Permit CITY OFTIGARD MECHANICAL PERMIT
i r DEVELOPMENT SERVICES PERMIT #: MEC2005 -00744
r.11 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 11/8/2005
PARCEL: 1 S135CD -03200
SITE ADDRESS: 09630 SW LEWIS LN ZONING: R -4.5
SUBDIVISION: RUTH LOT: 003 JURISDICTION: TIG
Project Description: 10' gas piping to dryer.
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:
FURN > =100K BTU: <= 10000 cfm:
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
LINDA STEWARD Description Date Amount
9630 SW LEWIS LN [MECH] Permit Fee 11/8/200E $72.50
TIGARD, OR 97223 [TAX] 8% State Surchar€ 11/8/200f. $5.80
Phone: 503 620 - 4861 Total $78.30
Contractor:
KOEHLER CONCEPTS LLC
10772 SE HWY 212 REQUIRED ITEMS AND REPORTS
CLACKAMAS, OR 97015
Phone: 503 650 - 9550
Reg #: LIC 120277
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: f ,/�� Permi • Signature: Ae .2_
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.
Pl
Mechanical Permit AppILerA• , , i O,Z O, I lc 1: 1:s11 O..1.,
City of Tigard Received
13125 SW Hall Blvd., Tigard, OR 97223 Dere/By:
Pl a d i $ Permit No V ! 426, Phone: 503.639.4171 Fax: 503.598.1960 NOV n , .•.-F * , Plan a O° 1 O"
... r, Dete/B Other Permit:
Inspection Line: 503.639.4175 r i I ' Y:
Internet: www.ci.tl5nrd onus . "` • I pate R0°Dth: /( B) See Page 2 for
Notified/Method: -�\ Supplementallnformetton
CITY OF
.. ',I /�i: ,i• n,, TN , .14. ' I : x ;li :l� , �1'i , C 6Y r� ,u1 ^,r' !i, :161'll', �;��1'diw 'T'ar ry. u�,!iN.�Ittr{11 n. ,,cmr,aam, ,��
1, .6 „.:I; I. 1, :•:1 ;! ..t .1 I L „�i,�.:,'11!ll �I, ,,, u�.l:•,g, tL� ( � k ,1,., t , a• l , 't a , n :;s , m l o1,7 R I „ •'i'l
. II , , ., G • ,.n �, I ,1 a •>t.16 ��(ulsda�,:M12. •. i rtllL,ilro:, I 1n�` x,., `� t � „I�
❑ New construction Igi Addition /altoration/replacement Mechanical permit fees' are based cm the value of the work
❑ Demolition ❑ Other; performed, Indicate the value (rounded to the nearest dollar) of III
}, ,y mechanical materials, equipment, labor, overhead, and profit.
I' L'il'; i.• :'i�u' i'ti,i ,Y'•' •vii 611R{Y1. a . ) .• I.t U ' 'I I d' Y , p., r' L : , I , ✓.•,
'���R''''����'�****'''^��' h' '' lip' pp qq� h la i • .'f;• 1 i h'�f
,'oJ, /I'il i'i!;!i!'. �� � "i'1,,,4i N >l ,� •N ,• I ' ,, � _ , . G , • til��;,l l'1,.�,�.�'r',Iidlotiti' .1iP ' ".1 %'a• °lyl t l � Value: $ Irlet'
® dwelling Commercial/industrial ;i, ",'✓ li<' a 1ta.l s, r �. 1 13 of Islr , p' �( .a�w�(A', af: 'sti,i
1 - and 2 W 1 br4MS:or4l,rCN�lrrlw rn„rfir'''(.vt,: l l ,r
Y B 0 0 building
For special Information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description I Qty. I Ea, _ 1 Total
:cv.1L;• ,l,:rt„i';II,,�tl:,■!ll n,' ����{{Wy�,,:.I t �t.n'j_rxtllw1lt�11 ,V '�� e{ � {, �. "I:�i� a�( +� .,. i 1 1 U I ' I,I
:4�11NI0. 3: ,!4-'lifktatool . :'. IIE;•,iirt:t::ll n mtil l�•I.l• t �1aIQ61.l is I l:I. Heatlup/cooling
Job site addreti : Ck i .. \.. " %9s invokes Air conditioning o p invokes CIO plan showing i ne placement) 14.00
City /State/ZIP: " ,o0.6 , Qre Ccr � Furnace 100,000 BTU (duets/vents) 14.00
Suite/bldgJapt_ no.: •S Project name: Furnace 100.000+ BTU (duete/ventsl _ 17.90
Oas hem pump 14.00
Cross street/directlons CO Job site: Duct work 14.00
-
Hydronic hot water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heaters (Biel -type, not electric),
in -wall, in -duct, suspended, cm. 10.00
Subdivision: Lot no.: - FlueJvent for any of above 10.00
Other: 10.00
Tax map/parcel no.: � ,{ Other Nel appllancce
1' �;� r' .P,iti ,',.' ) !l�' ;';ti^IL ;'1:t1tit m YR"r�'L - 4X`;:'} v PI`7V,,li „ I v�N •o n,,• ��IIiep .P' 'i't W ater heater
'I � "�''!� � � i•: .� � 1:. _ � , � •,ii.:i • :d!.If'I 7 �i J'l�;,$� I ' �I I '1'il :'r�, � � Y �� Cit ( ' ";S� I pp..
