Permit !P CITY OF TI GARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00108
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/16/2007
PARCEL: 1 S135DC - 01800
SITE ADDRESS: 11895 SW LINCOLN AVE ZONING: R -4.5
SUBDIVISION: TIGARDVILLE PARK LOT: 009 JURISDICTION: TIG
PROJECT: NOYES
Project Description: Gas fireplace, vent & gas line.
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:
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: 1
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
BONNIE NOYES Description Date Amount
11895 SW LINCOLN ST
TIGARD, OR 97223 [MECH] Permit Fee 2/16/2007 $72.50
[TAX] 8% State Surcha 2/16/200i $5.80
Total $78.30
Phone: 503- 620 -2067
Contractor:
ALL FUEL INSTALLATION & SERVICE LLC
PO BOX 69
TROUTDALE, OR 97060 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 674 -2350
FAX 503- 674 -2693
Reg #: LIC 169503
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: Permiftee Signature: in \k'
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.
', 08:38 » 5035981960 P 1/2
f e hanical Permit Application b t t l ( ( t I I I t I . I .I ( ) \ 1 ,
City of Tigard .r. ,/ _ ► Permit No \ . j 00 is l
13125 SW Hall Blvd., Tigard, OR 972 EC E V
1111
I Phone: 503.639.4171 Fax: 503.598 Other Permit:
t i . ,, , .,
Inspection Line: 503.639.4 FEB 1 6 2007 Date Ready/By: 'uric ® See Pagel for
Internet: www.ligard- vr.gov Notified/Method; Suppkmental Information
CITY OF TftaARD
TYPE OF valll -DING DIVISION COMMERCIAL FEE" SCHEDULE – USE CHECKLIST
p New construction A Addition /alteration /replacement Mechanics) permit fees• are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) drill
❑ Demolition ❑ Other: mechanical materials, equipment l abor overhead, and prote.
CATEGORY OF CONSTRUCTION Value: S
- RESIDENTIAL EQUIPMENT /SYSTEMS FEES'
xi I - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling_
\ I ` 6 9 5 ' - l Air conditioning or heat pump
lob site address: S ��ll [ ( (requires site plan showing placement) 14.00
City/ State/ZIP: ?" 4 e 3 D; r_ � D D - Furnace 100,000 BTIJ (duets/vents) 14.00
Furnace 100,000+ BTU (duets/vents) 17.90
Suite/bldg. /apt. no.: Project name; Gas heat pump 14,00
Cross street/directions to job site: Duet work , 14.00
- - - - - – — Hydronie hot water system 14.00
Residential boiler (radiator or
hydronic _ .,,_ _ 14.00
(Unit heaters (fuel -type, not electric),
in•wall. in -duct, suspended, etc. 10.00
Subdivision: Tot no.: Flue/vent ter any of above 10.00
Other: 10.00 _
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00 .
Cots fireplace }
Cra 10.00 1 U
v 5 } ti k' c ) <,. •» t v ? , V ' In f l A..' w c r; • ; Flue vent for water heater or gas ( 10.00 ti) fireplace
n S 7e Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
t Chimney /liner /flue /vent 10.00
)PROPERTY OWNER I ❑ TENANT Other: _ 10.00
Name: 'L.,,t,l, r lk.)o) e% _ Environmental exhaust and ventilation
Address: t Range hood/other kitchen
. - c , . • , ; suiement 10.0(1
City/ State/ZIP: Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: ( 5"03) (y 3 p . 1 t) C Fax: ( ) toilet compartments, utility roams) 6.80
ODAPPLICANT 0 CON1'ACT PERSON Attic /crawlspacc fans 10.00
') Other: 10.00
Busin name: S , C f '^ t• , Fuel P1mim
Contact name: 55.40 for first four: 51.00 for each additional
Furnace. etc.
Address:
Gas heat •um
City / State/ZIP: Wall/suspcnded/unit heater
. Phone: ( ) { Fax: : ( ) Water heate
Fireplace \ S• "l U
E -mail: Range
CONTRACTOR Barbecue _ _ ,
Business name: 'I.,%,.,1\ ! • Clothes dryer (gas)
A‘\ ,,, r e n d i_ LL Other: r
Address: (j L, G c\ MECHANICAL PERMIT FEES
City /State/ZIP: '�: „ ,.\ LI , 1 r Lt , Li 7 IN t) Subtotal S . y u
Minimum permit fee ($72.50) .> ]. Sit
Phone: ( 3 (, 1 y - 3 1 S () I Fax: (.71)3 ) (y 1 4 .. ' 6 9 3 Plan review (25 %of permit fee) /
CCD tic.: l t; rl S o 3 0 r4 it, • `3 `S S " State surcharge (8% of permit fee) .C '60
TOTAL PERMIT FEE IS . 1 D
Authorized signature: 7" - This permit application espireo ir permit a not obtained within 180
Authorized signature: 7" /. —77' This after it has been accepted as complete.
1 ...
r E . r C ' C . . . f � 7 1 l D '7 I �.........,..........
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007 -00108
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/16/2007
Phone: (503) 639 -4171 I �
Inspection Requests (24 Hrs.): (503) 639 -4175 . ' VIII
INSPECTION WORKSHEET FOR DATE: 2/20/2007 TIME: 7:09AM PAGE: 20
SITE ADDRESS: 11895 SW LINCOLN AVE CLASS OF WORK:
SUBDIVISION: TIGARDVILLE PARK LOT #: 009 TYPE OF USE:
PROJECT NAME: NOYES
DESCRIPTION: Gas fireplace, vent & gas line.
OWNER: NOYES, BONNIE PHONE #: 503 - 620.2067
CONTRACTOR: ALL FUEL INSTALLATION & SERVICE LLC PHONE #: 503 -674 -2350
Inspection Request Scheduled For: Date: 2/20 /2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 043599 -01 503 - 674 -2350 N
Corrections /Comments/ Instructions:
r °1
�S ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: f I � Date: Phone #: (503) 718 -