Permit a CITY OF TIGARD j MECHANICAL PERMIT
• ° COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00095
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/12/2007
PARCEL: 1 S133DD -13800
SITE ADDRESS: 11952 SW 127TH PL ZONING: R -4.5
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT: 175 JURISDICTION: TIG
PROJECT: SCHMITT
Project Description: Gas line to 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:
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
LORI SCHMITT Description Date Amount
11952 SW 127TH PL
TIGARD, OR 97223 [MECH] Permit Fee 2/12/200i $72.50
[TAX] 8% State Surcha 2/12/200i $5.80
Total $78.30
Phone:
Contractor:
MODERN PLUMBING CO
D & D ACQUISITIONS INC
11120 SW INDUSTRIAL WAY REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Contact #: PRI 503- 691 -6166
FAX 503- 691 -6771
Reg #: LIC 00087906
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
Issued By: ,� Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Feb. 12. 2007 2 :02PM Modern Plumbing No. 2329 P. 2
• 'Mechanical Permit Application l Ou Ofl IC. V. LSI: ON1.1'
r.'ity.ocTigard 3 E E U FRecZivcd SW RaU Blvd., TiOR 9 betcBy D� PerinitNo. �/ 7 q/f�`,�
Phone; 503.639.4171 Fax; 503.598.1960 Kin R
' abet Pit.
Inspection Line: 503.639.4175 y�;' a
I �; ' Darc/By:
[ 1 2 2 u ): 41. �q DSte Ready/$y: �rX 67 ace Page for
Internet wWW.Cj "tigard,or.U3 f E r] L7 .t <•� „-1 Notified/method: _/ Supplemental InfOrmation • y�� COMMERCIAL .TrEEa . SC1 Ijltl -.: US>. CI1 C7i11ST
0 New construction fin/aIterafion/replacement Mechanical permit fees* are based on the value of the work
r] Demolition [] Other: performed, Indicate the value (rounded to the nearest dollar) of all
mechanical materials. cquiipment, labor, overhead, and profit,
; ,' ' ' .. CATEGORY OE,'CONSTRIUCTION • ue: $ • • 1- and 2 1'arrli� dwelling • • RESLOFN'I'1`AL EQUIPMFNC SY"BTEhLS FEES.
Y g ❑ Conimercial/indusirial ❑ Accessory building
mild-family For special Information use checklist.
Y ❑Ma ster builder 0 Ot her: Description I Qty, Ea. Total
`. ' JOB :SITE XNR,MATIONV • AND LOC ATXON
. FO Heating/cooling
Yob site address; I C 5' 5 l� a P CZ G Air conditioning or heat pump
(requires Site elan shotvio> placement) 14.00 _
City/Statc/Z1P: • Q ( to Furnace 100,000 BTU (duets/vent) 14.00
Suitelbldg. /apt_ no,; Project name: Gk r^ r -+ arc 100,000 + BTU (di)ctslvcnrs) 17.90
chs heat pume 14.00
Cross street/directions to job site: Duct work 14.00
Hxtronic hot water system _ 14.00
Residential boiler (radiator or
hy'dronic) _ 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 OP.: WORK . . . • Water heater _ _ 10.00
Gas fireplace 10.00
Flue vent for water heater or gas
[. r Ca r\ - fireplace - 10.00
lighter (gas) 10.00
Wood/pellet stove 10.00
. Wood fireplace/insert 10.00 • ; PROJPERTY O,« R Chimney/liner /Auetvent 10.00
`. .0,40ANT'
Other. 10.00 _
Name: Environmental exhaust and ventilation
Address; Range hood /other kitchen
equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
(
Phone: ( ) Fax; ) toilet comear menta, utility rooms) 6.80
. , ...: 0. APPLICANT ❑. CCINPAC'f PERSON Attidcrawlspace fans 10.00
Business name: Other; 10.00
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) _ Water heater
E-rnail:
Fireplace
— Range I. - .
' CONTRACTOR' . .. . . Barbecue
Business name: ( c c of n , P �� b t ct'lli.Clothes dryer (pits) .. —
l Other:
Address: 1 k, ! Lo, a • U S I I (A) • MECHANICAL PE.RMTT FEES*
City /State/Zfl" — 1 --- tkci . \. Q-R 0)(2-__ 9' '7 0 Subtotal
Phone; c 1 ) ( A 9 ( t'e 1, (a - Fax: (5-� L ci I - Minimum permit fee ($72.50) 'Z 2 $
c/ --- ) Plan review (25% of permit foe) g, ffl,
CCB tic.; D ") 9 6 . (� /t 9/0 7 State surcharge (8% of permit fee) )
/ f i TOT PERMIT FEE � '�' l /L�
Authorized Signature; This per applieatlon eapire9 if permit is not obtained 'Malin 184
�_ days after it 1188 been accepted as complete.
[7 name; 0 e t Date: _ he methodology get by Tri- County Building Industry Serrvi B
er ()
, .hill dingle,- ......C- pcmitA.pp_doa 12/03 440- 4617r'(I 1/02/COM/WEM
CITY OF TIGARD
BUILDING DIVISION 1i PERMIT #: EC2QQ7..QQQrrr
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/1212007
Phone: (503) 639 -4171
A ..,, �1141iil�
Inspection Requests (24 Hrs.); (503) 639 -4175 ` __
INSPECTION WORKSHEET FOR DATE: 2/28/2007 TIME: 7 : 02AM PAGE: 45
SITE ADDRESS: 1 SW 127TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 175 TYPE OF USE:
PROJECT NAME: SCHMITT
DESCRIPTION: G line to range.
OWNER: SC:¢- gMi , LORI PHONE #:
CONTRACTOR: MODERN PLUMBING CO PHONE #: 5Q3 -531 -6165 .
Inspection Request Scheduled For: ' Date: 212'61 x007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 044077 -01 503..691 -6166 Y
Corrections /Comments /Instructions: e y
r „,,,, -- i i...„ 02iz_f2J__J>
11 2c Pk,,t," ,.
1 1 44 _
f 1f / , r • ir
X PASS n PARTIAL APPROVAL I I CANCEL I I NO ACCESS
I I FAIL n CALL F INSPECTION ADDITIONAL FEES ASSESSED
Inspector: Date: / t7 Phone #: (503) 718-
r^ — .
CITY �����~& �� ilw
��nm n OF m,em����D�i��
• ' +
BUILDING DIVISION - , PERMIT #: k8EC2007^00095
' 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2y12/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 ��6�'^
INSPECTION WORKSHEET FOR DATE: 2/27/2007 TIME: 7:01AK8 PAGE: 42
SITE ADDRESS 11952 SW 127TH PL CLASS OF WORK:
SUBDIVISION: VILLAGE AT SUMMER LAKE PARK 4 LOT #: 175 TYPE OF USE:
PROJECT NAME: GcHHA|TT
DESCRIPTION: Gas line to range.
OWNER: SCHMITT, LORI PHONE #:
CONTRACTOR: MODERN PLUMBING CO PHONE #: 503691'6166
Inspection Request Scheduled For: Date: 2127y2007 �� _y Pour Time:
_,
Code # Inspection Description Confirm # Contact # Message
610 Gas line 043980-01 503-681'6168 N
Corrections/Comments/Instructions:
,
| I PASS PARTIAL APPROVAL �� �ACANCEL 0 ACCESG
| | FAIL ri CALL FOR INSPECTION EI ADDITIONAL FEES ASSESSED
�
•
Inspector: �� �~`� Date: ' 7 - 0 ? Phone #: (503) 718-
-_ - ' '