Permit CITY TIGARD MECHANICAL PERMIT
1114 ° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00479
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 9/25/2008
PARCEL: 2S112CA -00800
SITE ADDRESS: 07895 SW GENTLE WOODS DR ZONING: R -4.5
SUBDIVISION: GENTLE WOODS LOT: 001 JURISDICTION: TIG
PROJECT: MUTER
Project Description: Install gas 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
REGINA MUTER Description Date Amount
7895 SW GENTLEWOODS
TIGARD, OR 97224 [MECH] Permit Fee 9/25/200E $72.50
[TAX] 12% State Surchai 9/25/200E $8.70
Total $81.20
Phone: 503 684 - 5005
Contractor:
JAY'S GAS PIPING
PO BOX 1507
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 - 819 - 6502
Reg #: LIC 119836
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 503 246 669 r_1800 332.2344.
Iss ed By: g2/000-1101 Permittee Signa re: 4 0 ,• •
.... i ce �.r
Cali 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.
OF WORK - Supplemental Information
Mechanical Permit Application 1 Olr�OI i It i t. 1)ti►: ;) }
of Tigard Rcv Pc r aut No
City g � ��� Date /ccl�y cd 9 a� o�
CI �, .Q, � 7 V
13125 SW Hall Blvd , Tigard, OR 97223 �[�r Plan Review
. • - Phone 503 639,4171 Fax 503 598 19601 ��/ F)atemy Other l'`l ""1 et
1, rc:: , 1 Inspection Lute: 503 6394175 �"" $
Notified/Method, 100 y Y Ann
Internet' J Date Read /B ■ "ate 1'olY4 Z for
t room ugard- or.gav p 2 , fied/Method, / 1�Y
� Mechanic
v' " 1
_.
TYPE . .
TYPE C ,.cV O Q �S COHf#fC1L,J�)� $� 01L I3SE,CpEC111,5T
New c o nstruction 1y " al permit fees* arc based On the value of the work
ID
—
New Addition /altemuon /� performed, Indicate, the value (rounded to the nearest dollar) of all
0 Demolition 0 Other mechanical ntatenals eyulpmenr, labor, overhead, and profit ,
CATEGORY OP CONSTRUCTION - - Value $
RESIDENTIAL kQw / SYSTEMS FEES"
E 1- and 24.. dwellin ❑ Commercial /industrial 0 Accessory building - -
For special lgformunun use checklist
❑ Multi - family ❑ Master builder 0 Other; Description
JOB Ea t Total
JOB S1lTs INFORMATION AND LOCATIQN Heating/cooling _ __
Job site address: 7 , 4, 5 � � w G c0( ' S J` ��� Air conditioning or heat pump -- —
Y ' (tegunes t ate plan showlnhplacc Dent) 14 UU
.1— Furnace 100,000 BTU ducisvenis) 14 00
City/State/ZIP: ,, /_ AKA 1 ' , Z- Z. C � u. .._ - M /
Furnace 100,000+ BTU (ducts /viola) 17 90
Suite/bldg./apt. no.: project name
d - Gas heat pump„ , 14,00
Cross street/directions to job site: Duct wor 10 00
. ,.- Hydromc hot water system_ 14 00
Residential boiler (radiator or
hydronic) 14 00
'Unit heaters (fuel -type, not electric),
in -wan, 1n -duct, suspended, etc _w 14 00
Subdivision: Lot no.: Flue /vent for any of above 6 80
.., Other. 10,00
Tax map /parcel no.: Other fuel appliances -
DESCRIPTION K
rION OF WORK Water heater 10 00
/-� Gas fireplace -�,, - 1 10 00
_ .. _ . H . -To 1( C- 1 a I Flue vent for water heater or gas -
fireplace 10 00_
". Log lighter (gas) 10 00
Wood /pcliet stove _ 10 00 _ —
Wood fireplace /insert 10 00 .
