Permit CITY TIGARD MECHANICAL PERMIT
I I ' " COMMUNITY DEVELOPMENT PERMIT #: MEC2006 -00622
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/6/2006
PARCEL: 2 S 102 D B -06200
SITE ADDRESS: 09079 SW HILL ST ZONING: R -4.5
SUBDIVISION: CHELSEA HILL NO.2 LOT: 039 JURISDICTION: TIG
Project Description: Gas line & gas fireplace insert.
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:
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
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
GRANT & LISA SHANAFELT Description Date Amount
9079 SW HILL ST
TIGARD, OR 97223 [MECH] Permit Fee 12/6/200€ $72.50
[TAX] 8% State Surcha 12/6/200€ $5.80
Total $78.30
Phone: 503- 969 -5782
•
Contractor:
T & K MECHANICAL
PO BOX 116
FOREST GROVE, OR 97116 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 844 -9173
FAX 503- 846 -0195
Reg #: LIC 121165
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: . 7 Permittee Signature: .SS2 2
Call 503.639.4175 by 7:00 a.m. for inspections that business d�y.
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.
FROM : FIREPLACE PHONE NO. : 15836269138 Dec. 06 2006 10:44PM P1
...�, xl e
1V.l.e4hanical Permit Application FOROt OFFICE USE ONLY
City of Tigard E 1�� Da / o r / 4 -4 6 �( 600X196
/
1 ');ti c Illy Permit No� ;)
13125 SW Halt Blvd,, Tigard, OR 97 3 Nan Review `
Phone; 503,6639.4171 Fax: 503.598,1960 iser,r, ° i A Other Permit:
Inspection Line: 503.639.4175 UEC 0 6 2006 rl Data luau
Internet; www.ci.tigard.or.us .r'P fled/Method:
Ready/By: j ( Sec Pagelfor
CITY OF TiGAAD Not d /Method - 1 I Supplemental information
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[] New construction 41 A dditipn /altcrttion/repiacerncnt Mechanical permit fens" are based on the value of the work
'� performed. Indicate the Value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other:
mechanical material S, equipment, labor, overhead, and profit.
' • •' .x ° : ,, t ,. 4iiAN e < ,..Ws � M4 . P � ti 4WO 0;6'i� t' ® :61'41 ' f' '' .c
r . :, . K. v �: ' ? .. ' 'r, � ; ,: Vii: value: $ • �p+
1- and 2-family „� . , a. ,• 1 v .l + Ref' i r r'en,rr�+. x ;y.: tw` ,. yap t- '44 ,::
dwelling ). ; �„ .a b +.� ` s :b
y b ❑ Commercial/industrial ❑ Accessory building - r--•• ���� -
❑ Multi - family ❑ Master builder ❑ Other:
For special information use checklist.
y � y, yam, '. rp�P_ Description 1 Qty. 1 Ea.�I Total
u , ; ry . �" fi H eatiu /cuolln
Job site address: q)p 7 / 1_I, l Air conditioning or heat pump
, S,nuires site plan shnwinKplacement) 14.00
City /Stak;/f1p: 1I Za , t T a 3 Furnace 100,000 BTU1ducts/vents) 14.00
�! s Furnace 100,000+ BTU duers/vent,i 17.90
Suite/bldg./apt. no.: Project name;
Gas heat .um• 14.00
Cross street/directions to job site: - -. • - .... 1Juct••work -. 14.00
llydronic hot water system 14.00
Residential boiler (radiator or . ,
• hydronic) 14.
• " Unit heaters (fuel -type, not electric), '
in -wall, in -duct, suspended, etc, 10.00
Subdivision: 1 of no,: Flue/vent for an of above 10.
Other: 10,00
Tax map /parcel no
1 e 3 aJ°� I Other fuel Appliances
•
M ha,: s' • vise i ` "r,'
,. a�, , k ti a Watcrh eat er 10,00 fireplace
Gas i la 5•e d- 10.00 •
aas tt n.4 av la Iv` Flue vent for water heater or SAS
fireplace 10,00 0
Log Tighter (gas) 10.00
M _ Wood/pellet stove 10.00
• y Wood fireplace /insert 10.00
.4 , � . • ' ' sv f,. t a �z #M i Chimne /liner /flue vent 10.00 • "`' MFG: Other: 10.00.
