Permit r. �
CITY OF TIGARD MECHANICAL PERMIT
I� DEVELOPMENT SERVICES PERMIT #: MEC2004 -00633
`' t 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/23/2004
PARCEL: 2S1 12 BA -03200
SITE ADDRESS: 14070 SW 80TH CT
SUBDIVISION: WAVERLY MEADOWS ZONING: R -7
BLOCK: LOT: 022 JURISDICTION: TIG
CLASS OF WORK: OTR 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:
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:
Remarks: Install gas fireplace.
Owner: FEES
HIGGONS, LINDA Description Date Amount
14070 SW 80TH CT [MECH] Permit Fee 9/23/200 $72.50
TIGARD, OR 97224 [TAX] 8% State Surcharl 9/23/200 $5.80
Phone: 503 698 - 0646 Total $78.30
Contractor:
OWNER
REQUIRED INSPECTIONS
Phone: Misc. Inspection
Final Inspection
Reg #:
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or dire questio • e - by calling
(503)246 -6699.
Issued By: <- Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspection -- needed the next business day
Mechanical Permit A & � ltl a t _ FOR OFFICE USE ONLY
Cl Ol Received
City ��"Igard Date/By: Permit No. W / _ 6c_2 I/� // 7
13125 SW Hall Blvd., Tigard, OR 97223 200t Plan Review 0
Phone: 503.639.4171 Fax: 503.598.1 y0P 2 3 �} /��, Y 11, "� Date/By: Other Permit.
Inspection Line: 503.639.4175 n!I II Date Ready/By: Juris: El See Page 2 for
Internet: www.ci.tigard.or.us d� y ����`p {��p��p Notified/Method: Supplemental Information
:g'SY 'C ;Ys +' R'a _,-0 t'tl na�rur a s ., t „,. ..:s °3 i t:r e x ' t. - , a .,,c . . s . ; —,,,t ..`$ , ' t ,, "'�-, - mat r yn ' i pY r , w : r a
V ,,3 YSL ' , ,P ,E OF S W ORK r , - 1 N'' ,� ' [? " 7, 4 4 ,, li , " OM MERCIALRFEE . .USE
❑ New construction Addition/alteration/replacement Mechanical 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.
— ° „ I';�'k gf a 7 4 r r+m O COlYSTIV O hs'� "-s �a r 7' Value $
'��.ur•.. w�- s��t'y„CATEGORY �.> �..t �''�ta��u'��.�..A� �t � � o ,�. �t. �, s
$ .�RESIDENk tal EQUIPMENT /pSYSEMS FEES*
SI and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description Qty. Ea. Total
a =', "th5,t ( A*n B SITE AND O T); W ` 2 Heating/cooling
Job site address: "" � Air conditioning or heat pump
/�d 7(� t '' om/ gO h o� (requires site plan showing placement) 14.00
City/State /ZIP: Cr r r/ o J e 7 Z ZV Furnace 100,000 BTU (ducts /vents) 14.00
f Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name:
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
��' / Hydronic hot water system 14.00
T c/ h /1 �p' -e. /C- Residential boiler (radiator or
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
Other: 10.00
Tax map /parcel no.: Other fuel appliances
k DES CRIPNTIONeOFWORK °i e xa Water heater 10.00
k., ac. :. A.,' `''? �3 , :.` . ,.,�w..,.aws.m, ;n.:..v: ^ �rso, is : ,s'::` _.e. k : » W.e.. .�`
Gas fireplace .— 10�9.----i e9' /'p '7 /4r- fj_— Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
l sue:, �, z� a ^ ac's �� Chimney /liner /flue /vent 10.00
1 ,,,',44'".,..V i w�PROP ERTY :, 1 , T ER yiI � s.' . �" . (tT , r � ��'
, •a . � °� •' t Other: 10.00
Name: .i,(1 &14 ,7/, �� �� 5 Environmental exhaust and ventilation
Address: / e , $ t) //- / Range hood /other kitchen
l equipment 10.00
City/State /ZIP: — Z Clothes dryer exhaust 10.00
t 2 f /� Single -duct exhaust (bathrooms,
Phone: ii7 ) 5-9 e - 046, Fax: ( ) toilet compartments, utility rooms) 6.80
' 0®, „5., CANT { '�® CON"TAGT *PERSON Attic /crawlspacefans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: - $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City/ State/ZIP: Wall /suspended /unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E ,,,, Range
r 'ii* z,ti rs xr �# �' s i ;t
_ , t, �` � x sCO N TRt1CrT OR 1 � "4G 4 : - '1'_-:, , ,,3p, -. 1t: ' r . _ 1 Barbecue
Business name: Clothes dryer (gas)
Other:
Address: fp < "7 s HA` ''PERIVITT`EEES*
,5., a: s raver a _ y �:- t �. ..
City/State/ZIP: Subtotal
Minimum permit fee ($72.50)
Phone: ( ) Fax: ( )
Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE
• T his permit application expires if a permit is not obtained within 180
Authorized signature: days after it has been accepted as complete.
Print name: ax,,, h ' � / k, 9 4, y - Date: 7 ` Fee methodology set by Tri- County Building Industry Service Board
Pcn
i:\ Building \nitsVvMEC- PermitApp.do %12//03 / r t n d G / r ,` ..., A 15 440-4617T (11 /02 /COM/WEB)
� Iv
Mechanical Permit Application - City of Tigard ..-
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Vitai n F ' twz,A, w " "A'a�9nwry m sf o
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
_ $100,000.00.
$100,000.01 and up $1,396.50 for the first $100,000.00 and
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
i:\ Building \PemritsWIEC- PermitApp.doc 12/03 2
PirTY OF TIGARD 24 -Hour
BUILDING_ Inspection Line: (503) 639 -4175 °'
IN ECTION DIVISION Business Linb: (503) -4171 MST
? BUP
Received C 3 7 Date Requested f / AM — PM BUP
[1
Location / (1 7 Suite MEC Q 633
Contact Person Ph ( ) ?6I' / 4 16 PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
ELC
Foundation Access:
Ftg Drain �- J,C ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation w�� 7 -�,� ._�-_
Drywall Nailing � /� ' - ' "f ' ��—c s . _ /� t , i 'e- /S
Firewall / C ' 4.7 < 74
Fire Sprinkler
Fire Alarm alb eG
Susp'd Ceiling ����1 L �� G Pa
Roof
Other:
Final
PASS PART FAIL
PLUMBING,
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan -
Other:
Final
PAS_S__47ART FAIL
ME
Post& Beam cR
Rough -In
( 0 5 ma pers 1�
anal
SS PART FAIL
ELECTRICAL
Service
Rough -In
UG/Slab
Low Voltage
Fire Alarm
Final ❑ Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA
Approach/Sidewalk Date ,e ' Inspector Ext
Other:
Final DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL