Permit II CITY OF TIGARD
COMMUNITY DEVELOPMENT MECHANICAL PERMIT PERMIT #: MEC2007 -00735
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/18/2007
PARCEL: 2S 115AD -00600
SITE ADDRESS: 16740 SW 108TH AVE ZONING: R -4.5
SUBDIVISION: WILLOW BROOK FARM LOT: 030 JURISDICTION: TIG
PROJECT: HACKETT
Project Description: (2) gas lines to (2) fireplace inserts.
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:
WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 2
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 2
> 10000 cfm:
Owner: FEES
BRUCE HACKETT Description Date Amount
9H
TIGARDIGARD, , OR R 97224 [ MECH ] Permit Fee 12/18/200 $72.50
[TAX] 8% State Surcha 12/18/20C $5.80
Total $78.30
Phone: .
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: Permittee Signature: '
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.
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2007-12-14 16:47 » P 2/2
Mechanical Permit Ap plic ()k 972 l OR ItI.FI( f
23 / . O : 1.1•:„\ ,
City of Tigard CE1VED Permit N _ � 0 735
1, . 41 13125 SW Hall Blvd,. 't igard,
1 s Phone; 503,639,4171 Fax: 503.598.19t?EC 1 .: 2001 Other Permit.
u
1 , , A I. t •, Intipection Line: 503.639.4175 gate Readyrlty: luris: RI Sec rage 1 fur
Internet: www.tigard-ot.gov CITY OF rIOARD Notiticd lvlcthod: Supplemental information
RU,LOINr nalIStON
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - 115E CHECKLIST
❑ New construction ® Addit ion / alteration /replacement Mechanical permit ices arc based on the v alor of the work
perti)rmud, indicate the value (rounded to the nearest dollar) of all
❑ T)emo!ition ❑ Other; mechanical materials, equipment, labor. overhead, and root.
CATEGORY OF CONSTRUCTION Value'. $
...•. -.._. RESIDENTIAL EQUIPMENT I SYSTEMS FEES*
® I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For ..Fecial in /ormwwn use checklist.
❑ Multi- family ❑ Master builder ❑ Other: u cscri p u on Cray. I iia. Total
.109 SITE INFORMATION AND LOCATION heating /cooling
,h
Alt conditioning or heat pump
Job site address: 16740 SW 1013 Ave (rcgl site pl9n sliuwing placcumul) 14,00
City /State /71P: Tigard, OR 97224 — furnace 100.000 BTU (duets /vents) 14,00
Furnace 100.000+ RT(1 lams /vents) 17.90
Suite /bldg. /apt. no.: Project name: Gas heat pump 14.00
Cross street/directions to, job site: Duet work 14.00
_tydronie hot waters steal 14.00
_- _ Residential boiler (radiator or
•ydronic) MI 14.00
Unit heaters (fuel -type. not electric),
in -wall. induct, suspended. etc. 10.00
l..at no.; Flue /vent for any of above 10.01)
Subdivision:
1 _o.; Other 11) UU
'fax map /parcel no.: Other fuel appliances _
DESCRIPTION OF WORK Water healer „ _ _ „' 10.0(1
y install gas lints and vent to (2) fireplace inserts � Gas lireploec 10 0 {1
Flue vent for water heater or gas
' m — ' — fireplace 10.00 -
_ Lod lighter (Va s) --_ - 10.00
Wood/pellet stove 10,00 Wood fireplace /insert_ 10,00
— ® PROPERTY OWNER 0 TENANT (' :himney /liner /llue /vu;nl 2 10,00
- __- ._�. -.
-. Other — _ _ IMMIIMI
Name; Bruce Hackett Environmental exhaust and ventilation
Address: Same as Above - -- Range hood /other kitchen
,.. eyuiiTment,... _. - 10.151
City/State/JP; Clothes d er exhaust 10.00
--- - Singtc - duct exhaust (bathrooms.