Name: G,a, „4 4 - Li See S vkQkt2.( Environmental exhaust and ventilation -
Address: c r f 1 Range hood/other kitchen
cg
(� 7 u-_) iii / / c7d v' uiptnent • , , III 10,00
City/State /Z1P- - ,, O €79:g_.0_3 . C lothes d ryer exhaust 10.00
-
Phone: /'_ F'ax; . Single•duct exhaust (bathrooms,
0 �� ( ) toilet compartments, utility rooms) 6.80
1� ” E' l:." ,a` •. 1 . - w -ittWM ., ^ � r :� ti n
t ai �k k' ,r t =,.r < is ' Z" l "1s , 0 e 4R ty:. , , ,S Arti Gcrawlapacc fans 10.00
• " ~ u Other: 10.00
., er.,1- r p14- .c -``a- Fuel ,f.in
Contact name: e. — $S :40 for first four; $1.00 for each addittoual
Address; 3(.,...) ILQ,�. , • Furnace, etc.
• . Gas heat pump
•
. City /State/ZIP: ., ; r v 76 of; Wall /suspended/unit heater
• Phone: ( • • _ .( 'Fax:: , 3) ' .t . .. —. 343 heate
•• „,
Fire. lace
E- rnail:
Range
H� WSREZ i 101 4" e 7 .14,: 1 .r�.' ;; ' a�f'jn t }t f Si v ` Barbecue ,.,.
•Business naive: • 5-t75” ct g s` / AO Clothes dryer (gas)
• Address: I " a 1/L • Che r r� i!"
Ci /SlA[r/Z / die y i � --1,0 el D ✓' 9 � � . ",. .� . r +j � �� }T
ice / �/ Minimum permit fee (572.50) liar-(
Phone:) ) , C Fax: ( C ) - -' _ Flan review (25% of •omit fee)
CCB lie.: ,/,„2/,/ Stale surcharge (8 %of pr mit fee EMMA
•
TOTAL YIS12M1T FEE '7 + a)
/ " This permit application expires if a permit Is not obtained within 180 .
Authorized signatu ' '
I� � d 02: ; ,,,, _,,,,, , ,,,,,, •_,„ "�• days after It has been accepted as semiotic.
Print name: „� �� 1 - e: �p� /!O /i . Fee methodology set by Tri- County Building Industry Service Board
1 : \13uildina\Partnita0vi m
C- Pni. d
tAp ,due 12103 440-4017T (1 V021COM/WEIi)
CITY OF TIGARD .,-
BUILDQNG 491VISION PERMIT #: MEC700 &- 00522
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/6/20 6
Phone: (50Y) 639 -4171 Aro no ',l
Inspection Requests (24 Hrs.): (503) 639 -4175 '__..
INSPECTION WORKSHEET FOR DATE: 12121/2c306 TIME: 7 :O0Am PAGE: 31
SITE ADDRESS: 09079 SW HILL ST CLASS OF WORK:
SUBDIVISION: CHELSEA HILL NO .2 LOT #: 039 TYPE OF USE:
PROJECT NAME: SHANAFELT
DESCRIPTION: Ga line & gas fireplace insert.
OWNER: SHANAFELT, GRANT & LISA PHONE #: 503 - 969.5782
CONTRACTOR: T & K MECHANICAL PHONE #: 503.344 -9173
Inspection Request Scheduled For: Date: 12/21/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 041419-02 503 -&44 -9173 V
Corrections /Comments/ Instructions:
PASS I 1 PARTIAL APPROVAL 7 CANCEL NO ACCESS
I I FAIL El CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
• Inspector: _ Date: 12- Zi-a (A Phone #: (503) 718- 7 -4-4 -3
i - -
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2006-00622
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/6/2006
Phone: (503) 639-4171
Jir :i
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 12/21/2006 TIME: 7:00Am PAGE: 32
SITE ADDRESS: 09079 SW HILL ST CLASS OF WORK:
SUBDIVISION: CHELSEA HILL NO.2 LOT #: 039 TYPE OF USE:
PROJECT NAME: SHANAFELT
DESCRIPTION: Gas line & des fireplace insert.
OWNER: SHANAFELT, GRANT & LISA PHONE #: 503969-5782
CONTRACTOR: T & K MECHANICAL PHONE If 503-.0449173
Inspection Request Scheduled For: Date: 12/21/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 041419-01 503-844-9173 Y
Corrections/Comments/Instructions:
Li PARTIAL APPROVAL I l CANCEL 0 NO ACCESS
l I FAIL If CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: .,,
Date: /1- - Phone #: (503) 718-