,, , 'iii 11'. ti "tlie , h1„•,•,9.1�s, i'I.F: ,., �;W'"t 1 0.00 -
Gas Fireplace 10.00 -
- 14Vt"N ∎vets 1 AOpn31 kL A- CA.. 6t042 Flue vent for water heater or gas
fireplace 10.00
rid \ ¢1 Log liter (gas) 10.00
Wood/pollet stove 10.00
Wood fireplace/insert 10.00
1 • f� ,'e;'nra ; Ith;l,A� �ti;l•KBt ��I �; 1 , ••,• tmt 10.00
•.: J ,.: ., l0jVl7PiFli il;�;,I J J : Ul,g,<,1 Too . i "�; li�',� ,,,i A', i 1 •�.
S! " s• ti„='n'„ „ � I•:.I i,; rChimney /liner /flua/v J 1
lo.00
Name: \tom Environmental exhaust and ventilation
Address: C>�-b ,%,,,,D \.2.1......1%, Range hood/other kitchen
equipment _ 10.00
City/State/MP: , &L _ t>��3 Clothes dryer exhaust 10.00
`"�"� Single -duct exhaust (bathrooms,
�`�
Phone: ) k , ., %V, ` Fax: ( ) toilet compartments, utility rooms) 6.80
T . °''(V ' ,• i•I n�yMl,Nlir.•� 1 I; S1 • ir"�tri4 ;d trgifr yl1 , - , rflir., n4
.;e,.. , I I Ii'Aeil l 1 ;6 I t !� , I,w - ' ; ,1 `11 •F'„ i , � r !� i Attic%rnwlepace tltn8 10.00
, � �. ., � „G • h t ;i.: I,. ` 11� Gr fi! $,9p1.,: rt. . fl1 •b. ri
Other: 10.00
Business name: \\. Cise..v.tde, Fuel piping
Contact name: $5.40 for first four, $1.00 for each additional
Address: tM,__ Furnace, etc. L
1v� -Z St x^41-, s,., 7.2a._ Gas heat pump
City /State/ZIP: keb1ew+.e. C:111 QM:1\ Wall/suspended/unit heater
Phone: (cam ) ue>",p`S� I Fax: : (rte) LIND - We heater
E-mail:
Range Fire •lace
p q
��J'�, :.10,• _jIi' I, , 1 of :1 ry`U•I n uslrl', 18. 11'•y1� Ai ' 1 6 , ; i� I, l;l ' Cl't7 ., [ B
v ,u,'I riII�SIY Yii, ,! ntr�r 01 4 1 ,� I „AST. �' T I I)l�
�!uadr;�aa.t '�;;i "',n v'�(:,, •.l' t, Ns�,Lw�i�' ,
Business name; \( ��X 5. Clothes dryer (gas) \
Other:
Address. \'. - n S1 k)10.._,...1Lc1_
3;709,1.61,141t, c: t" , :; s lE� >v I1,i, I " I ; '
City/State/ZIP: I i; Subtotal ° I '11 0
- ' CJ. (ski_ ` BLS �
Phone: ) I Fax: ) O - RZO Minimum permit fee ($72.50) 1'(- SO
�'y'�\SS� Plan review (25% of permit fee)
CCB lie.: not-y-1 State surcharge (8% of permit foe) S Mx)
TOTAL PERMIT FEE lea .
Authorized signatlrre: • Thla permh application expires Ile permit to net obtained within 180
days after it bas been accepted as complete.
.►_ Date: \` .Q ' Poo methodology sot by Tet -County Building Induany Service Board
i:\ aulldIngWarmlli \MEC.permItAppdoe 12/02 440.4617t (1I/OVCOM/Web)
Z00 /100 S1d33NO3 831H3071 0ZZ1099809 XVJ 99 :30 9002 /L0 /ll
CITY OF TIGARD C[ ' ( 3
BUILDING DIVISION ;r 40 PERMIT #: MEC2005 00744
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/8/2005
Phone: (503) 639 -4171 nitl
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/14/2005 TIME: 7:12AM PAGE: 72
SITE ADDRESS: 09630 SW LEWIS LN CLASS OF WORK:
SUBDIVISION: RUTH / #: 003 TYPE OF USE:
PROJECT NAME: STEWARD
DESCRIPTION: 10' gas piping to dryer.
♦
OWNER: STEWARD, LINDA PHONE #: 503- 620 -4861
CONTRACTOR: KOEHLER CONCEPTS LLC PHONE #: 503-650-9550
Inspection Request Scheduled For: Date: 11/14/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message •
610 Gas line 021120-0/ 503-620-4861 N
Corrections/Comments/Instructions:
177 -2: .4 0 7 ic 7
.: \
I ,/di.) '
. ylZ \\,‘ : l. ,
•
[X] PASS _ _ ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO- ACCESS --
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /W
" Date: if i B 7 Phone #: (503) 718-