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Permit ... 3 4, ,P d. CITYOF TIGARD MECHANICAL PERMIT DEVELOPMENT SERVICES PERMIT #: MEC2004 -00390 Ail SW Hall Blvd., Tigard, OR 97223 ( 639 -4171 DATE ISSUED: 6/18/2004 PARCEL: 2S 109AA -01600 SITE ADDRESS: 14378 SW 130TH AVE SUBDIVISION: WOODFORD ESTATES ZONING: R -7 BLOCK: LOT: 004 JURISDICTION: TIG 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: 1 FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: > 10000 cfm: GAS OUTLETS: 4 Remarks: Wall Heater install, 4 outlets. BBQ, dryer and heater. Owner: FEES THAN, TIN Description Date Amount 14378 SW 130TH [MECH] Permit Fee 6/18/2002 $72.50 TIGARD, OR 97224 [TAX] 8% State Surchaq 6/18/200 $5.80 Phone: 503 620 - 1427 Total $78.30 Contractor: T & K MECHANICAL 11525 SW CANYON ROAD BEAVERTON, OR 97005 REQUIRED INSPECTIONS Phone: 503 626 - 4652 Gas Line lnsp Mechanical lnsp Reg #: LIC 121165 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 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questions to OUNC by calling (503)246 -6699. / / // Issued By: ►� /L /' '_,,, Permittee Signature. Call (503) 639 -4175 by 7:00 P.M. for inspections -ded the next bu • ess day Mechanicd1 Permit Application - FOROFFICE_USE ONLY " - . City of Tigard Received permit N�,/�� 13125 SW Hall Blvd., Tigard, OR 97223 Date/By: ,/ ( ` c1 IV I at . „ /Q —D 0 . , Plan Review Phone: 503.639.4171 Fax: 503.598.1960 4c l i+\ Date/By: Other Permit: Inspection Line: 503.639.4175 � y A � Date Ready/By: ffila 0 See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: Supplemental Information i ,€ �`s;»;',^»�`��' � �>`' e :,�'�. i ' n -� : " z '°" t �an ' �,%�;,, s; r �a � . x : �,^ . - - ; V . ,� i _ IM OF WORK. r ; #. . lRi at` GOIVIMERCIAI:rOti ::SCI)iD.ULE , ;, ;IJSE> CKL[ST '� :�:.wzs ". m ^' a�.,., r z .6?n.��ae °, b- �rw.`�u a �aa - .. 4 $ ., �� . . ..° ... II] 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. ' _` . 1: Il : :;: g, fiVA G O R gIF: 9E %.M TION ieU � x' =�_ ='� +>�.zR. < ° .:'.. z-.- = a:..,: skda:"::'_° �,:. �: 3:". J. s�a .,r:.xn;�..aa:zs:rs.?�� � =ara�:.� .::'f^'3��'.e':;x°?^R�.;�a �..`k��:.�� „a:� ;r;, °:. �. ; -�s S T;�:.a. +y ro :r^:;�. :� - t,1RE IDE_ . "EQ� IPMENTS FEES* - and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building Ty For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total r ;� ' fi ” � " � " �„Y'�* > ,�;r;�ex:;�g� �t .:^: a ' � ..: �: � &WK.�rv�:x�°x � z u h ' *sxv.:w, : � °., ^ '- ; . ;..^^ ; ^ : .� ^,c g „� : 4. ; x JOB SI TE. ,I NF ORMATIO t'DLOCAT?T O � Heatinp/cooling . ,LEt,. e,,. rs.„, . „:,,, , ; S : ,,„, u „a^,ae,: 1�: � z^ ; ^. afi:4k,r4 -. _> , ,,. Job site address: Air conditioning or heat pump / 3 7 S /' Q ��%/ F' (requires site plan showing placement) _ 14.00 City/State /ZIP: - /9 ( �/ C, 2 Furnace 100,000 BTU (ducts /vents) _ 14.00 Suite/bldg./apt. no / % !! : / Project name: Furnace 100,000+ BTU (ducts /vents) 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), J 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 r, :� "'. 'uv v � ^° , 11t a i Water heater 10.00 "� � ,� � � "DESCRIP�TION� °OF =��'O :w'�' .� t, »�^ .�, r s a . . ��. s ^a�,�: aar� ".> te e �' . „�:.