' 0 PR a PEATY OWNER 0 TENANT Chimney /liner /floc /vent .. 10 00
— Other 10,00 M
Name: r ' 4 L LI - Environmental exhaust and ventilation --
7 e Range hood /other kitchen
Address: f l , /4 t Y I „ e w 10 0 0_
City /State /ZIP: Tc�,
/ , C 7.ZZ V Clothes dryer exhaust 1000
I r Single -duct exhaust (bathrooms,
Phone: ( ,) 6 N5 Fax: ( ) mm toilet compartments, utility rooms) W _ a 80
0 • APPucANT 0 CONTACT PERSON Attic/crawlspace fans M 1000
---- Other: 10.00
Business name: Fuel piplu_ _
Contact name: $S for first four; $1.00 for each additional
Address: —" ^ Furnace, etc ll
_w,..."»....,.,...,�...,., ".. Gas heat pump . ,.,._..-,.- - JJ, ----- ....
City /State /ZIP Wall/suspended/unit heater
__ heater
Phone: ( ) Fax:: ( ) Water -
Fireplace
E- mail: Range
�� CONTRACTOR Barbecue —__ _ ^.,
1 * Clothes dryer (gas) __
Business name: * � i� '_
,.,..,.__ Other,
Address: ` _ . ` L ..,_./—C~ Mr-EliOiCA4 PEST FEES"
City/State/ZIP: 4 �
^7 /l t ' . / / S � ` �— Subtotal
p.r . c�` t ^ 0+ �t 9 7 7 7 G ' 7
q _— //"" 1�Minimum permit Cer ($72 SO) �i
Phone: �jp3 p� ) D f t _ G 6 "Z Fax: ( ) Plan review (25% of permit fee) 4
CCB Iic,: ( /3 C. State sin chatge (12 %ofpenmlt fee) S 76
ti ,, ,._.^ W _ -' ` TOTAL PERMIT _ FEE g ( .
Thin permit application eapira if a p rmit e la oel obtained within 180
Authorized signature: , days after it has beta atecpaed as complete.
r print name: 4 d L t„ ' Date: , n 0 - ( " Fee methodology set by'1 ri- COUnly lluitdwg irldun ry SGn we Board
--
?Buildmy\PermnelPtTa,C- Perm,tApp doe 01/10/117 440 - 461 iT ( i 1 l021COMMTi6)
Z 0 E d 100HOS EL OD1OH 56LbL59S05 L51aT 800Z/SZ160
. ,
CITY OF TIGARD ,,. .. .
BUILDING DIVISION
A ; PERMIT #: MEC2008-00479
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/25/2008
Phone: (503) 639-4171 4,0 006MII F I
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 10/2/2008 TIME: 7:00AM PAGE. 40
SITE ADDRESS: CLASS OF WORK:
07095 SW GENTLE WOODS DR
SUBDIVISION: LOT #: TYPE OF USE:
GENTLE WOODS 001
PROJECT NAME: MUTER
DESCRIPTION:
•
Install gas fireplace.
OWNER: MUTER, REGINA PHONE #: . , -
503 684
CONTRACTOR: JAY'S GAS PIPING PHONE #:
• 503-819-6502
Inspection Request Scheduled For: Date: 10/2/2008 Pour Time: g c . ,
V
_
Code # Inspection Description Confirm # Contact # Message
699 bilectrailical final 076171-02 503-6845005 Y
ri
Corrections/Co ments/Instructions:
1X,ri■ J p e;17
ve 3
\ /
7 PARTIAL APPROVAL 7 CANCEL NO ACCESS
I FAIL CALL FOR INSPECTION 1 1 ADDITIONAL FEES ASSESSED
Inspector: . 0/74 0
Date: ' Phone #: (503) 718-
, .
�J \ ,
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008-00479
-00479
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/25/2008
Phone: (503) 639 -4171 /� i l l 'I
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 10/2/2008 TIME: 7:OS1AIV1 PAGE:
SITE ADDRESS: 07895 SW GENTLE E WOODS DR CLASS OF WORK:
SUBDIVISION: f;EN l LlODDS LOT #: TYPE TYPE OF USE:
PROJECT NAME:
MUTER
DESCRIPTION: Install gas; fireplace.
OWNER: MUTER, REGINA
PHONE # : 503 - 68+5005
CONTRACTOR: JAY GAS PIPING PHONE #: 503 -819 -6502
Inspection Request Scheduled For: Date: /0/212008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 076171-01 503 - 6845005 Y
Corrections /Comments/ Instructions:
PASS n PARTIAL APPROVAL ❑ CANCEL 1 i NO ACCESS
1 I FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
•
I
Inspector: Date: " /'J o 1 Phone #: (503) ' - J
r ( ) 718 - v