Permit 'iik- CITY OF TIGARD
MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00336
TIGARD; 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/26/2008
PARCEL: 2 S 104 D D - 01400
SITE ADDRESS: 13612 SW 130TH PL ZONING: R - 4.5
SUBDIVISION: MOUNTAIN HIGHLANDS LOT: 013 JURISDICTION: TIG
PROJECT: SORG
Project Description: Install gas line to cooktop
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:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
SORG, BRET K + PEGGY ANN Description Date Amount
13612 SW 130TH PL
TIGARD, OR 97223 [MECH] Permit Fee 6/26/200€ $72.50
[TAX] 12% State Surch 6/26/200E $8.70
Total $81.20
Phone: 503- 866 -9665
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
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: __.44 / /1�
Call 503.639.4175 by 7:00 a.m. for inspections that business d- .
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.
( t
, _ . e i I
+ IVtechanical Permit Application f „le holy ohrlt l•: l ,h: oNI.I. '
City W Tigard • Y� Received Pe it No.: fl E iD(6"d0 33
4 13125 SW Hall Blvd., Tigard, OR 97223 plan Review
e Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
Inspection Lute_ 503.639.4175 Date e
T I G A R D Date Readyl3y: lurid: 21 See Page 2 for
Internet: www.ligard- or.gev Nod6cdlMcthod: Supplemental Information • TYPE : OF WORD ' .:. , COMMERC[AL;;FEE* SCIiEDULE ` —` USE CHECKLIST
❑ New construction ❑ Addition/alteration/replacement Mechani 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: $
❑ 1 - and 2-family dwelling ❑ ColnmerciaVindustrial :RESIDENTIAL EQUIPMENT / SYSTEMS FEES'
❑ Accessory building
❑ Multi -family 0 Master builder ❑Other: For special information use checklist.
Description Qty. i Ea. 1 Total
-.JOB SITE- INFORMATIO1V : .'AND: LOGI,T.I.UIY : ::, Heating/c
Job site address: /- o / Air conditioning or heat pump
/ c e! �� �L�/ /_,30 e..- (requires site plan shooing placement) 14.00
City /State/ZIP: Furnace 100,000 BTU (ducustvetus) 14.00
Suite/bldg./apt. no.: Project name: t Furnace 100,000+ BTU (ductstvents) 17.90
Oas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or t
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: Lot no.: Flue/vent for any of above 10.00
1 Other: 10.00 ,
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water beater 10.00
Gas fireplace 10.00 I
. / 4/ .S,G // •9‹,1 // 2JP _• Flue vent for water heater or gas
t � fireplace 10.00
' k j O ,to Log lighter (gas) r 10.00 _
Wood/pellet stove , 10.00
Wood fireplace/insert 1 10.00
}PROPERTY OWNER - 'CI TENANT Chimney/liner/Sue/vent 10.00
/
Other 10.00
Name: "?/y/ — ci W &. Environmental exhaust and ventilation
Address: , Range hood/other kitchen
equipment 10.00
CitylState/Z1P: Clothes dryer exhaust 10.00
' Single -duct exhaust (bathrooms,
Phone: ) e 9465 Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ' Attic/ crawlspace fans 1 0 .0 0
_ - -- -
[J CONTACT PERSON' ....---,'.'.• ,� -
Business name:
Other: 10 00
Fuel piping
m
Contact nae � -D r b y 55.40 for first four; 51.00 for each additional
Furnace, etc.
. Address:
Gas heat pump
City /State/ZIP: Wall/suspendcdlunit heater
Phone: c 1 3 1 3 ) 93' 1 1 - ;- 7 D i I Fax.: 3 ) t - 7 O) 6) Water heater
Fireplace
E-mail: Range
CONTRACTOR Barbecue `.
