Permit !pi a CITY OF TIcARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00523
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/30/2007
PARCEL: 2S 103DA -06300
SITE ADDRESS: 10920 SW PARK ST ZONING: R-4.5
SUBDIVISION: MIRA PARK LOT: 001 JURISDICTION: TIG
PROJECT: WOLFRUM
Project Description: Install gas line, vent and new gas fireplace insert.
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: 1
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:
OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES •
WOLFRUM, J T DELANE AND Description Date Amount
•
ALICIA
10920 SW PARK ST [MECH] Permit Fee 8/30/2007 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcha 8/3012007 $5.80
Phone: Total $78.30
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..
Issu= • = y: ���� , _ L Permiftee Signature: sa& fipf ifrAMO1
Call 503.639.4175 by 7:00 a.m. for inspections that business da .
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.
2007 -08- 2917:14 >> 5035981960 - P 2/2
Aieciaanical Permit Application _ .» l ,l< , ,, , ,, i I , 1 , , , I ■
City of Tigard ED D ; D Ci 5 �r • •
Other Permit:
i
13125 SW Hall Blvd., T ' 9 i; �� Pica Review
• Ph 503.639.4171 Fax: i 60
_ t)aoeBy:
: (, , . 1 Inspection Line: 503.639.4175 1 Ol Dale RadyiHy: MI 0 sue Page 2 r.e
Internet: www.tigardar.gov 6 v LO Notified/method: SapplemeaW Lfotmatloa
TYPE ``( ° v;1tGAN
,,,t 9 DIVISI COMMERCIAL FEE' SCHEDULE, — USE CHECKLIST
❑ New construction ® Additi �fteration /replacement Mcdianical permit fees' arc based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, egwpment labor, overhead, and profit.
CATEGORY OF CONSTRUCTION
Value: S $800.00
1- and 2- family dwelling ❑ Commercial /industrial 0 Accessory building RESIDENTIAL EQUIPMENT / SYSTEMS FEES'
El Multi-family • ❑ Muster builder ❑ ( For special information use checklist
Description 1 Qty. I Ea Total
JOB SITE INFORMATION AND LOCATION Heagag/coolI*R
Job site address: 10920 SW Park St Air caing or hat pump
(requires site plan showing placement 1 14.00
"
City/State/LIP: 97223 Furnace 100.000 BTU (ductaA des) 14.00
Furnace 100,000+ BTU tducts/venta) 17.')0
Sitite/bldg. /apt. no,; Project name: Gas heat pump 14.00
Cross street/directions to job site; Duct work 14.00
l lydfunic hot water system • 14.00
Residential boiler (radiator or
' hydronic) 14.00
-- - - Unit heaters Mel-type, not electric),
in -wall. in -duct, suspended. etc. 10,00
Subdivision: i Flue/vent for any of above 10.00
j Other: 10.00 1
Tax map/parcel no.: Other foal appliaam
DESCRIPTION OF WORK Water heater _ _ 10.00
• Install gas vent and new insert Gas fireplace 1 10.00 10.001
>Wa � Flue vent for water heater or gas
fireplace _ 10.00
- Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10 - 10.00
Other; 10.00
Name; Alicia Wolfram Environmental exhaust and ventilation _ _ ___
Address: Same as Above Range hood /other kitchen
equipment 10.00 ,
City /StatdLIP: Clothes dryer exhaust ' 10.00
Single -duct exhaust (bathrooms.
Phone: (593)620 -9311 I Fax: l ) toilet compartments, utility rooms) 6.80
® APPLICANT 0 CONTACT PERSON Anic/crawlspace fans 10.00
Other: 10.00
Business name: See Below
Fad pipits
Contact name: $5.40 for tint four: $1.00 for each additional -
Address: Furnace, etc.
Gas heat pump
City /State/ZIP: Wall/Suspended/unit heater
Phone: ( ) 1 Fax: : ( ) , Water healer
`
— Fireplace I 5.40
&mail: - Range _ ,
CONTRACTOR Barbecue _
Business name: All Foal Installation and Service, LLC CtotiiC9 dryer (gas)
Other: _
Address: PO Box 69 MECHANICAL PERMIT FEES*
...
City /State/I.IP: Troutdale. OR 97060 .. Subtotal _. 25.40
—
Phone: (503) 674 -2350 I Fax: (503) 6742693 Mi r ie r permit fee ($72.5 72.50
Plan revw (25% of permit feee )
CCA lie.: t69903 State surcharge (8% of permit fee) 5,80
• / TOTAL, PERMIT FEE 78.30
/ e I a 9' / mice permit apptieaf e on empires if . permit I. not obtained widths 180
Authorized signature: C days after it his beeo.ceepted m complete.
CITY OF TIGARD _
BUILDING DIVISION PERMIT #: MEC2007- 00523
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8!3012007
Phone: (503) 639 -4171 A ..
Inspection Requests (24 Hrs.): (503) 639 -4175 ,..., k:_..
INSPECTION WORKSHEET FOR DATE: 2/7/200F3 TIME: 7 PAGE: 38
SITE ADDRESS: 10920 SW PARK ST CLASS OF WORK:
SUBDIVISION: MIRA PARK LOT #: 001 TYPE OF USE:
PROJECT NAME: WOLFRUM
DESCRIPTION: Install gas line, vent and new gas fireplace insert.
I - 3:30
OWNER: WOLFRUM, J T DELANE AND, PHO E #:
CONTRACTOR: ALL FUEL INSTALLATION & SERVICE LLC PHONE #: 503-674-2350
Inspection Request Scheduled For: Date: 2/7/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 06465401 503.620.0311 Y
Corrections /Comments /Instructions:
•
•
•
b; • ' SS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
IN FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 4N, Date: Q 7 - v C6 Phone #: (503) 718- _ 97C)
CITY- OFJIGARD - .
BUILDING DIVISION PERMIT #: MEC2007- 00ei23
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 813W2007
Phone: (503) 639 -4171 I
Inspection Requests (24 Hrs.): (503) 639 -4175 °_ ..
INSPECTION WORKSHEET FOR DATE: 9!6/2007 TIME: 7:00AM PAGE: 33
SITE ADDRESS: 10920 SW PARK ST CLASS OF WORK: ,
SUBDIVISION: MIRA PARK LOT #: 001 TYPE OF USE:
PROJECT NAME: WOLFRUM
DESCRIPTION: Install gas line, vent and new gas fireplace insert.
OWNER: WOLFRUM, J T DELANE AND, PHONE #:
CONTRACTOR: ALL FUEL INSTALLATION & SERVICE LLC PHONE #: 503- 6742350
Inspection Request Scheduled For: Date: 9/6/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 055250 -01 503 - 674 -2350 N
Corrections /Comments /Instructions:
❑ ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
// / ' ,
1 - Inspector: - , // \ Date: 9 -6 - O > Phone #: (503) 718- Z.