Phone: (503)747 -4756 Fax:1 1 toilet comportments, utility rooms) 6.80
_ -,
QE1 APPLICANT 0 CONTACT PERSON Attic /erawlspuce fans 1(1,00
J Other: (0,00
Business name; See Bellew
. Fuel piping ... ..
Contact name: $5.40 fur first four; 51.04 for each additional
I•'urnaee etc..
Address:
-.._. Gas heat pump ••,_•
City /StatefLIP: Wall /suspended /unit heater t. ,
Phone'. ( ) Fax:: ( ) - Water heater
- Fireplace 2 5.411 -
E-mail; _.. Range _.. ,
CONTRACTOR Barbecue _
Business name: All Fuel Installation and Service Clothes dryer (bad _
. _ . t ither.
Address: PO Box 69 MECHANICAL, PERMIT FEES*
City /State /ZIP: Troutdale, OR 97060 — Subtotal 45.40
".. ... Minimum permit tee ($72.50) 72.50
Phone: (503) 674 -2350 Fax; (S03) 074.2693 Plan review (25% of permit fee)
__,._.. -.
CCB lie.; 169503 Slate surcharge (R'/ of permit tee) 5.80
l't7TAL PERMIT FE @. 78.30 - 17 Authorized signature; 11l.� `} ISO This permit application expires if a permit is not obtained within
Eu [ 11 V days after It 110 been accepted as complete.
I
CITY OF TIGARD .._ . w.
BUILDING DIVISION PERMIT #: 1FC7007 QCl73 i
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: /2/90007
Phone: (503) 639 -4171
A 4N
Inspection Requests (24 Hrs.): (503) 639 -4175 j I.
INSPECTION WORKSHEET FOR DATE: 1/17/2008 TIME: 7 :00AM PAGE: 34
SITE ADDRESS: 16740 SW 108TH AVE CLASS OF WORK:
SUBDIVISION: WLLOW BROOK FARM LOT #: 030 TYPE OF USE:
PROJECT NAME: HACKETT
DESCRIPTION: (2) gas lines to (2) fireplace inserts.
OWNER: HACKETT, BRUCE PHONE #: 503747.4756
CONTRACTOR: ALL FUEL INSTALLATION & SERVICE LLC PHONE #: 503. 674 -2350
Inspection Request Scheduled For: Date: 1/17/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 063422-01 503 747.4758 N
Corrections /Comments/ Instructions:
XPASS U PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V Date: 1' -1 1 . M Phone #: (503) 718 7
CITY IGARD " /...
1 BUILDING PERMIT #: r ..
UILDING DIVISIO ERMI ,�4r..C2U07 QO7;S5
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 121 18/2007
Phone: (503) 639 -4171 Ahl l�iut
Inspection Requests (24 Hrs.): (503) 639 -4175 ' 'I L
INSPECTION WORKSHEET FOR DATE: 12/1912007 TIME: 7 :00AM PAGE: 33
SITE ADDRESS: 16740 SW 108TH AVE CLASS OF WORK:
SUBDIVISION: WILLOW BROOK FARM LOT #: 030 TYPE OF USE:
PROJECT NAME: HACKETT
DESCRIPTION: (2) gas lines to (2) fireplace inserts.
OWNER: HACKETT, BRUCE PHONE #: 503747475G
CONTRACTOR: ALL FUEL INSTALLATION & SERVICE LLC PHONE #: 503-674-2350
1,
Inspection Request Scheduled For: Date: 12/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 061827 -01 503 6742350 N
Corrections /Comments /Instructions: //
S (- c� G oo �� Sv/9 S -- S'.� — ,- > L -Yvs' .
PASS I ARTIAL APPROVAL n CANCEL n NO ACCESS
❑ FAIL n CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
//' ,
Inspector: Date: /2--- / 9— &) Ph # : (503) 718- 2-y,cz-V