Business name: Lb i rj,/n h1 Gv 14„L /r . y E0.011 G I Clothes dryer (gas)
Other:
Address: '9 �
I J o x . 2 3 0 3 g nIB,CIIANICA,L PERMIT FEES'
City /State/ZIP: r�D v' - 9 Subtotal 1
Fax:
Phone: (M) lv 2- Z �0 p b minimum permit fee (572.50) 7a,
)�/ Q � Plan review (25% of permit fee) l
CCB tic.: 7 , 3 ,S 9 1 State surcharge (12% of permit fee) , 70
TOTAL PERMIT FEE 1 . - D, (y,
_
Authorized signature: � This permit application expires if a permit is not obtained within 180
CG// �� Y � — ,/, 4, duos duet it has beet] y w tcd as S
Print name:
t %, Date: j • roe method set by Tri Couunty Building Inddustry ustry Service Board
'd OLZ0 J DNIIV8H VI8Wf1100 e9£ :60 90 9Z unf
CITY OF TIGARD
MECHANICAL PERMIT
o COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00336
TlGAK DATE ISSUED: 6/26/2008
13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S104DD - 01400
SITE ADDRESS: 13612 SW 130TH PL ZONING: R-4.5
SUBDIVISION: MOUNTAIN HIGHLANDS LOT: 013 JURISDICTION: TIG
PROJECT: SORG
Project Description: Install gas line to cooktop. 7/9/08, ADDING GAS FOR BAR B - QUE.
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:
> 10000 cfm: GAS OUTLETS: 2
Owner: FEES
SORG, BRET K + PEGGY ANN Description Date Amount
13612 SW130TH PL
TIGARD, OR 97223 [MECH] Permit Fee 6/26/200€ $72.50
[TAX] 12% State Surchai 6/26/200€ $8.70
Phone: 503- 866 -9665
Total $81.20
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
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.
Iss ed By: G - ��J ' Permittee - / , ,'f /
Call 503.639.4175 by 7:00 a.m. for inspections th urine 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 Fon oil lc l: USE ONLY .•
City of Tigard �� " may. , ' /� gRillint
u 13125 S W Mall Blvd., Tigard, OR 97229✓� Plan Review
II Phone: 503.639.4171 Fax: 503.598.1 ' , Date/13y:
Other Permit
T I G A Lt U
Inspection Line: 503.639 1 l l I Ca t tik- .Daze Ready/By: tom: 0 See Paze 2 for 1
Internet: www.tigard -or goo .i _i -- 1i Notifiod/Method: Suppirwcnial Information
TYPE OF WO -tI ,,,, 0 D ('` COMMERCIAL,-PEE • S CHE D U L E U SE CHECKLIST
t 1lr Mechanical permit fees* are based on the value of the work
❑ New construction ❑ Additionlalterdtiothepacement performed. indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
l CATEGORY OF CONSTRUCTION,.;',.'..._. Value: S
RES1i»ENTIAL EQUIPMENT / SYSTEMS FEES"'
❑ 1- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other: Description ' Qt). j Ea. Tots
JOH SITE WFORMATION- AND 1L.004 ON Headng/cooliag
Job site address: / J 3. 7., / / Air conditioning or heat pump
/� 'i 3o �G (requi es site plan shrnvina placement) 14.00
City/State/ZIP: f Furnace 100,000 BTU (ducts/vents) _ 14.00 1
- Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldgiap'.no.: Project name: Gas heat pump 14.00 '
Cross street/directions to job site: Duct work I 14.00 f
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. 10.00
Flue/vent for any of above 10.00
Subdivision: Lot no.: Other: 10 QO •
__J
Tax trap /parcel no.: Other fuel appliances
DESCRIPTION OF WORK . _. Gas Water el 10.00
fireplace 10 i
I ) fj/ 5 // / <i 4l ' O " 8. Flue ver.t for water heater or gas
fireplace 10.00 I
1 .-- � /(l f Log lighter (gas) 10.00
Woodlpellet stove I 10.00
Wood fireplacelmsert 10.00
•
Chimney0iner, luawent 10.00
PROPERTY OWNER • . ,. - [] TENANT . •:..:.:.. •••: 5r_ ...........
Other: 10.04
Name: % lee ,f _c3,:,. Environmental exhaust and ventilation
/ Range hood/other kitchen _ I
Address: equipment i t 10.00
City /State/ZIP: Clothes dryer exhaust 10.00 1
Single -duct exhaust (bathrooms, II
Phone: 5 J) f 17i, / Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT 0 CONTACT PERSON Atticfcrawispace fans 10.00 1 .
