Permit f q CITY OF TIGARD MECHANICAL PERMIT
°.;; COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00333
DATE ISSUED: 6/26/2008
TIGARDI'' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S103AC - 03500
SITE ADDRESS: 12498 SW 114TH TERR ZONING: R
SUBDIVISION: WALNUT GROVE LOT: 004 JURISDICTION: TIG
PROJECT: SACKOLA
Project Description: Gas piping to range
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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
JASON SACKOLA Description Date Amount
12498 SW
TIGARD, OR 97223 [ MECH ] Permit Fee 6/26/200€ $72.50
TIGA 97
[TAX] 12% State Surchar 6/26/200€ $8.70
Phone: 503 - 590 - 7361
Total $81.20
Contractor:
KOEHLER CONCEPTS LLC
10772 SEHWY212
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 650 -9550
FAX 503- 650 -1220
Reg #: LIC 120277
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws.
All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is
suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center.
Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OU NC by
calling 503.246.6699 or 1.800.332.2344.
Issued By: ( _ Perm ittee Signature: _1M � �� l�J
Call 503.639.4175 by 7:00 a.m. for inspections that business dal.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
it
M echanical Permit �I{ ia�N {Ica `�V ll f' T"-'y l 1 err Y , lE. r ' ✓b'}N 1' "�M Frfl� .m'}!` I h{p,.� ik, rr �µ : �' '',,g Lt'P'l o "�' f
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***,f,:i ? ,! - Received c;>ty or T�a>na �, � n �1 0� y 1, Pamir No. 13125 SW Hall Blvd., Tigard, OR 97221. }, Date/9: � �C 2 b n O 6 3 Phone: 503.639.4171 Fax: 503. . 5981960 `\� u J R� ti 1 i v _ • a- - : Other Permit:
' 7T } C - Inspection Lim: 503.639.4175
4a.g4c itoew i Internet: www.tigard- or.gov ` . Z eReady/$y: Jurir: ® See Page 2 for
` f- �� Notified/Method: Supplemental Information
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❑ New construction ® Addition/alteration/replacement Mechanical permit fees* are based on the value of the work
E1 Demolition Other: mechanical Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead, and profit.
iffil },,, �ytttsse+sa s ! t r s n ar7� (a, II ,, u Value: S
ti:L. it /ail m s % YUt lzl�:>n ibc tar TNIPI i , i/ r r P .i
os $ i a 1 incurs' lie a �sauelmlw�
1 - and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building 1! 4 CA A1 L �' � q i i ur,. it4tL:rlrmr,
For special
❑ Multi - family ❑ Master builder ❑ Other; Pe l information use checklist.
Description 1 Qty. I Ea. 1 Total
y .' ��,�. . � u��.�y�, cxa .. � s ' i "arc T r:+lG„ at � �r r ��.
t " u:ls gg s irr .x i � rit 1 fiarr�°`b1mL :�. tl„ .i Itl ` i'ru•. Heating/cooling
Job site address: \ t.G e -� � \ \y ..��--- -��{ Air conditioning or heat pump
(requires site Plan showing placement) 14.00
City /State/ZIP: `--- \c.,&sr1C�. , :!C.p v'', - -`ZZ Furnace 100,000 BTU (ducts/veins) 14.00
Suite/bldg./apt. no.: project name: Furnace 100,000+ BTU (ducts/vents) 17.90
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
Tax ma Other: 10.00
p/partl no.: Other fuel appliances
i�a,�'�a' t• •' a cur g='.� a: r v+
i itiIIMINEME rjr x rE .l4 a�; i ce} " i +� r . 1,. „l ) ' 31 t' Water heater 10.00
om- Gas fireplace 10.00
r�` C 'c d �� tc C�C,LS .,`. Flue vent for water heater or gas
• q.. `r'G� C� ' 0.�i ` fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
°m° rs }" }�� � Chinn /liner /flue /vent
�I, I , f�rstE1�'�a`'' ,, S. M : l r "r�,'� "5 iAI r 0 s eY 10.00
' 1 1, f.�� W?tlIR4x1 c' tic:�,�.�.�n�lt':. i�l�'ir~t�elt�ilz ,;, }.�� �u''u.r�
Otlxr 10.00
Name: jG
� - •C'\G\-CJ `LA Environmental exhaust and vendlatioo
Address: \Z �- \�rU c, 1��Y" Range hood/other kitchen
��,.. \ \-\ - equipment 10.00
City/State/ZIP: ---"- \ c„.. c),(-,E. , C"\-1-22-7=--, Clothes dryer exhaust 10.00
Phon e ^ -, ( Single -duct exhaust (bathrooms,
ax: toilet compartments, utility rooms) 6.80
i _ inf L ;,ffiiFSZwk'+I erg ry '°� a t I � ® �. °,i' It 9l P
��'��` �,t� � � i q
� r Attic%rawls a ce fans 10.00
asrn�s.r
Business name: \ (- .C�e> ,e.r- (` ,,.,_,� P _ 'AS_ Other. 10.00
Contact name; e s. '(('N")`._3, �~ Fuel piping
-�._J� \ S5.40 for first four; $1.00 for ends additional
Furnace, etc.
