Permit MECHANICAL PERMIT
n CITY OF TIGAR®
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00587
TiGnRq 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/1/2008
PARCEL: 25111 CD - 05900
SITE ADDRESS: 09610 SW BRENTWOOD PL ZONING: R - 7
SUBDIVISION: SUMMERFIELD NO.9 • LOT: 518 - JURISDICTION: TIG
PROJECT: MILLER
Project Description: Gas key valve installation.
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: 0
Owner: FEES
VICKIE MILLER Description Date Amount
9610 SW BRENTWOOD PLACE
TIGARD, OR 97224 [MECH] Permit Fee 12/1/200E • $72.50
[TAX] 12% State Surch 12/1/200E $8.70
Phone: 503- 730 -0870 Total $81.20
Contractor: •
FIRESIDE DISTRIBUTORS
18389 SW BOONES FERRY RD
PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -595 -3737
FAX 503- 620 -5699
Reg #: LIC 40979
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other
applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon
Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these
rules or direct questions to OUNC by calling 503.246.6699 or 1.800.332.2344.
•
Issued By: - : - Signature: / 7 �! l/
Call 50 . • 9.4175 by 7:00 a.m. for inspections that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
INSPECTOR'S SIGNATURES ARE NOT ' •
Inspections Required for: ,lco$ -c� sy7 REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description I PASS Date I By ✓ Code I Inspection Description PASS Date 1 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 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:
_ 699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in -
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
12/01/2008 10:18 5036707905 WIDDOWS PAGE 02
Mechanical Permit Applicati Foh OFFICE. USE ONLY
CI of Tigard Received permit No.: C
131 Hall Blvd., Tigard, OR 97223 DEC 01 2008 Date Plan S . v /� ..
III D an Review
Phone 503.639.4171 Fax: 503.5 98.14b0 DareBv: Other Permit:
T 1 GA R O inspection Line: 503.639 CI TY OF 11GARD Date Ready/By: lurk: ® See Page 2 for
Internet: www.tigard- or.gov BUll,D1NGDNISION Notified/Method: Supplemental Information
!f'' II I 1' I1i11! -, . il' i .. II o 1 + S�1 L .. , � o• I I
I'i h i I t' ,• bE b i : I 0 141 1 11 L . I ∎ St i� 6 CF Li(S
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❑ New construction ❑ Addition / alteration /replacement Mechanics permit fees* are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanica materials, equipment, labor, overhead, and profit.
p,,, I . :
'.,. 1 1 ! ':!.; t 1!�iA`t GbR�Y!.OP G01401I .001St' '....';A!!: I u ; + .0 Value $ • •
,�, 1 I(ii�{'i([II2 $i CW1 C 1'I4iL EQ17'''M*41 s l 1 i r !>±*A �ii,Ifi 1 ;�
�d 1- and 2 - family dwelling El Commercial /industrial ❑ Accessory building
El Multi ❑ Master builder El Other:
For special information use checklist.
Descriptior Qty. Ea. Total
l i:: ., 4 I'1 '40 ;SIT[ 10'' Ri11AT1O& ,OGAI1 Njil 'i +11 , I'+, 'AEI ,'"1 Heating/ceoling
Job site address: `'1 �, 0 s 8 r-t0 to } 2 ��/1 R Air fires ite plan or heat pump
' Vt t u (requires sit plan showing placement) 14.00
City /State /ZIP: tZ ^ ai('d \ O R cA' , l., Furnace 10),000 BTU (ducts /vents) 14.00
"� Furnace 101,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no,: Project name: , m . r f �I Gas heat pt mp 14.00
Cross street/directions to job site: Duct work 10.00
Hydronic h )t water system 14.00
Residential boiler (radiator or
hydronic) 14.00
Unit heater: (fuel -type, not electric),
in -wall, in- iuct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent t Ir any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
'l; ' +' 1 f I + , ;, , [,. l• i i rot( Water heat r 10.00 • 1il ,l, h,I�I � +,�1�EStf�RIP'�';ION i OF..;,�'�';OR��a'' ;�: , i i + ifllll�,1
Gas firepia :e 10.00
4 \\Doc\ Ts vtti \/U \v . Flue vent fin water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellc t stove 10.00
Wood firep [ace /insert 10.00
w Chimne /1i ter /flue /vent 10.00
i,' ii m }!4 OWl'VER I , • , T:111;11..1....1. �' t I l 'I ❑ •: •k, A1A^lT .�' '.+.Ii "',1• "" Other: y I • 10.00
Name: v ` 'n p WI (1 t Q j r- Environmt ntal exhaust and ventilation
ik1� '' Range hood /other kitchen
Address: 1 et ti r . 5.14j. ,8 ,° n 1- wood Q 12 ii, equipment 10.00 1
City /State /ZIP: -17 " -o O A. ti '7�-Y Clothes dry er exhaust 10.00
1 Single -duct exhaust (bathrooms,
Phone: (5 3 ) - G � n n Fax ( ) toilet comp trtments, utility rooms) 6.80 •
it 1 I , iiti 'ANT f ' +' .tijVlTAC7 �7V l .''r Attic /crawl :pace fans 10.00 •
0 �. 1J J Other: 10.00
Business name: F f P.r51 f J l ` i L i a p 1 o Fuel pip ing;
Contact name: 3 e / ,(� (' 55.40 for first four; S1.00 for each additional
Address: 1
1� 3 9 S'u) • g (Ant) n K) j e , ^ � t( 1p ` (k Furnace, et.:.
Gas heat pi. mp
City /State /ZIP: by, . - \cU 1� lip. °!"7 D- _9 Wall /suspended /unit heater
Phone: p� 5DtS' •'73`f , Fax: : (S 3 va-D.J 'I q Waft lace r
E -mail: / 1
Ran :e • ' 1ii! 4 `I ,l,i(,i I • IOO ITRACI'OR L 14 t :iili if � 11!1111 Barbecue
Business name: fi f y f f o "'�t�1 S A. O t ® t ,r� Clothes d :r (gas)
1 i a .L� r I • Other: I
Address: ��� n ,,. +
`4 —_�._ a V IIi!ii III; I IIy Et fCA�l�E I � `lliil
City /State /ZIP: Subtotal
Minimum permit fee ($72.50) 7� 5
( ) .
Phone: ( ) Fax Plan review (25% of permit fee)
CCB lie.: t Ot1 { 4 ... State surcharge (12% of permit fee) F. t /�( TOTAL PERMIT FEE g )
Authorized signature: `� This permit application expires if a permit is not obtained within IRO
days after it has been accepted as complete.
Print name: \ A Mggd�. Date: \a. - j)$ ' Fee meths dology set by Tri -County Building Industry Service Board
C 1Building \Permits \MEC- rermitApp.doc 01/19/07 • 1 C 440 -4617T (11 /02/COMAVE0)