Other: 10.00 l .
Business name: Fuel piping
Contact namef J fj .4 ) - 55.40 for first four; 51.)0 for each additiona
l
Furnace, etc. 1
Address: . Gas heat pump i
CityJStateeJZEP: WalUsuspended/unit heater � •
Phone: )/q > t - ; 701 I Fax: : 3)S q g'- D - Waterbeater 1
1 Fireplace
E-mail: - 12Lust e l
CONTRACTOR ... . Barbecue / - {
n I / I /� / / Clothes dryer (gas) ! �J
Business nam _ e: 2 l0 07 b/ Cr....) /t / Yr' [Jr I r( `_, Other:
Address: (Fe, 3 o x .23 o 3 9 . MECHANICAL PERMIT FEES'
Cit /SrarefZIP: is 12 2 q 7 2�/ subtotal
Minimum permit fee (572.50)
Phone: (5n) (O 2 � p ) $ / Fax: ( ).9 0:)• --70 Plan review (25% of permit fee)
CCB Tic.: 7712 3 5 / 1 State surcharge (12% of permit fee)
— - TOTAL PERMIT FEE I I
�� T his per a pplication expires if a permit Ls nut obtained within 180
Authorized signature: / B days after it has been accepted as complete.
� /f v � Date: �j id ' , — • Fee methodology set by T ounry Bu leg Industry Service Board
Print name: ,, /!� "*I !/r
l'd OLZO - £09 ONLLV3H V18Wl100 ebb :80 20 60 Inf
CITY OF TIGARD
BUILDiNG DIVISION
PERMIT #: MEC2008-00336
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/26/2008
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 _ ---
INSPECTION WORKSHEET FOR DATE: 7/10/2008 TIME: 7:00AM PAGE: 39
SITE ADDRESS: 13612 SW 130TH PL CLASS OF WORK:
SUBDIVISION: MOUNTAIN HIGHLANDS LOT #: 013 TYPE OF USE:
PROJECT NAME: SORG
DESCRIPTION: Install gas line to cooktop. 7/9/08, ADDING GAS FOR BAR-B-OUE.
OWNER: SORG, BRET 1< 4- PEGGY ANN, PHONE #: M3-866.9665
CONTRACTOR: COLUMBIA HEATING & COOLING INC PHONE #: 503-624-2704
Inspection Request Scheduled For: Date: 7/10/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 072353-01 503.-624-2704
Corrections/Comments/Instructions:
644_ /AI S' CrIe
1 0 PARTIAL APPROVAL El CANCEL NO ACCESS
0 FAIL • CALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Ar 4
Inspector: ,■ Date: 7--/i —C1i3 Phone #: (503) 718- 2+-f-75---
CITY TIGARD MECHANICAL PERMIT
1
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00336
-rtc 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/26/2008
PARCEL: 2S104DD -01400
SITE ADDRESS: 13612 SW 130TH PL . ZONING: R -4.5
SUBDIVISION: MOUNTAIN HIGHLANDS LOT: 013 JURISDICTION: TIG
PROJECT:. SORG
Project Description: Install gas line to cooktop
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: •
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
•
Owner: FEES
SORG, BRET K + PEGGY ANN Description Date Amount
13612 SW 130TH PL
TIGARD, OR 97223 [MECH] Permit Fee 6/26/200E $72.50
[TAX] 12% State Surch 6/26/200E $8.70
Phone: 503- 866 -9665
Total $81.20
Contractor:
COLUMBIA HEATING & COOLING INC
P.O. BOX 230397
TIGARD, OR 97281 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 624 -2704
FAX 503 -598 -0270
Reg #: LIC 76359
•
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:
Call 503.639.4175 by 7:00 a.m. for inspections that business d- .
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: 1)1 E,c of DOg —D REQUIRED ON GREEN INSPECTION CARD.
✓ • Code I 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 >< 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- Blankdoc 02/02/07