Address: \�- \--�-. �., \.. Z+�
`� Gas heat pump
City/State/ZIP:
C. ... ..._ _ _ _FC-1-0 WalUsuspended/unitheeter
Phone: E3 -3-.) �
,sCD, _CACS I Fax: . t.3`u� ) L e LW
- Water heater
\,.. Fireplace
E ,l�e.�c , c • - , r _ C(1,%-..,-..„. Range I
,le �I �' � '..; ��f: r 9^ t 'rt..' F ` �1� wll ii,.i t C' ..,
n �...: d i � i r�r'rirzi ' ; .' �, � r ) Kil ni, i Barbecue
Business name: , f a \_\...L._ Other:
dryer (gas)
Other
Address: ! 7 7 a Fe�etpirr 4h y u �t E tom+ ., Ord
\� )1� - L� Cl ,\� 17 n} S t r ; /li ra w.� 8s,', JtfYe�?.+u TLICart 7 1 } e
City/State/ZIP: ��fJ.L'-,-�� C�I,NS Subtotal
Phone: tt [ ,(` Minimum permit fee ($72.50) -17...c--j1/4 , ) �2� �(~ " l( ) Fax: �� - \ZZ.�
Plan review (25% of permit fee)
CCB lie,: \ State surcharge (12%ofpermit fee) B .1
TOTAL PERMIT FEE E\ :Z(C
Authorized signature: This permit applic tion expires If a permit Is not obtained within 180
days after it has been accepted as complete.
Print name: \..) > & Dat Fee methodology set by TO-Corn Building Industiy Service Board
Y� � 1.0. �j - L � '� • g!' Y tY g
I: \ NuildingTemlilAMMEC- PermitApp.dne 0 /07 7�C1 440-46177(11 /07JCOM/WEa)
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- CITY OF TIGARD
BULLRING DIVISION PERMIT #: MEC2008 00333
13120 SW'Hall Blvd., Tigard, OR 97223 p DATE ISSUED: 612612008
Phone: (503) 639 -4171 u 1 '
Inspection Requests (24 Hrs.): (503) 639 -4175 1 . "
INSPECTION WORKSHEET FOR DATE: 7/8/2008 TIME: 7:OOAM PAGE: 58
SITE ADDRESS: 12498 SW 114TH TERR CLASS OF WORK:
SUBDIVISION: WALNUT GROVE: LOT #: 004 TYPE OF USE:
PROJECT NAME: SACKOLA
DESCRIPTION: Gas piping to range
OWNER: SACKOLA, JASON PHONE #: 503 -590 -7361
CONTRACTOR: KOEHLER CONCEPTS LLC PHONE #: 503-650-9550
Inspection Request Scheduled For: Date: 7/0/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 GaF. line 072292-01 03.590.7361 N
Corrections /Comments /Instructions:
/ 5, 5/ ✓2� , �i4Lc� /L-
PARTIAL APPROVAL ❑ CANCEL fI NO ACCESS
n FAIL n C LL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: / Date: 7 — 00 Phone #: (503) 718-
-•••' */ CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00333
rtcnK� 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/26/2008
PARCEL: 2S 103AC -03500
SITE ADDRESS: 12498 SW 114TH TERR ZONING: R-4.5
SUBDIVISION: WALNUT GROVE LOT: 004 JURISDICTION: TIG
PROJECT: SACKOLA
• Project Description: Gas piping to range
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: 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: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS:
> 10000 cfm:
Owner: FEES
JASON SACKOLA Description Date Amount
12498 SW 114TH TERR
TIGARD, OR 97223 [MECH] Permit Fee 6/26/200E $72.50
[TAX] 12% State Surchai 6/26/200E $8.70
Phone: 503 - 590 - 7361
Total $81.20
Contractor:
KOEHLER CONCEPTS LLC
10772 SEHWY212
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 - 650 -9550
FAX 503- 650 -1220
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 OU NC by
calling 503.246.6699 or 1.800.332.2344.
Issued By: 9 Permittee Signature: _A/1
Call 503.639.4175 by P 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.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: Ec j.,00 063 33REQUIRED ON GREEN INSPECTION CARD.
✓ • Code 1 Inspection Description I PASS Date I By ✓ Code Inspection Description PASS Date 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 >4 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 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: •
X 699 Mechanical final
BUP - Fire Protection System Permit
905 . Sprinkler underfloor /slab
910 Sprinkler rough -in PLM - Plumbing Permit
915 Fire alarm rough -in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
• 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