� C'`-7'-/ 14- /p M--7,---1-=v- ' / Gas fireplace 10.00 /.9 I ( ! // � � ` 1v�L Flue vent for water heater or gas ,� fireplace 10.00 Q \I /, ° 1 /t `« ��y�� A-l/1 / (, Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 I- 1;�.�,r ' v 4 . .v. ',;:a^ ..:r r: t,;S; > vs.vw'yoEv : s gr �,•.�w ;� °: . ,z•v=a_.ww's`�°�"-'"'� ^' 3�•'•,Y`. ;ik�i ias Chimney /liner /flue /vent 10.00 „ ... , ® ; UWNE x r' f . . �f l* ) k 6 ` L 1 � ° �-��� � °�.�.Fl,� �1°--r .. Other: 1000 Name: 77---n ' I % Ah Environmental exhaust and ventilation Address: / � '" 7 f � / 30 �� Range hood /other kitchen C equipment ment 10.00 City/State/ZIP: t `. / 7d Oy 97 2 - (.f - Clothes dryer exhaust 10.00 J Single -duct exhaust (bathrooms, Phone: (5 3) 6 ��r1 Fax: ( ) toilet compartments, utility rooms) 6.80 ``r,` .<!; Jam' I / ", ' ;„ :' f d 4; '{` Attic/crawlspace fans 10.00 Attc cr AP. a '; E, o ;..:..;,, ° ri" <. :. t.A - P '`� ,.; &���,«, - � .^ . �. ,_.�� `„�� � �,�' d ''� vim,- ,:. .am < �"¢�,. ^sa?*��`;x �.�'��.� °b: r�,..,°�+�^a,�',�,7u.ns,.s� Ewa- �r�a€:.z� � • «�r,:ef's°r 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 - mail: Range s s ` .7 .'1 xut mr ° - . - s ue "t &+ s 1 a a :Jr. - CONTRACIt ©R ,, . P• 1- ,; Barbecue Business name: 7 /1 Clothes dryer (gas) �/ 1 O /� '� / 9�1 1G Other: Parry p t-f , Address: `/9' C ° ; p, . t.:,; -, : ttw . ES* �S S�� /a` � �'�/ !f( CA/ R” .,.... i1 E „' MECH . ,:.: P�ERIVI,IT,,,,„ , , . City/State /ZIP: / 'f 6�trr/e'- CY777i- — °�� – Subtotal 7...2.. 571 Minimum permit fee ($72.50) Phone: (7'3) 3g 6 --' Fax: ( ) g - BO -0 / permit e Plan review ( (25%25% of permit fee) CCB lic.: / '�. /7 6 3 /I cg ' 5 . / —3 / ? State surcharge (8% of permit fee) j` ,X� TOTAL PERMIT FEE '7 - 30 � / --- Thi perm application expires if a permit is not obtained within 180 Authorized sign - days after it has been accepted as complete. Print name: , Z c/ /c' ":„” ) 7 ,. i. p Date: G (r Okr- * Fee methodology set by Tn- County Building Industry Service Board i:\ Building \Permits \MEC- PermitApp.doc 12/03 440 -4617T (11/02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information • • Commercial Fee Schedule: Total Valuation �Pe>rm t °Fee r: ¢° y $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 -4175 INSPE iON'DIVISION - Business Line: 3) 639 -4171 MST �.., BUP Received Received v Z "� Z Date Requested - ` Z AM PM B • Location /11S t ` e Suite EC ( — 00 S To Contact Person Ph (,S I ) SS " JJ 7 PLM Contractor Ph ( ) SWR BUILDING Tenant/Owner ELC Footing ELC Foundation Access: Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear I nt Sheath/Shear � ��Lz7 _ J Framing Insulation � �y Drywall Nailing L u U ' '� -� O �u 0 L-A'S N KeZ�C� Firewall Fire Sprinkler Fire Alarm • Susp'd Ceiling 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 PASS FAIL HC A am Rough -In Gas Line S Dampers • SS PART FAIL CTRICAL Service Rough -In UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hail, 13125 SW Hall Blvd. PASS PART FAIL SITE El Please call for reinspection RE: r ' El Unable to inspect - no access Fire Supply Line ' / / - ADA 1 Zz - Q / Ins ector Ext Approach/Sidewalk Date ` p _ • Other: Final DO NOT REMOVE this inspection record fr + the Job site. PASS PART FAIL