Permit •
n CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00605
TIGARD`' 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/11/2008
PARCEL: 25111 CD - 05600
SITE ADDRESS: 09580 SW BRENTWOOD PL ZONING: R - 7
SUBDIVISION: SUMMERFIELD NO.9 LOT: 515 JURISDICTION: TIG
PROJECT: KOEPKE
Project Description: Replacing gas log lighter.
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: 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
KOEPKE WARREN Description Date Amount
9580 SW BRENTWOOD PL
TIGARD, OR 97224 [MECH] Permit Fee 12/11/20( $72.50
[TAX] 12% State Surch 12/11/20( $8.70
Phone: Total $81.20
Contractor:
JACOBS HEATING & A/C
4474 SE MILWAUKIE
PORTLAND, OR 97202 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 234 -7331
FAX 503- 808 -9108
Reg #: LIC 1441
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: P (9 U J\ JJQ ).J Permittee Signature: jeL l VC,
CaII 503.639.4175 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: �yy�F� • REQUIRED ON GREEN INSPECTION CARD.
Code I Inspection Description I PASS Date 1 By I I I Code I 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
F 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 , 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
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
1: \ Building \ Forms \InspCard- AOP- Blank.doc 02/02/07
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ILI nit Applicae ... ,
C sieViSiti
4y of Tigard 0 . . &caved
miclay, 2 . ( OE _ P "u" Nu M EC 2411k... - 00 • 11 S
-, 2 . t3i3s SW Hall Blvd., Tigard, OR' 7'04'
c I e ‘)° •
• . Phone: . S05.5394171 Fax: 503.5 8.1960,6 ._ 12.011Eiiii Other Pcneit;
inspetlon We: 503.639.4175
% 41 %n 314 -1 _r1
NE r..„„i telt riga
Intert: VAvIV.Ligrud-or.gov u oi. % ig 1( ..inecumemod.
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. be. r i 1 ; .410..L.L,..._i Ct)011111EliCIAL:n0q*Itilldit ItEct7412.1ST
0 New constr4tion 0 Addillion/alt ;, on/replacement Mechanical iiermil ftes" art based on the value atlas work
performed. Indicate the value (rounded to the nearest dollar) . of all
o Demolition I 0 Other:
mechanical materials, equipntent. labor, overheat and milt_
• . s ci — k y '01,---77TrisoR ________ , vows
>I I • and 2-1amily dwelling 0 Corn ercial/bdusWjaj 0 Arc ry bu ' .'::1.1tESIDE4rW' 40.01ZNUSYST7616.001*,
Far aerial iiformalloa are checklist.
0 Multi-faintly 0 Winer builder 0 Other
.. .
..Docription CO ME Total
• . • •.:•t" .:,:•! 1 . JOB. SITV11 9 r ORMOWAitilli.thcAtiON .:. ;• :: : :i; . ' ' ,':': ' Head ... Loan
'''' 1 Air - . Waning or hut putop
Job site address: SS-V3-.71,AT7) Locc41., ,i,...ii. tipeihow.gpi......1)
14.00 III
City/StaturZIP: 'T.; / ,P..,a Furnace 100.0ao Btu dertuveau 14.00
Furnace 100,000+ BTU ituen/vcatia 17.90
Suite/bldg./apt. oo.: c•J 1 Protect nem e! e- In g,
Gas heat pump
14.00
Cross strecl/direetions 10 Job site:
Dud work I
_ 10.00 III
• - T"----------'—'"—— ' H drunk hot water s km 14,00
-,
Residential bailer (radiator or
—._--,__ h dronie
--. --
Unit heaters C • I-10c. not Wcdri MI
14.00
in-wall. in-duet. • , , • etc. 14 00
. ._
Flue/vent for an of above EM 611 MN
-
Subdivision: — ___ . !
1 Lot no.:
--.._ Other In 10 • 0 0 Mil
t
Tax map/parcel no.:
other fuel appliances
1 -____ v _,.______ ,_e_______._ ' • • • • .' ::'.1****11161140.F.W*C" ....,..,„,.;.,..'1'' ''' - ',1 .. Willtrheatcy le 10.0D
Gas fireplace 10.00 Mili
- ki- t E.-:-Lus 40 5,-. \ - 4-04 r- p cLeck
VCIII fp( water beater or gas IIIII
firsplace
10.00 1..
Log (gas) Sill ion ICI 41)
.,—. Woqpellet stove 10,00
—.—,
Wood fireRlandinsen 10.00
--77 7k'' - r - c "I; "f3 — Oillfi'41C12':Y.:''' '. •'-.7:`:,:•. : - .011464Ast:! i ;,• :, ,.• :,,, —• aim ilillm_eivert1 ) 0.00
10.00
Name: f 1 .. , II u Other
1. ) 0.-1 y .t cy fp F,..g.__________ Environmental exhaust rind vemilatiari
Range hood/other kitchen
Address:
.
-,••■■•■■•■■•.. C4161Micrit I 10.00 II
,
City/Slate/ZIP: !
Cloth dryer 10110
- _
-- - Single•duct exhaust (bathroom.
PbOur. (Et1) /62 5' f Fax: ( ) toilet coat • nrunents. milk rooms) 6.80
iness ahl . , •,;,.. ..,. - .0 cornAcr 'POISON : . • fuliciarAvi ram
' 10.00
— Other, 10.00
Bus name: j
-
Fuel pie
Contact name: i
5540 for tint tour: 51.110 for each uddidogrul
Address: I
Furnace, etr.
- '•••—
Gas hear pump
CilY/State/ZIP:
Wollisus . . • unit heater
Nil
Phone: ( ) 1 ------ , ( ) Water heater
_
Firealace
E-thall: . . !
Range IIIMIOM
.
. :. ri • .. CiiiqtliACTOR, • ' - =7",77--- Barbecue 111.1
es er (ges MIM
Business name: Junin Heating & Mr Conditio Cloth dry
ning
--________ Other MEM E
NON.'
Address; 4474 SE Who/made
.: • . • ' ME0 PEES -
City/Suite/ZIP: Pdrtland, OR 9720r----------------- -
Subtotal /4 • ' •
Minimum pemiia fee 472.101 7 . —
CCB He.: 1441
Phone: (S03)234.7331 1..L,c: (503)111,18910___11 _________
Plan review (25% of permit fey/
1
State surcharge (12% of permit (ee) y . 70
- i
TOTAL PERMIT FEE 7 _At
A iiilsear...■1 a i an laimm•
Tlas Banat esoanliesdirso •Inl.... If • o.....mi. L. ... h4-.4 ..,:.•.7. ..1.
NIIV3H SHODVF LSZEZT8E0S VT:9T 800Z/OT/ZT
O
Da/Z0 39Vd