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Permit CITY TIGARD MECHANICAL PERMIT : s COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00176 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 4/8/2008 PARCEL: 2 S 104A D -0 3101 SITE ADDRESS: 12976 SW WALNUT ST ZONING: R-4.5 SUBDIVISION: LOT: JURISDICTION: TIG PROJECT: LAYTON Project Description: Installation of 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: 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: Owner: FEES ELIZABETH LAYTON Description Date Amount 12976 SW WALNUT TIGARD, OR 97223 [MECH] Permit Fee 4/8/2008 $72.50 [TAX] 12% State Surch 4/8/2008 $8.70 Total $81.20 Phone: 503 - 590 -0236 Contractor: GIGS CONSTRUCTION 17 NW HARLEY AVE GRESHAM, OR 97030 REQUIRED ITEMS AND REPORTS Contact #: PRI 503- 888 -4409 Reg #: LIC 172076 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 • - is to OUNC b calling 503.246.6699 or 1.800.332.2344. Issu >d By: k / / �� �_ / Permittee Signature: �9A_A.A �r ■ Call 503.639.4175 by 7:00 a.m. for inspections that busines • - 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. ., --> Mechanical Permit Application , -� -,,F, K ' ' ` `" " PP , , �, # FOR OFFICE SEiO , : • r x 1 . /, -' frCs : s2. _atnc azstso?,uunsr2_ er .tt+c s .., t 1 ;: - - , . r a,_ s ' x , _ Received 41 . .-60/76. City of Tigard Date/By: Permit No.: III V 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review 9 :! Phone: 503.639.4171 Fax: 503.598.1960 Other Permit. - DateBy: T I C n li D: Inspection Line: 503.639.4175 Date Ready /By: Juris: in See Page 2 for eta Internet: www.tigard - or.gov Notified/Method: Supplemental Information TYPE OF WORK COMMERCIAL 'FEE* SCHEDULE — USE CHECKLIST ❑ New construction ❑ Addition /alteration /replacement Mechanical permit fees* are based on the value of the work performed. Indicate the value (rounded to the nearest dollar) of all ❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit. CATEGORY OF CONSTRUCTION • Value: $ RESIDENTIAL EQUIPMENT /SYSTEMS FEES* ❑ 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION Heating/cooling Job site address: (� Air conditioning or heat pump l 297-6 r J) d , ]� (requires site plan showing placement) 14.00 City /State /ZIP: r ( � � s t ®,Q - 7'? 2.2. Fumace 100,000 BTU (ducts /vents) 14.00 Project name: Fumace 100,000+ BTU (ducts vents) 17.90 Suite/bldg./apt. no.: Q.,V ` / ( 'e tP S Gas heat pump 14.00 Cross street/directions to job site: Duct work 10.00 Hydronic hot water system 14.00 Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Subdivision: Lot no.: Flue /vent for any of above 6.80 Other: 10.00 Tax map /parcel no.: Other fuel appliances DESCRIPTION OF WORK Water heater 10.00 Gas fireplace / 10.00 /0 r d� Flue vent for water heater or gas ■ e fireplace 10.00 1 (7 , . _ ` Log lighter (gas) 10.00 n �� otoes_,,„ \ Wood /pellet stove 10.00 � f `t S Wood fireplace /insert 10.00 ❑. PROPERTY. OWNER ❑ TENANT Chimney /liner /flue /vent 10.00 Other: 10.00 Name: C, d� r'7 /1 /3 �— T /cam y N Environmental exhaust and ventilation Address: /' tq l 7 � - / �\, ' y, I `4 r l A d- c ' Range hood/other kitchen ( (.� V z equipment ment 10.00 City /State /ZIP: - .,;. C ��i © �' Z Clothes dryer exhaust 10.00 Single -duct exhaust (bathrooms, Phone: ( 5 ! • - j6, Fax: ( ) toilet compartments, utility rooms) 6.80 ❑ APPLICANT . ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: Fuel piping Contact name: $5.40 for first four; $1.00 for each additional Address: Furnace, etc. Gas heat pump City /State /ZIP: Wall /suspended/unit heater Phone: ( ) I Fax:: ( ) Water heater Fireplace E -mail: Range , • - CONTRACTOR ' Barbecue Clothes dryer (gas) Business name: G , * G , etPet f9 �� - � S Other: Address: MECHANICAL PERMIT FEES* City /State /ZIP: A 7 Z \ 3/) #A- 6e TL 6 7 Avg- Subtotal !/ ` Minimum permit fee ($72.50) '50 Phone: ( ) ' Ai 4 Fax: ( ) . a i 1 Plan review (25% of permit fee) ,�-- CCB lic.: / ‘?ii 2 0 6 y / 3 o`(; State surcharge (12% of permit fee) g. g(7 TOTAL PERMIT FEE •' . • J - -■41P iiw This permit application expires if a permit is not obtained within 180 Authonzerlp,;. - days after it has been accepted as complete. Print name. Dm 4 0,) € T c (Q L r/'- De: 2co 2 • Fee methodology set by Tri- County Building Industry Service Board I:\Building\Permits\MEC- PermitApp.doc 01/19/07 440-4617T(11 /02 /COM/VEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: $1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. $100,000.01 and up $1,396.50 for the first $1 00,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. L\ Building \Permits \MEC- PermitApp.doc 01/19/07 2 CITY )FTIGARD BUILDING DIVISION PERMIT #: r IC C -OOi► 76 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 41[1 /2CUi Phone: (503) 639 -4171 I t. nspection Requests (24 Hrs.): (503) 639 -4175 ...Vi . INSPECTION WORKSHEET FOR DATE: •t; 3Of2;')1't l TIME: 7:O AM PAGE: . SITE ADDRESS: 12';7 ; ,SW W'ALi4i, _ t SI CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: 11.E f € UN DESCRIPTION: Itt.; 41,3'siw.v :.1 :R' ir:e . C: -... OWNER: t AY* {;N, k:1.1Z`1! l TH PHONE #: r;O'..'■_. 023€i CONTRACTOR: i GS ,,i'. %TI LJC ON PHONE #: & Inspection Request Scheduled For: Date: 4/30:7.0V2 Pour Time: Code # Inspection Description Confirm # Contact # Message G: :. i\tit::'l _ ;t:al ? ..iri 06:',4..)5'..!,--() 1 :.4.-.J3 i8 -elii 0 E4 N Corrections /Comments/ Instructions: 0 G/S LA/6" /,5'-i7 i 1 • • • ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS ❑ FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: 9 .3a Phone #: (503) 718 - CITY OF 'WARD _ _ BUILDING'DIVISION PERMIT #: y ME 200 001'76 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 4113/20(38 Phone: (503) 639 - 4171 At Inspection Requests (24 Hrs.): (503) 639 -4175 _ : -_.. INSPECTION WORKSHEET FOR DATE: 4/10/2008 TIME: 7:02AM PAGE: 17 SITE ADDRESS: 12976 SW WALNUT ST CLASS OF WORK: SUBDIVISION: LOT #: TYPE OF USE: PROJECT NAME: LAYTON DESCRIPTION: InsiallatioD of gas fireplace. OWNER: LAYTON, ELIZABETH PHONE #: 603 CONTRACTOR: (31(3S CONSTRUCTION PHONE #: 503-030-4409 Inspection Request Scheduled For: Date: 4/10/2003 Pour Time: Code # Inspection Description Confirm # Contact # Message 615 Mechanical rough-in O60179.01 503.810- 2565 N Corrections /Comments /Instructions: / •pr i ,.S Aid . 1- -4- g -Uti /v _ , . �.. —rG L `L Zo /i -1[. - , so Ai i crS' ❑ PASS ❑ PARTIAL APPROVAL ❑ CANCEL _ NO ACCESS AlL , CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: ' Date: 4--/0 O g' _ Phone #: (503) 718-