Permit CITY TIGARD MECHANICAL PERMIT
AP A\ DEVELOPMENT SERVICES PERMIT #: MEC2004 -00477
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/20/2004
PARCEL: 25111 BD -01601
SITE ADDRESS: 14815 SW 98TH AVE
SUBDIVISION: ALDERBROOK FARM ZONING: R -3.5
BLOCK: LOT: 005 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:
LPG 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
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: 1
Remarks: Installation of gas fireplace and gas piping.
Owner: FEES
ROGERS, MICHAEL R + ELIZABETH A Description Date Amount
14815 SW 98TH [MECH] Permit Fee 7/20/200 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchart 7/20/200 $5.80
Phone: Total $78.30
Contractor:
MIKE LARKIN
11901 NE COUCH ST
PORTLAND, OR 97220 -2361 REQUIRED INSPECTIONS
Phone: 503 Gas Line Insp
Mechanical lnsp
Reg #: LIC 68996 Final Inspection
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
952-0s -i I u :. !h OAR 952 - 001 -0100. You may obtain copies of these rules or direct q sti • s to OUNC by calling
(5e )246 -6699.
sued By: / 0 10_24. �y _ _� Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Meanical Permit Application : UIi OFFICE USE ONLY
+ City of Tigard Date/By: ( D ' _ '� Permit No.: V4 p�� -�
1
Y
13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 // - 2 , : Other Permit: I
qm.' (+' D ateB y :
Inspection Line: 503.639.4175 1 Date Ready/By: y: El See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information
' * ' - L* ° : . Z `4° ' ; ` .1 ` .bh ERC TEE* , S CHEDULE — USE CHE "CICLIST
❑ 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.
' ": - , r7 Value: $
..,. - = - . �€ 'A I-'' - -' ' : xnr... -- �, ='e' > .' - . > ' -
❑ 1-and 2-family dwelling R ESIDEN'I�AL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total
„ V ._ a =?� s * ' . , ,s1,,,-;,,,,,s kik epu ;. `, ., _ Heating/cooling
Job site address: 4 S l (� 7-1... Air conditioning or heat pump
s 7 (requires site plan showing placement) 14.00
City / State/ZIP: �LitoLy ._ P 9 7 `-k Furnace 100,000 BTU (ducts/vents)
Furnace 100,000+ BTU (ducts vents) 14.00
Suite/bldg. /apt. no.: I Project name: 17.90
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
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
Subdivision: I Lot no.: Flue /vent for any of above 10.00
Other: 10.00
Tax map /parcel no.: Other fuel appliances
< ' v`i'e , t ', Water heater 10.00
s E :ate : =refiltiv'. 4 *:. < s `.�c. - ^` ..7
Gas fireplace 10.00 Ja 0
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
. .,. Chimney /liner /flue /vent 10.00
� x t
. _ 1_ z*��,. �,.��. � •- ' "� .�._a ,� -�"+�! Ot her: 10.00
Name: / / z k tp 1(`. Environmental exhaust and ventilation
Address: 1 q pc ! - S W' I Range hood /other kitchen
equipment 10.00
City/State/ZIP: ri & 0 L d V ` Clothes dryer exhaust 10.00
6 a - - 7 J Single -duct exhaust (bathrooms,
Phone: 0 -- dg Fax: ( ) toilet t compartments, utility rooms) ms ) 6.80
4* „ " Attic /crawlspace fans 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: ( ) I Fax: : ( ) Water heater q(-) Fireplace 6-,
E -mail: Range
g ~~tea l
„ l i1� a. . � ; ” ;' Barbecue
Business name: / ix.'L i ( CO ( Clothes dryer (gas)
// � / Other
Address: /X E w O 0-C l-, y � 4 1!'CHSOe#E tEItIl11'F'R.LES*
City/State /ZIP: Vd r - - t- d 51 7 z 2.0 Subtotal
^ 3 „pc-6 et Ck. Fax: ( ) SCE Minimum permit fee ($72.50) '�, �j L
Phone:
_ �w Q U�� Pl an review (25% of permit fee)
CCB lic.: 60-?5,t- State surcharge (8% of permit fee) ,b.
TOTAL PERMIT FEE `75f ,
/
Authorized signature: /O 410 / This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: / ‘C 0...r C 6 l/".. Date: ! OZ.( • Fee methodology set by Tri- County Building Industry Service Board
i:\ Building \PermitstMEC- PermitApp.doc 12/03 440- 4617T(11 /02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
9 aIu�a f r 'e - h t�ce
$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 \Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business Line: (503) 639 -4171 MST
BUP
Received Date Requested r. ) ? 3 AM PM BUP
Location 1. "--i ( 815 3`, ASW Suite MEC b l i . "' C- 0 L} 9 1
Contact Person N \( \ 'KO ��'' - Ph _) 1 2)�y` aIP5P? PLM
Contractor Ph ( ) I SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear ,
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
Other: _� /� I
Final ,a`:. 1� � 46 ('�' ' 1 1
PASS
PLUMBING FAIL (3 t 4q 1 ci
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain &Nh-Y
Shower Pan
Other:
Final
C=T FAIL
Post & Beam
Rough -In
Smoke Dampers
PART FAIL
EL
Service
Rough -In
UG /SI
- L6w Volta
Fire Ala
Final El Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE 0 Please call for reinspection RE: El Unable to inspect — no access
Fire Supply Line
ADA \
Approach/Sidewalk
Date `' Inspector _ Ext
Other:
Final DO NOT REMOVE this inspection record fro he Job site.
PASS PART FAIL