Permit c l
' w ' - CITY OF TIGARD MECHANICAL PERMIT
. ;I ° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00535
T [G A It D1 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171
DATE ISSUED: 10/30/2008
PARCEL: 2S103AC - 07000
SITE ADDRESS: 12955 SW 113TH PL ZONING: R - 4.5
SUBDIVISION: FONNER WOODS LOT: 006 JURISDICTION: TIG
PROJECT: GOHIER
Project Description: Installation of tankless gas water heater, gas piping and a/c unit.
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: 1 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:
CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
PIERRE GOHIER Description Date Amount
12955 SW 113TH PL
TIGARD, OR 97223 [MECH] Permit Fee 10/30/20C $72.50
[TAX] 12% State Surch 10/30/20C $8.70
Phone:
Total $81.20
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact #:
Reg #:
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.
11 l'" ;/ 1
Issu d By: Permittee Signature: V .
Call 503.639.4175 by 7:00 a.m. for inspections that siness 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.
Mechanical Permit Application FOR OFFICE USE ONLY
City of Tigard DateBy: (O Permit No.: t 1 „t4 ,o0 53
q 14 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
_ : Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit:
T 1 G A R D Inspection Line: 503.639 Date Ready /By: WI Hi See Page 2 for
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 LOCATIOI ' l� n Heating/cooling
�
Job site address: \ � s � � l w Air conditioning or heat pump
(requires site plan showing placement) 14.00
City /State /ZIP: Fumace 100,000 BTU (ducts /vents) 14.00
Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: O L ; .ef 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
Flue /vent for any of above 6.80
Subdivision: Lot no.:
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
‘‘.4 SU i _� / Gasfi 10.00
U u C e_ c ( Flue vent replace for water heater or gas
` ! ` ? ems, fireplace 10.00
7 �� V Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
Chimney/liner/flue/vent 10.00
PROPERTY OWNER ❑TENANT Other: 10.00
Name: , err_ � , \ t Environmental exhaust and ventilation
Address: l v19 Ss z) 1 ` r i Range hood/other kitchen
1 f � l equipment 10.00
City /State /Z_IP: �x �a r O C/ -. . Clothes dryer exhaust 10.00
11�� ✓✓ Single-duct exhaust (bathrooms,
Phone: (50 ( _ ? � 5 5 Fax: ( ) toilet compartments, utility rooms) 6.80
llw ❑ 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: Fumace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax::( )
Water heater I
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Business name: n,o„)ei,___ Clothe s dryer (gas) Other: Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Minimum permit fee ($72.50) 70? C
Phone: ( ) Fax: ( ) Plan review (25% of permit fee) �
CCB lic.: State surcharge (12% of permit fee) D • 7
TOTAL PERMIT FEE p-0
This permit application expires if a permit is not obtained ithin 180
Authorized signature: days after it has been accepted as complete.
Print name: p er " 6 t , Date: ' 0/56/0e) * Fee methodology set by Tri- County Building Industry Service Board
\ \
1:\BuildingPermits NEC- PermitApp.doc 01/19/07 440- 46 (11 /02/COM/M/WEEB)
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 $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
1:\ Building \Permits \MEC- PermitApp.doc 01/19/07 2
CITY TIGARD
BUILDING DIVISION PERMIT #: MEta2008 -00535
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10f301(1t78
Phone: (503) 639 -4171 moo" hell flI�
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 1111312008 TIME: 7;OOAM PAGE: 28
SITE ADDRESS: 12955 SW 113TH PL CLASS OF WORK:
SUBDIVISION: FONNER WOODS LOT #: 006 TYPE OF USE:
PROJECT NAME: GOHIER
DESCRIPTION: Installation of ta7kless gas water heater, gas piping and afc unit. .
OWNER: OHIER, PIERRE PHONE #:
{
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 11//312008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
9
G.JJ Mechanical final 078012-02 503 - 070 -7255 N
&10 G
Corrections /Comments /Instructions:
I PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL _ CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
Inspector: r Date: //- /3 - °8 Phone #: (503) 718- «?4rc"'
INSPECTOR'S SIGNATURES ARE NOT "
Inspections Required for: I` 'E - aZ53 5 ' REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description PASS Date By I ✓ Code Inspection Description I PASS Date I By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG- Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling V 615 Mechanical rough -in
295 Misc. inspection: _ 1 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final _ 630 Fire damper
_ 299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
•
695 Misc. inspection:
i C 699 Mechanical final KA
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in
915 Fire alarm rough -in 305 Plumbing underslab
310 Crawl drain
920 Suppression trip test 315 Post /beam plumbing
995 Misc. inspection:
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
fi
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I: \Building \Forms \InspCard- AOP- Blank.doc 02/02/07
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