEES*
City /State/ZIP: Troutdale, OR 97060 Subtotal 25,40
Minimum permit fee ($72.50) 72.50
Phone: (503) 6742350 Fax: (503) 674 -2693
Plan review (25% of permit fcc)
CCIi lie.: 169$03 State surcharge (R of permit fec) 5.8
- TOTAL PERMIT FEE 78.30
Authorized signature: �� This permit application a *ptrca it a permit is not obtained within 180
��^ - days after it has been accepted as complete.
CITY OF TIGARD
BUILDING DIVISION
Ai 1, PERMIT #: MEC200&00633
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1211212006
Phone: (503) 639-4171 iswitvotiiii-
Inspection Requests (24 Hrs.): (503) 639-4175 .- ■ F''..i. / a00 6 -6 g.
INSPECTION WORKSHEET FOR DATE: 12115/2008 TIME: 7:04AM PAGE: . 46
SITE ADDRESS: 12200 SW 128TH AVE CLASS OF WORK:
SUBDIVISION: BELLWOOD NO 3 LOT #: 160 TYPE OF USE:
PROJECT NAME: MULLIGAN
DESCRIPTION: Gas line to stove and bbq, vent new gas stove.
OWNER: MULLIGAN, PATRICK J AND, PHONE #:
CONTRACTOR: ALL FUEL INSTALLATION & SERVICE LLC PHONE #: 503-674-2350
Inspection Request Scheduled For: Date: 12/15/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 041139-01 503-674-2350 ¥
Corrections/Comments/Instructions:
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PASS 7 PARTIAL APPROVAL 0 CANCEL :t ' 7 ' i 0 ACCESS
I I FAIL PI CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: , .
/ Date:/2 — i S a (6 Phone #: (503) 718- Z-41-4--Ci