Permit •
CITY OF TI CARD MECHANICAL PERMIT
AA DEVELOPMENT SERVICES PERMIT #: MEC2005 -00810
13125 SW Hall Blvd., Tigard, OR 97223 503 639 -4171 DATE ISSUED: 12/9/2005
� a v -
r PARCEL: 2S111 CA -09100
SITE ADDRESS: 15360 SW 100TH AVE ZONING: R -7
SUBDIVISION: GULF SIDE ESTATES NO. 2 LOT: 035 JURISDICTION: TIG
Project Description: Gas line and fireplace insert.
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:
WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
SANDERS, WARREN L + EVA M Description Date Amount
15360 SW 100TH ST [MECH] Permit Fee 12/9/200° $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 12/9/200E $5.80
Phone: 503 684 - 0117 Total $78.30
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact #:
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 direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Issued By: .� ■ / Permittee Signature C.-- 9 1
• Call 503 - 639 -4175 by 7:00 a.m. for inspections that business da .
This permit card shall be kept in a conspicuous place on the job site until com tion of the project.
Approved plans are required on the job site at the time of ea nspection.
,
,a � ,
Mechanical Pernt ._. p i t n Hoa off 1 i ce USE ONLY
City of Tigard Received o2 • , / �� Permit No 06- o 0
Date/By. __
13 f 25 SW Hall Blvd., Tigard, OR 972 � 0 9 200 Plan Review
Phone: 503.639.4171 Fax: 503.59W ( , h A.,
' "i ll I Daz e /B y . Other Permit:
Inspection Line: 503.639.4175 _ I Date Ready/By: ME �r
CITY ., .l El See Page 2 for
Internet: www.ci.tigard.or.us CI 1 Y OF TIGA .R - Notified/Method: �/ , Supplemental Information
1/?TLD1NTr DrVISION 1_.
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction , �ddition/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: $ 215-rGb
and 2-family dwelling RESIDENTIAL EQUIPMENT /SYSTEMS
y g ❑ Commercial/industrial ❑ Accessory building
❑ Multi- family ❑Other: For special information use checklist.
❑ Master builder
Description I Qty. I Ea. I Total
" JOB SITE INFORMATION AND LOCATION Heating /cooling
53eoo -5�
Air q uires site plan showing ho or heat l a
Job site address: em
(requires placement) 14.00
City /State/ZIP: 71 A c, _17 �- 4, Furnace 100,000 BTU (ducts/vents) 14.00
' ) I Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name:& 1Zte-5 Gas heat pump 14.00
Cross street /directions to job site: Duct work 14.00
� y� Hydronic hot water system 14.00
,
�? ®�L. . .� '='�" k- A -- a`'1 I (n 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
DESCRIPTION OF WORK heater 10.00
�/'''� Gas fireplace V 10.00
...d.X'1 64A-It ° �J!/ 1 }' j Pi/ . '/ Flue vent for water heater or gas
1 /
fireplace �/ 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert • 10.00
®°P ' OPERTY OWNER ❑ TENANT Chimney /liner /fluelvent 10.00
. !`" Other: 10.00
LA
Name: L ,..,a s-, Environmental exhaust and ventilation
Address: t 6'3�a .5 e....4--, t �-U_ Range hood/other kitchen
s equipment 10.00
City /State /ZIP: -r� ,r1` z :7,....... 9 i Clothes dryer exhaust 10.00
I Single -duct exhaust (bathrooms,
Phone: (1;31) avg5 4 4,1 i 1.— Fax: ( 5/ ite3 lec ,,,,,,ay toilet compartments, utility rooms) 6.80
❑ APPLICANT ' ❑ CONTACT PERSON ' Attic/crawlspace fans 10.00
Business name: Other: 10.00
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
r Furnace, etc.
Address:
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
/
Phone: ( ) Fax: : ( ) Water heater ✓
Fireplace
E -mail: Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name:
Other:
Address: MECHANICAC:PERMIT FEES*
City / State/ZIP: Subtotal
Minimum permit fee ($72.50)
/ .t.
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lie.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE 7 g 3
Authorized si ature: This permit application expires if a permit is not obtained within 180
j i �L ..�j; , d days after it has been accepted as complete.
Print name: 0 w Date: * Fee methodology set by TO-County Building Industry Service Board
mo.`s r M �'r 214
i:\ Building \Pemmas\EC- PermitApp.doc 2/03 440- 4617TQ1 /07JCOM/WEB) g`� ' "
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't• $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 $11,100.00 $141.50 for the first $5,000.00 an
$1.80 for each additional $100.0 t or
fraction thereof, to and includi
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,00',.00 and
$1.35 for each additional :;100.00 or
.. ction thereof, to and • eluding
$51,! 00.00.
