Permit CITY TIGARD MECHANICAL PERMIT
Att, DEVELOPMENT SERVICES PERMIT #: MEC2005 -00784
DATE ISSUED: 11/28/2005
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 103AC -02600
SITE ADDRESS: 11550 SW FONNER ST ZONING: R -4.5
SUBDIVISION: LOT: JURISDICTION: TIG
Project Description: Extend gas line, install gas fireplace.
CLASS OF WORK: OTR 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: 1
GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
JEFF & SHA GIANOLA Description Date Amount
11550 SW FONNER ST
TIGARD, OR 97223 [MECH] Permit Fee 11/28/20( $72.50
[TAX] 8% State Surcha 11/28/20( $5.80
Total $78.30
Phone: 503- 624 -1472
Contractor:
G P & W SYSTEMS INC
732 MARBLE RD
WASHOUGAL, WA 98671 -9601 REQUIRED ITEMS AND REPORTS
Phone: 360 - 835 -3516
Reg #: LIC 108176
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: 1 Permittee Signature: � Q 1.
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.
Nov 9 5 05 11:51a GP &W Systems, Inc. 360- 835 -5716 p.1
Mechanical Permi A FOR OFFICE U
' � c1loo' SE ONLY
City of Tigard , t ateB , / ✓� FcmitNo. y / , �� l �. & / a `fvd7S
13125 SW Hall Blvd, Tigard, OR 972 F 3) K, ) U L ao J D Pla Review
+ e
Phone: 503.639.4171 Fax: 503.598.1960 .'•.�, -.t ' i, Date/By: Other Permit
Inspection Line: 9.41
nspection 503.6375 t 1 ( .-
Internet Ine:.tigar9.41s CITY OF TIGARD ► -II.. Date ied / y: See Page for
BUILDING DIVISION NotifiedlMe Method " I I G S upplementallnfortaatton
TYPE OF WORK I COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction ' AdditionJalteration/replacement Mechanical permit fees* are based on the value of the work
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
' ['1 and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building RESIDENTIAL EQUIPMENT SYSTEMS FEES*
❑ Multi - family 0 Master builder For special information use checklist.
❑ Other: Description
Qty. 1 Ea. L Total
.LOB; SITE INFORMATION AND LOCATION Heating/cooling
Air conditioning or heat pump
Job site address: i 1 550 S Ltd - r-on -C t (requires site plan showing placement) 14.00
City/State/ZIP: Tt5curcA ` -722-3 Furnace 100,000 BTU (dw n/vents) 14.00
Furnace I00,0004- BTU (ducts/vans) I7.90
Suitelbldg.fapt no.: I Project name:
Gas heat pump 14.00
Cross street/directions to job site:- - - - - -- - - - - - -- - - - -Ductwork- - - - 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) I 14.00
Unit heaters (fuel -type; not electric),
in-wall, in -duct, suspended, etc, 10.00
Subdivision: I 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 /a -- e4Cie B 1 i / J T3 -uevo- Flue vent for water heater or gas
�� i fireplace 10.00 0 -
Vtt Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood frreylaedinsert 10.00
,_,/ Chimney/liner /flue/vent 10.00
12 PROPERTY OWNER ❑ TENANT Other. 10.00
Name: <Je4 i- S m e ` 6 � ' i Environmental exhaust and ventilation
Address: I E 55o S� r €.Y Range hood /other kitchen
equipment 10.00
City /State/ZIP: -11 d ip o . 7123 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: SO ) as IF - 11 - 1(72--- Fax: ( ) toilet compartments, utility moms) 6.80
r APPLICANT - 0 CONTACT PERSON Attie/erawlspace fans 10.00
Business name: 44 / 19 f it) S ((STE InS Z/l1C Other: - 10.00
' Fuel piping
Contact name: `V/LJ/V, $5.40 for first four, 51.00 for each additional
Address: (�
7,3 a O / (rf f� gap Furnace, etc.
` r Gas heat pump
City/State/Z1P: T'ti/ 1 fi �, V 'eS67 / Wall/suspended/unit heater
Phone: (30 Cci.5 • ?Sft'o I Fax: : ( ) 835'57/4 Water heater
Fireplace / is Vo
E -mail: Range
CONTRACTOR Barbecue
lusinessname: 6 p0..� .S`,,svefrta ,,,:)4,_._ es `c 2
Other: 1
Address: - 73:.)._ ,ri+(G -t /e ".43did MECHANICAL PERMIT FEES* �y,
City/Statr/ZIP: WkSH613 6 _ t A- 7fb7) Subtotal ZS• T�
Minimum permit fee ($72.50) 72.0 -
Phone: (2h6 g3 E5/(4,.. Fax : ) Ine°,. S`ffk . Plan review (25% of permit fee)
CCB lic.: Iti xr Ale,70 3 State surcharge (8% of permit fee) ...5', go
ex T r i 4 r] - TOTAL PERMIT FEE , 7g 30
Authorized This permit application expires tea permit is not obtained within 180
days after it has been accepted as complete.
Print name: LyAW No Date: (I 12.516S I * Fee methodology set by Tel- Comity Building Industry Service Board
CITY OF TIGARD .,
BUILDING DIVISION PERMIT #: MEC:2005.007
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11128/2005
Phone: (503) 639 - 4171 .0aiirnd ,����ll�' (,I�,
Inspection Requests (24 Hrs.): (503) 639 - 4175 ' :W '1
INSPECTION WORKSHEET FOR DATE: 12/30/2005 TIME: 6:59AM PAGE:
SITE ADDRESS: 11650 SW FONNER ST CLASS OF WORK:
SUBDIVISION: LOT #: TYPE OF USE:
PROJECT NAME: GIANOLA
DESCRIPTION: Extend gas line, install gas fireplace
OWNER: GIANOLA, ,JEFF & SHANNON PHONE #: 503-624-1472
CONTRACTOR: G F' & W SYSTEMS INC PHONE #: 360836-3516
Inspection Request Scheduled For: Date: 12/3012005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mech iiical final 024229 -01 360.772 -6328 N
Corrections /Comments /Instructions:
'PASS ❑ PARTIAL APPROVAL ❑ CANCEL fl NO ACCESS
I I FAIL ❑ CAL . FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: ' 7° ' Date: / [-f '3 O Phone #: (503) 718-