Permit 4 CITY OF TIGARD - ° MECHANICAL PERMIT
IN
e , COMMUNITY DEVELOPMENT
PERMIT #: MEC2008 -00311
. ,
T � 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/18/2008
PARCEL: 2S114BA - 12000
SITE ADDRESS: 09510 SW MILLEN DR ZONING: R -7
SUBDIVISION: COPPER CREEK STAGE 3 LOT: 085 JURISDICTION: TIG
PROJECT: CARTER
Project Description: Installing gas insert and gas line.
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:
WOODSTOVES:
GAS PRESSURE: 50 + HP: CLO DRYERS:
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
MIKE CARTER Description Date Amount
9510 SW MILLEN DR
TIGARD, OR 97224 [MECH] Permit Fee 6/18/200E $72.50
[TAX] 12% State Surch 6/18/200f $8.70
Total $81.20
Phone: 503 -598 -6706
Contractor:
FIRESIDE DISTRIBUTORS
18389 SW BOONES FERRY RD
PORTLAND, OR 97224 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -595 -3726
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: / �, / � . Permittee Signature: � ?f 44/1
Call 50 ! 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.
06/17/2008 13:28 5036707905 WIDDOWS PAGE 02
Nlechanical Permit Application 1 FOR OFFICE USE ONLY
City of Tigard coo E. E ew D j'' Permit No.: . , gar OR 972 C y
Phone: 503.639.4171 Fax: 503.598.1 60 Date/By: Other Permit:
T I G R O Inspection Line: 503.639.4175 1� N . Date Ready /By: kris. 63 See Page 2 for
Internet: www.tigard- or.gov J QdlNotifred/method:
1 Supplemental Information
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❑ New construction E Ad dition /alteratW acement Mechanica l permit ', fees* ..... are based on the value of the work
performed Indicate the value (rounded to the nearest dollar) of all
❑
❑ Demolition Other: mechanic: I materials, equipment, labor, overhead, and profit.
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,� C`( L„' I�;(( ��i�� ' �;,��I��]t`���'����r��(�1�� ,, I � l � �I�I) �l,! l��I ,,III Value: $
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V1- and 2- family dwelling ❑ Commercial /industrial El Accessory building r�ll!- I ` °! ! ,ui `i IG L� F * ��I�� li f� j l � l y
Multi Tor special informalion us checklrrr.
❑ y ❑ Master budder ❑ Other:
Description Qty. I Ea. Total
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Job site address: 951 D 5 • \ 1\1u\ "Dg.. Air conditioning ho heat pump
.LJf� (requires sin plan showing placement) 14.00
City /State /ZIP: �; a t ng cti a r_, Furnace I (0,000 BTU (dams /vents) 14.00
Suite /bldg. /apt. no.: Project name: _7 Furnace 100,000+ BTU (ducts /vents) 17.90
�a r f .0 Gas heat pimp 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 heater.; (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent f n any of above 6.80
Other: 1 10,00
Tax map /parcel no.: Other fuel appliances
1 r ;Iliii t •Yj(N, i ,.i l ,�4r Qllll I Il qr; V III. 7 l rr
1 ( D�� 1 Fi�l l i III �SI I iII(IIII(III]I iIIl,(. Water heat. :r 10.00
I irr,,, i rt�. ;rlt� �i,Q,l(T ! t 711 i , ti Il,l
.. hi ll . ' ..i ,+ 171!I11
` L ' ` d c r' ' l r - 4 Gas fireplace j 10.00
[7�J� TS Flue vent fcrr water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood firep ace /insert 10.00
t '„�. 4S{I'l 11 i s' rill,.. 111t1i Ir
i "1 , i6 ll1 �,, ,'1 �Y t I .r r` ! t,�,. ,, rl 118� 1E , I `' . Ilh. l.i I T; i III II II It;:;; Chimney /!ii ter/flue/vent 10.00
,0,, h , , .Itl •la' � .'.. Other:
n,. 10.00
Name:
1K p ei), r Environmental exhaust and ventilation
Address: Q1510 s.U) - J " 1 1.11 t. Range hoot /other kitchen
``
equipment 10.00
City/State /ZIP: ,,x 6 �A /� iD. , 1 1 f Clothes dryr:r exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: IC "1 O Y
( bqc LD-m Fax ( ) toilet compartments, utility rooms) 6.80
it p , 1 , , ELI O , , I I h I(''; Ill I 1
( rr (� l III! At[ic /crawle. pace fans
Y' ?! 1�! I;!!,!I?!I +l II I�y�Y!�� ':fit ills P 10.00
Business name: Other: 10.00
FI reSidl . -014 O nrP9on Fuel piping
Contact name: ;J
�� $5.40 for first four; 51.00 for each additional
Address: ! O 3s 9 5 w �ft fg5 / fv � n � Furnace, etc.
