Permit ` CITY OF TIGARD
MECHANICAL PERMIT
,, . COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00649
,,,
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/7/2007
PARCEL: 2S 111 AB -04200
ZONING: R 4.5
SITE ADDRESS: 14400 SW 92ND AVE
SUBDIVISION: PENMAR TERRACE LOT: 006 JURISDICTION: TIG
PROJECT: HOWARD
Project Description: Gas to fireplace.
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:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
GLENN & PAULA HOWARD Description Date Amount
14400 SW 92ND AVE
TIGARD, OR 97224 [MECH] Permit Fee 11/7/2001 $72.50
[TAX] 8% State Surcha 11/7/200i $5.80
Total $78.30
Phone: 503- 624 -2157
Contractor:
OREGON HEATING & AC
PO BOX 397
DUNDEE, OR 97115 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -538 -2953
FAX 503 -537 -2172
Reg #: LIC 172126
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: A , 4 ./ j ' ', J /_. Permittee Signature: y!7) e g� �� L
Call 503.639.4175 by 7:00 a.m. for inspections that busines 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.
'� 07 09:21a Oregon - - �� A/C
: 503 -537 2172 p 1
: Permi
t----...., • ei— . h - * FOR OFFICE USE O�'LX
17
City of Tigard yAAy�� 1n' P 20 Received �( PetntitN ` f t
W .1" 1 Date/By: iI � d� 'i _ �r''i te i /
13125 SW Hall Blvd., Tigard, 2
Plan Review
Phone: 503.639.4171 Fax: 503.59�8.1 p Date/By:
Other Permit
Ins ection Line: 50 5 5 V I ` ° kris: El See Page 2 for
T IGARD p D ate R ea d y tB y:
Internet: www o v AIDING DTI rIf SIO Notified %Method: Supplemental information
Rit !/ i
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
El New construction ® Addition /alteration /replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor. overhead, and profit.
'CATEGORY OF CONSTRUCTION. Value: S
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
Z 1- and 2 - family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. Ea. 1 Total
JOB SITE' INFORI�L�TION AND LOCATION Heating/cooling
1 Li �O
Air conditioning o !teat pump
Job site address:
��j c) �( c \ �� � (requires site plan shwinQplacemen0 14.00
City/State/ZIP: Furnace 100.000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ductstvents) 17.90
Suite /bldg. /apt. no.: Project name:
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in- wall, in -duct, suspended. etc. 10.00
Subdivision: Lot no.: Flue/vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF • WORK
Water heater 10.00
Gas fireplace 10.00
H VAC- n; r , ( \t' - i U £l .l-e p Inc F. Flue vent for water heater or gas —
fireplace 10.00
Log lighter (gas) 1 10.00
Wood/pellet stove 10.00
Wood fireplace/insen 10.00
iner /flue / ent
• (N: PROPERTY OWNER ::.: 0 TENANT
Chirruteyil v l
Other. 10.00
Name: cj\ e-v l t' Pa )'( l\ r.) . _ o _ ( _ Environmental exhaust and ventilation
Address: I Li 14 u j 9,D n 6 A \e, equipment hood other kitchen
co 1.JV e ui menu 10.00
City/State/ZIP: --Ti C n� o 3, Clothes dryer exhaust 10.00
03 157
utility Single -duct exhaust ( l
Phone: r3 - f7t I t / ( Fax: ( ) toilet compartments, utility ily roo rooms) 6.80.
,: ® APPLICANT : 0 CONTACT PERSON crawlspace fan_
Attic! �
Other: 10.00
Business name: Oregon Ileating & A/C
Fuel piping
Contact name: Ea�h �> S5.40 for first four; $1.00 for each additional
Address: PO BOX 297 Furnace. etc.
Gas heat pump
City/State /ZIP: Dundee OR 97115 Walllsuspended'unitheater _
Phone: (503) 538 -2953 Fax: : (503) 537 -2172
Water heater
Fireplace I _
E -mail: Range • CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: Oregon Heating & A/C
Other. ,
Address: PO BOX 397 MECHANICAL PERMIT FEES*
City/State /ZIP: Dundee OR 97115 Subtotal
Minimum permit fee (572.50) 7a ,r7G
Phone: (503) 538 -2953 Fax: (503) 537 -2172
Plan review (25% of permit fee) ,
CCB lic.: 172126 • State surcharge (8% of permit fee)
^ , ,M1 �l
I TOTAL PERMIT FEE 7 �' . 30i
.J / r , This permit application expires if a permit is not obtained within 180 • Authorized signature: eee���
�i ^^--7� days after it has been accepted as complete.
Print name: I�l\svvit� 5� � Date: `^` «�0 ! ' Fee methodoloSy set by Tri- County Buildin8 Industry Service Board
i t B
I aitding 'PermitsMEC- PemitApp.doc 04106.01 440 -1617r (11 /02'CO I .
CITY OF TIGARD
BUILDING DIVISION
PERMIT #:
MEC2007-00649
1
I I 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1117/2007
Phone: (503) 639-4171 aft_ .
Inspection Requests (24 Hrs.): (503) 639-4175 4!!J' t7e 7 — 00 ev V
INSPECTION WORKSHEET FOR DATE: 11/9/2007 TIME: 7:00AM PAGE: 56
SITE ADDRESS: 14400 SW 92ND AVE CLASS OF WORK:
SUBDIVISION: PENMAR TERRACE LOT #: 006 TYPE OF USE:
PROJECT NAME: HOWARD
DESCRIPTION: Gas to fireplace.
OWNER: HOWARD, GLENN & PAULA PHONE #: 503-624-2157
CONTRACTOR: r101M0,141/0114% PAULA PHONE #: 503-530-2953
•
Inspection Request Scheduled For: Date: 11/9/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 059381-01 503-538-2953 Y
Corrections/Comments/Instructions:
; \ °
00 \
F ig2
V illi
...-
PASS PARTIAL APPROVAL CANCEL 0 NO ACCESS
0 FAIL . CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
, 4
Inspector: - , Date:// —c--.' 7 Phone #: (503) 718-
CITY TIGARD
BUILDING DIVISION PERMIT #: MEC2007-00649
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/7/2007
Phone: (503) 639 -4171 ...� fill
Inspection Requests (24 Hrs.): (503) 639 -4175 Ji1L ne Aoe 7 .. !a 66 y?
INSPECTION WORKSHEET FOR DATE: 11/8/2007 TIME: 7:00AM PAGE: 28
SITE ADDRESS: WOO SW 92ND AVE CLASS OF WORK:
SUBDIVISION: PENMAR TERRACE LOT #: 006 TYPE OF USE:
PROJECT NAME: HOWARD
DESCRIPTION: Gas to fireplace..
OWNER: HOWARD, GLENN & PAULA PHONE #: 603 -624 -2157
CONTRACTOR: OcalVeR,IiiainteMPAULA PHONE #: 503- 538 - 2953
Inspection Request Scheduled For: Date: 11/8/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gm line 069279 503 - 638.2953 V
Corrections /Comments /Instructions:
e ,V 'i j i / - . - d i -S r g
I I P El APPROVAL ❑ CANCEL n NO ACCESS
F AIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: , , Date: L1- i -- 6 7 Phone #: (503) 718- z -1- " �