Permit `" IT �I MECHANICAL PERMIT
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COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00164
TiGn►tD, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/1/2008
PARCEL: 2S112CB -07700
SITE ADDRESS: 15143 SW KENTON DR ZONING: R -7
SUBDIVISION: ASHFORD OAKS NO. 2 LOT: 091 JURISDICTION: TIG
PROJECT: TAKAHASHI
Project Description: Installing gas supply extension to kitchen range.
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:
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:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
TETSURO & AKEMI TAKAHASHI Description Date Amount
15143 SW KENTON DR
TIGARD, OR 97224 [MECH] Permit Fee 4/1/2008 $72.50
[TAX] 12% State Surch 4/1/2008 $8.70
Phone:
Total $81.20
Contractor:
ANCTIL PLUMBING INC.
16900 SW MERLO ROAD
BEAVERTON, OR 97006 -0000 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 642 -7323
FAX 503- 642 -7755
Reg #: LIC 24184
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 B //� � �` Permittee Signature: / )i-
Call 503 :6 ' .175 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.
$ �.�. i5B17p # � � pu r aj` Sru s7s. } r r_.S:�tta _ t I tJ .zf
-t- 'a 13f15 SW Han T L 1. e GI; ;� V .'ok.'+ ii l 71 l .. 1( L
, ,' ` I 503.x.4171 Farr 1?' 7. .1 y g \ m Other ,' l L net Inspection Line 503.639.4175 �' ' Sans j) � ' I( N „1 a$ seel?age :
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FEE* SCHEDULE - USE
❑ New con A ddrtion/albesatioah eat Ade�tl permit fees* are based on the value ofd work
❑l /❑ pew. love the value (mew to Ore dollar) of all Other: urerbanical =tennis, equipment, labor, mahout and profit
CATEGORY OF ` VaLre $
/SYZs7IRK F EES*
and 2 -family ❑ ❑ 'bur'! Farsperml we cite :r
❑ M ulti - family ❑ lobster builder ❑ Off:
Description 1 Qty. 1 F 1 Ta1si
JOB SITE INFORMATION AND LOCATION Elealrefonsfrog
Job steaddress / J 3 5- f
579 1' / it, nd g b lamomp
/ P--7-c)-1-1 1 1� �= ( Airso�t�aa�msn p 1400 City/State/ZIP: - ' GAT i r (? d %man 100,000 BM ( Iv) 14.00
Pomace Suite/bldgJapt. no.: Pro I , A-/. A J// -Ly" W 0 BTU (d�lwes) 14
Cross street/directions to job site: / r Duet wort 14.00
Hydramic Lot water system 14.60
Ilesulential boiler (nth= or
Lydmaic) 14.00
Unit Leas (fuel-type, not electric),
in-wan, in-dint, suspended, etc. 10.00
Fhelvett; for any of above 10.00
Subdivision: , Lot no.: 10.00
Other Tax map/parcel no.: Other fuel
DESCRIPTION �y /OF K War beater 10.00
Gas fireplace
X 1 , 1 , J 5 Lr�4 EX t 6 -4 Sl O Floe vat for water heater or gas 10.00
fireplace �p / / n��/ 10.00
/ " /Cr 7 v 1 Z 17ge she 1000
Wood firepbeciunat 10.00
Et ' ❑ 10.00
Other 10.00
Name: �ik ii ftS /f/ . fr -f � � Eassirommentrall almost and vectinfiun
s ✓7)
Range Lood/atherkitd=
Address. t equipment 10.00
City/State/ZIP: Clothes dryer endunst 10.00
Phone: ( ) F a r e ( ) Wet compartments, u y moms) 610
❑ APPLICANT ❑ CONTACT PION fans 10.00
Business name Othe 10.00
Feel paper
Contact name: $5.49 for first four; SLOG for t
Address: Fm are t
Gas beat pump
City/State ZIP
W heater
Phone: ( ) 1 Fax:: ( ) Wan heater
Fneplaoe
E-mail: 1 :alige / 5:4 5, Barbaare
Other
Business name �,, /C fi CO v /',�/ _Z
Clothes dryer ((gas) Address: / 6 9 0.0 �5 J ,41 6� ,
E O NISCHANICAIL PERMIT FEES'
City/State/ZIP: 504 e, 9g it O OR 97006 Su
3 2 - 73 23 I Fa='53) (y /- 7-�ss Mme ti
pan* _72
(o4 05D
Flan mewl (2516 of pe fee)
CCB l i c . : 2g/84/ State same (12%apeman the) 2 :
p TOTAL PERMIT `d k .
Authorized signature: G„ • p &a� 11
apPa permit a not obta within 180
1 days after it has been accepted as complete
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CITY OF TIGARD
i
BUILDINL DIVISION PERMIT #: MEC2000-00164
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4/1/200B
Phone: (503) 639-4171 , 6/41 Tit\
m& ,Ido ?
Inspection Requests (24 Hrs.): (503) 639-4175 .„...., - 4 --....
INSPECTION WORKSHEET FOR DATE: 412/2008 TIME: 7:00AM PAGE: 18
SITE ADDRESS: 15143 SW KENTON DR CLASS OF WORK:
SUBDIVISION: ASHFORD OAKS NO. 2 LOT #: 091 TYPE OF USE:
PROJECT NAME: TAKAHASHI
DESCRIPTION: Indalling gas supply extension to kitchen range.
OWNER: TAKAHASHI, TETSURO & AKEMI PHONE #:
CONTRACTOR: ANCTIL PLUMBING INC. PHONE #: 503-642-7323
Inspection Request Scheduled For: Date: 4/2/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 067738-01 503-642-7323 . V
Corrections/Comments/Instructions:
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I PASS I PARTIAL APPROVAL 0 CANCEL fl NO ACCESS
I I FAIL n CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: Date: 1-- 1 Phone #: (503) 718-