Permit rr - -s CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00628
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/29/2007
PARCEL: 25111 CB -01601
SITE ADDRESS: 15055 SW 100TH AVE ZONING: R -3.5
SUBDIVISION: THE MARGUERITE OCHS TRACTS LOT: 001 JURISDICTION: TIG
PROJECT: SLAUGHTER
Project Description: Installation of propane gas line for 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:
LPG 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:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1 •
> 10000 cfm:
Owner: FEES
JOHN SLAUGHTER Description Date Amount
15055 SW 100TH AVE
TIGARD, OR 97224 [MECH] Permit Fee 10129120C $72.50
[TAX] 8% State Surcha 10/29/20C $5.80
Total $78.30
Phone: 503- 256 -3720
Contractor:
WATSON PLUMBING CO.
7935 E BURNSIDE ST
PORTLAND, OR 97215 REQUIRED ITEMS AND REPORTS
•
Contact #: PRI 503- 256 -3720
Reg #: LIC 111855
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.
•
Ise ed By: _ / Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for inspections that bu ess 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 F OR OFFICE USE ONLY
•
• 2i y i f Ti and Received C '
Permit N
ermt o.: �l / /�/�/ n v
'
Ii� g Date/By: �D �! i l - / "7 we2./
' q 13125 SW Hall Blvd., Tigard, OR 972 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 DateBy: Other Permit:
T I GARD Inspection Line. 503.639 Date Ready /By: ® See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction Addition/alteration / replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL'-EQUIPMENT /SYSTEMS FEES"
T24--1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder ❑ Other:
Description Qty. Ea. Total
JOB SITE, INFORMATION AND LOCATION Heating/cooling
Job site address: /1-4.;.:. ' S l k [ ' �, , / 00 Air conditioning or heat pump
/ +� `-� J r " / vim/ ref -{ (requires site plan showing placement) 14.00
City/State /ZIP: . 77 6-/12 Q 9 7 2,p d Furnace 100,000 BTU (ducts /vents) 14.00
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 10.00
Hydronic hot water system 14.00
F L /J - 6 - L_O 7 0 /"` / 0 Orb' Residential boiler (radiator or
hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
9 Gas fireplace 10.00
6- iid (-- `"'7 PLC f ' - e A L G' (f , L/ 6 H /' /L Flue vent for water heater or gas
�� �� � o � fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY 'OWNER • � ❑ TENANT. Chimney /liner /flue /vent 10.00
Other: 10.00
Name [Q ft-/Q, L_if(A(,- -- Environmental exhaust and ventilation
Address: /6 ,1'S S (C) 7 0 Q ry 0 .c) Range hood /other kitchen
equipment 10.00
City /State /ZIP: i 0 9 7 3.7 4 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
- .❑; APPLICANT ❑ CONTACT PERSON' Attic /crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address:
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace /
E -mail: Range
CONTRACTOR Barbecue
Business name: \ 1 y� f c ...,„ j /VI � (/ Cs Clothes dryer (gas)
Y `b / ' Other:
Address: -7 9 7 ,- 0 LL J t // MECHANICAL .PERMIT FEES*
City /State /ZIP:(,O (�rt� r`,(0 9 7,,V (5 Subtotal n
Phone: ( C31) Z, , - 3 7 2O Fax: OM ' ' U 1
Minimum permit fee ($72.50) �/�
l Plan review (25% of permit fee)
CCB Iic.: G C t d` S'S- 7 O State surcharge (8% of permit fee) . O
TOTAL PERMIT FEE 1 S .:2,0
Authorized signature: i' . %G "/` J(O This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name:J // u VD , ,t� C 4:- C1(1 Date/ O _a_ �1 - -C , . 7 * Fee methodology set by Tri- County Building Industry Service Board
1:\Building \Permits \ M EC PermitApp doc 01/19/07 440 -4617T (l l /02 /COM/WEB)
Mechanical Permit Application - City, of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: ' Permit Fee:,
$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.
1:\Building \Permits \MEC- PermitApp.doc 01/19/07 2
CITY OF ��
��u u n n~�n TIGARD
| BUILDING DIVISION PERMIT #: MEC2007.00528
| 13125 SW Hall Blvd., Tigar , OR 97223 DATE ISSUED: 10/29/2007
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175 „AM 1E.
INSPECTION WORKSHEET FOR DATE: 10y310007 TIME: 7:00AM PAGE: 77
SITE ADDRESS: 16086EW1DOTHAVE CLASS OF WORK:
SUBDIVISION: THE MARGUERITE ()Ci�TRACTS LOT #: 001 TYPE OF USE:
PROJECT NAME: SLAUGHTER
i DESCRIPTION: }UsialladmD of propane gas line for log lighter.
OWNER: SLAUGMTER, JOHN PHONE #: 603..2%3720
CONTRACTOR: WATSON PLUMBING CC). PHONE #: 5O3-266-8720
.
Inspection Request Scheduled For: [}ate: 10/31/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 058710-01 503-320-0104 N
Corrections/Comments/Instructions:
PASS � PARTIAL APPROVAL � CANCEL �NO ACCESS
/ / �� o
FAIL [ | CALL FOR INSPECTION III ADDITIONAL FEES ASSESSED
Inspector: o Oote:/0 ~ — Y/ -- 0 7 Phone #: (503) 718-
CITY OF TIGARD
BUILDING-biViSION PERMIT #: tv1f 02007-
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 10128/2007
Phone: (503) 639 - 4171 , ail l
Inspection Requests (24 Hrs.): (503) 639 -4175 I ..
INSPECTION WORKSHEET FOR DATE: 11/1/2007 TIME: 7:02AM PAGE: :31
SITE ADDRESS: 150156 SW 100TH AVE CLASS OF WORK:
SUBDIVISION: THE MARGUERITE OCHS TRACTS LOT #: 001 TYPE OF USE:
PROJECT NAME: SLAUGHTER
DESCRIPTION: Installation of propane gas line for log lighter.
OWNER: SLAUGHTER, JOHN PHONE #: 503256 -3720
CONTRACTOR: WATSON PLUMBING CO. PHONE #: 503 - 256.3720
Inspection Request Scheduled For: Date: 11/1/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 058804 -01 503- 256.3720 V
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL n NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: 1. -- / — U Pho ne (503) -4 =�
p 7 #: ( ) 718- '-