$50,001.00 to $100,000.00 $771. i or the firs 50,000.00 and
$1.25 for e. a • o ttional $100.00 or
fraction thereo ', o and including
$100,000.00
$100,000.01 and up $1,396.50 or the first .11 000.00 and
$1.10 f• each additional $11 i.!1 or
fract' n thereof.
Note: All new comm cial buildings require 2 sets of plans.
•
i:\ Building \Permits\MEC - PermitApp.doc 12/03 2
s 6 3 — sl-qr 7.S
• CITY OF TIGARD , ...
7.2.._u.s
l•
1 ) BUILDING DIVISION PERMIT #: MEC2005•00810
II . 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/9/2005
Phone: (503) 639-4171 A
w
Inspection Requests (24 Hrs.): (503) 639-4175 2 a l t
INSPECTION WORKSHEET FOR DATE: 4/26/2006 TIME: 7:03AM PAGE: 13
SITE ADDRESS: 15360 SW 100TH AVE CLASS OF WORK:
SUBDIVISION: GULF SIDE ESTATES NO. 2 LOT #: 035 TYPE OF USE:
PROJECT NAME: SANDERS
DESCRIPTION: Gas line and fireplace insert.
, .
OWNER: SANDERS, WARREN L + EVA M, PHONE #: 503-664-0111
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 4/26/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message ,
699 Mechanical final 026741-01 CO3-369-9447 Y ,z_f_tv.i
Corrections/Comments/Instructions: 5 4 - 67 3
(W, Corrections/Comments/Instructions: -( $
-Arc-L-e-J-d pt- , (7? , f‘---- 4--
( .
A vy e
I / —
/..... ,/ ...------ 1 -------
1
PASS 1 i PARTIAL APPROVAL D CANCEL 1 j NO ACCESS
0 FAIL I I CALL FOR INSPECTION I ADDITIONAL FEES ASSESSED
Inspector: V( ../t, . ci Ct 7
Date: t/'' , ' Phone #: (503) 718-V
_ .
CITY'OF TIGARD
BUILDING DIVISION PERMIT #: MEC2006- 00:310
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 121912005
Phone: (503) 639-4171 k
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 4/2512006 TIME: 7:00AM PAGE: 81
SITE ADDRESS: 15360 SW 100TH AVE CLASS OF WORK:
SUBDIVISION: GULF SIDE ESTATES NO. 2 LOT #: 035 TYPE OF USE:
PROJECT NAME: SANDERS
DESCRIPTION: Gas line and fireplace insert..
OWNER: SANDERS, WARREN L + E.:VA M, PHONE #: 503-664-0117
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 4/26/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 028590-01 603.684-0117
Corrections/Comments/ Instructions:
c7 / 445774.2, .3-77e zx /MA)
fl PASS „--- I I PARTIAL APPROVAL fl CANCEL fl NO ACCESS
CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
Inspector: _/ Date:4 Phone #: (503) 718- Z-q-el<A
~~_ _ -- - '
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BUILDING DUNG DUVUSUON PERMIT #: kAEQ200500810
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12y9/2805
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 4/34/2006 TIME: 7:03AkA PAGE:
SITE ADDRESS: 1538{)SYV 100TH AVE CLASS OF WORK:
SUBDIVISION: GULF SIDE ESTATES NO. 2 LOT #: 036 TYPE OF USE: .~
PROJECT NAME: SANDERS
DESCRIPTION: Gas line and. fireplace insert.
OWNER: SANDERS, WARREN LfEYAhl. PHONE #: 503-604-0117
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 4/24/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 028578-01 503-969-907 kl
Corrections/Comments/Instructions:
•
�'..
I | PARTIAL APPROVAL n CANCEL n NO ACCESS
I | FAIL FOR INSPECTION ri ADDITIONAL FEES ASSESSED
/ �� x
Inspector: '� '~~ . Date: �r--^�^f---�/4� Phone (503)
,..
CITY OF TIGARD `� �Z _
BUILDING DIVISION PERMIT #: ' d �� 0
13125 SW Hall Blvd., Tigard, OR 97223 it- •b -ri " --'- DATE ISSUED:
Phone: (503) 639 -4171 " �h l 1 -
Inspection Requests (24 Hrs.): (503) 639 -4175 -�.�±� �' I
INSPECTION WORKSHEET FOR DATE: C O 0 6 TIME: PAGE:
SITE ADDRESS: /S 6.0 /60 to CLASS OF WORK:
SUBDIVISION: LOT #: 3 s ----- - TYPE OF USE:
PROJECT NAME:
DESCRIPTION:
OWNER: PHONE #:
CONTRACTOR: PHONE #: iijy_ 01) ?