r !� Gas heat pump
City /State /ZIP: r P O r +' ...J t D R q 72 "1 t / Wall /suspended/unit heater
Phone: _J '1 , 37 au Fax:: 6 o 11N 10, 1 r) . 6 oQ q Water heate
b D 7iy /y
E -mail: Fireplace 1
u i ��.yl Range 1
: i I '''�:11(I, I I , , ci ill IIiII i ii ll I d CV II II3 qq( I (} I. , i u {I Ill p r ii (IL'n,1
1 ! 4" t r,rr - II r 1 - I l {il!IJ i! r1r Il.!,IJ!:,I!. ul,l : j! I .,U� Barbecue
Business name: Fir A id (' 'T i s 0 P o (poi, n Clothes dryer (gas)
U T t Other
Address: SQ._I cts a n,
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u hra( ,
City /State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee (572.50) 7) -
Plan review (25% of permit fee)
CCB lic.: Lim -74 State surcharge ( 12 %of permit fee) 'NJ r
/ TOTAL PERMIT FEE $ 4 Q
Authorized signature: y� ,F /Jr Thi permit a pplication expires if a permit is not obtained within 180
1 I ` [ days after it has been accepted as complete.
// �� trn 1 "l }4
Print name: 1 A�
T — ( . l Date: ti) ._ 1 p ' Fee rnethorology set by Tri- County Building Industry Service Board
I:\ Building \Permits\MEC- PermitApp.doc 01/19/07 440 - 40171'(17!02 /COM/WEB)
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200E -00311
13125' SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 6/1W2008
Phone: (503) 639 -4171 e�mu °��11 -
Inspection Requests (24 Hrs.): (503) 639 -4175 s!_!�
INSPECTION WORKSHEET FOR DATE: 7/7/2000 TIME: 7:00AM PAGE: 24
SITE ADDRESS: 0961() SW MILLEN DR CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 3 LOT #: 085 TYPE OF USE:
PROJECT NAME: CARTER
DESCRIPTION: .Installing as insert and gas line.
OWNER: CARTER, MIKE PHONE #: 503- 698-6706
CONTRACTOR: FIRESIDE DISTRIBUTORS PHONE #: 603-696-3726
Inspection Request Scheduled For: Date: 7/7/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 072196 01 603 -69 -3726 Y
Corrections/Comments/Instructions:
0 e4LL , . /.'►Bs".o cq -p'a 1 Q 7
, ASS 111 PARTIAL APPROVAL El CANCEL n NO ACCESS
(l FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: ..------- Phone #: (503) 718 -
INSPECTOR'S SIGNATURES ARE NQT
Inspections Required for: ii/ col ,Y] . c.0// REQUIRED ON GREEN INSPECTION CARD..
✓ Code Inspection Description PASS Date By I ✓ - Code I Inspection Description - I PASS Date I B l
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
I 1 255 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
I 280 Insulation
605 Post /beam mechanical
285 Drywall nailing 610 Gas line 7- 7-01 eh
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG- Structure final 625 Duct work
1 498 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
910 Sprinkler rough -in PLM - Plumbing Permit
915 Fire alarm rough -in 305 • Plumbing underslab
920 Suppression trip test 310 Craw] 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 dram
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
g _ 595 Misc. inspection:
499 Final inspection 599 Final inspection
•
i. \ Buildmg \ Forms \ nOP- Blank.doc 02/02/07 •