Inspection Request Scheduled For: Date: Pour Time:
Code # Inspection Description Confirm # Contact # Message
[( n d . 0017e()-.S =�'/
r Corrections /Comments /Instructions: (pal 4 / 1 4 K Z 4., c4 1 j
Oxs s -k L
, , ,
p077)--as 7 7 )./' 7. 1
I
PASS n PARTIAL APPROVAL ❑ 'CANCEL ❑ NO ACCESS
FAIL n CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: IV 3/ Phone #: (503) 718- 2,y al
tv
Inspections Required for: MEC2005 -00810
✓ Code Inspection Description PASS Date 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 1
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors , 199 Electrical final - I
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage ___I
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 _X 610 Gas line 1
287 Suspended ceiling , X 615 Mechanical rough -in 1
x ? _ 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 J
.- 640 Exhaust hood _
695 Misc. inspection:
X 699 Mechanical final
x BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in 305 Plumbing underslab 1
f' 915 Fire alarm rough -in
920 Suppression trip test 310 Crawl drain
315 Post/beam plumbing :
995 Misc. inspection: 320 Plumbing rough -in _
998 Alarm final 322 Shower pan 1
999 Sprinkler final
330 Water service
335 Rain drain
340 Storm drain J
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert/catch basin I
410 Fill _ 350 Septic tank
—7
415 Grading 395 Misc. inspection: I
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer _1
498 Grading final 595 Misc. inspection: 1
499 Final inspection _ 599 Final inspection
I: \Building \Inspection Cards \Forms \.AOP- InspCard- Blank.doc 12/09/2005
CITY TIGARD MECHANICAL PERMIT
i DEVELOPMENT SERVICES PERMIT #: MEC2005 - 00810
''' X 1 1 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 12/9/2005
PARCEL: 2S111 CA -09100
SITE ADDRESS: 15360 SW 100TH AVE ZONING: R -7
SUBDIVISION: GULF SIDE ESTATES NO. 2 LOT: 035 JURISDICTION: TIG
Project Description: Gas line and fireplace insert.
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: 1
Owner: FEES
SANDERS, WARREN L + EVA M Description Date Amount
15360 SW 100TH ST [MECH] Permit Fee 12/9/200E $72.50
TIGARD, OR 97224 [TAX] 8% State Surchar€ 12/9/200; $5.80
Phone: 503- 684 -0117 Total $78.30
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
0
Contact #: U'
I
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 direct questions to OUNC by calling 503 - 246 -6699
or 1-800-332-2344.
Issued By: ,A0 / Permittee Si natur j ,
Call 503 - 639 -4175 by 7:00 a.m. for inspections that business da
This permit card shall be kept in a conspicuous place on the job site until com tion of the project.
Approved plans are required on the job site at the time of ea nspection.
Case Activity Listing 7/10/2006 8:50:06AM
TIDEMARK Case #: MEC2005 -00810
COMPUTER SYSTEMS, INC.
,�- ,,....,.,,.�,,,,,,,.,> ,,,,,.,ri- ,�.,,.�, ;. -. 'Assi "Weds Done U'..dateil %F" "
� `max .�,>
ry 'l
r
�;;° � a Nbtes
"''Da 3 : °Hod ` s �� ,
;.Date 2:'- � .
Dec ti at �',;�,. y ,,.
�.` p':`_ y,,, ..... , °
MEC1010 Application received 12/9/2005 None RECD BB 12/9/2005
BLD
MEC1020 Permit created 12/9/2005 None DONE BB 12/9/2005
BLD
MEC 1030 Check for parcel tags 12/9/2005 None DONE BB 12/9/2005
BLD
MEC1280 Issue permit 12/9/2005 None DONE BB 12/9/2005
BLD
MEC2610 Gas line 4/24/2006 4/24/2006 4/24/2006 None PASS KBS 4/24/2006 028578 -01 — 503- 969 -9447 — VM -
STI N
MEC2699 Mechanical final 4/24/2006 4/25/2006 • 4/25/2006 None FAIL KBS 4/25/2006 028598 -01 -- 503- 684 -0117 VM -
STI N —180
MEC2635 Smoke detector 4/24/2006 4/25/2006 4/25/2006 None CANC KBS 4/25/2006 028603 -01 — 503- 969 -9447 - VM -
shutdown RB Y
MEC2699 Mechanical final 4/25/2006 4/26/2006 4/26/2006 None PASS RB 4/26/2006 028741 -01 — 503- 969 -9447 — VM -
STI Y
MEC 1740 Case finaled 4/26/2006 None DONE RB 4/26/2006
RB
MEC2699 Mechanical final 4/11/2006 4/13/2006 4/13/2006 None FAIL RB 4/13/2006 027825 -01 — 503 - 969 -9447 — VM -
RB Y
Page 1 of 1 CaseActivity..rpt