Permit t•
l ill CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00618
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/29/2008
PARCEL: 2 S 114 B C -05100
SITE ADDRESS: 10321 SW BONANZA WAY ZONING: R -7
SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT: 088 JURISDICTION: TIG
PROJECT: ROGERS
Project Description: Run gas line for range.
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
HEIDI ROGERS Description Date Amount
10321 SW BONANZA WAY
TIGARD, OR 97224 [TAX] 12% State Surch 12/29/20C $8.70
[MECH] Permit Fee 12/29/200 $72.50
Total $81.20
Phone: 503 -523 -2641
Contractor:
NW SUNDACE SERVICES
10117 SE SUNNYSIDE RD SUITE Fl
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 888 -6881
FAX 503 -981 -3347
Reg #: LIC 163547
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 1, I /46,,, , , - Permittee Signature: `., tbf
Call 503.639.4175 by 7:00 a.m. for inspections t - 4 usiness 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 FOR OFFICE USE ONLY
City of Tigard Received Ai. -A Permit No.: ee iD��eO /g
N I 11 ..' • '� 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 Date/By Other Permit:
TI G A R D Inspection Line: 503.639.4175 Date Ready/By: lu n ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: '! 0, Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE,CHECKLIST
❑ New construction V1Addition /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.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
0 I- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. Total
JOB SITE INFORMATION .AND LOCATION, ,. Heating /cooling
Job site address: Air conditioning or heat pump
103 a 1 , gXi) ' v�anza (..xici� (requires site plan showing placement) 14.00
City /State /ZIP: �; (10 1 or q-1111 Furnace 100,000 BTU (ducts/vents) 14.00
Suite/bldg./apt. no.: I 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),
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 . . Water heater 10.00
Gas fireplace 10.00
YN UYI 3,3 \∎r e ' 2Q f Flue vent for water heater or gas
�J J fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace /insert 10.00
[3 PROPERTY OWNER . ❑ TENANT Chimney /liner /flue/vent 10.00
Other: 10.00
Name: i_i a � 11..\ cw r3 Environmental exhaust and ventilation
A �J "� Range hood/other kitchen
Address:
0.31 Sl.t J .IJ0 ncmaa u )o.L3 equipment 10.00
City /State /ZIP: ' l l O - t c)� I I iI Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (, 33) 5 l t -- 1('_/ t j Fax: ( ) toilet compartments, utility rooms) 6.80
APPLICANT, 0 CONTACT PERSON Attic/crawlspace fans 10.00
Business name: Other: _ 10.00
��1�� 9U Y1(�C9tn�'P T1 (1 � e . 3 Fuel piping
Contact name: s a, 11 c , 3 $5.40 for first four; $1.00 for each additional
11 r1 � ✓ � , t `` ^ Furnace, etc.
Address:
1O1' 1 ✓C_ .St)Ylf� )ic' . 20 e Vt1e F 1d0` Gas heat pump
City /State /ZIP:C'CC lh OmnS1 or g7oIS Wall/suspended/unit heater
Phone: ( 9 3) 8 W_ COezi Fax: : (D13) ( =lb) -3L/q7 Water heater
Fireplace lite
E -mail: Range
. CONTRACTOR Barbecue
Business name: Clothes dryer (gas)
��1 t �Ul(1(� 3e vm(`F15 Other:
Address: 10‘1/ .se ,50 vide - �d ✓UiTC I a3k MECHANICAL PERMIT FEES*
City /State /ZIP: C 1Q Subto
I� , or 47015 ,
Phone: (X33 ) gob`cee�� Fax: ( )981- a review (25% fee ($72.50)
fee `7 "--
� Pla review (25% of permit fee) 159"
CCB lie.: 1C -I 7 g h -/ State surcharge (8% of permit fee) 8. '70
t TOTAL PERMIT FEE qt , j
Authorized signature: *__ ---- . ---- -. -- This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: l , JX c -y- Date: 1 / /01 ` Fee methodology set by Tri- County Building Industry Service Board
1: \Building\Permits\MEC- PennitApp doe 04 /06/06 440 .4617T(11 /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
P >
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
I:\Buildin PermitApp.doc 12/30/05 2
`` . '
CITY OF ��nw n ��m mn���mnm��
BUILDING DIVISION PERMIT ~°~""~~~�""°~� ~°"~"~°"=~"° #: kdEc2008.0061a
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/29/2008
Phone: (503) 639-4171
Inspection Reque�y(24Hroj:(5O3)630'4175 m6 *���
/
INSPECTION WORKSHEET FOR DATE: nj 'c»n« TIME: 7 PAGE: 16
7,Avo��1
SITE ADDRESS: 10321 SW BONANZA WAY CLASS OF WORK:
SUBDIVISION: RI VFR VIEW ESTATES NO. 2 LOT #: O80 TYPE OF USE:
PROJECT NAME: R0W�RS
DESCRIPTION: Run gss line for range.
OWNER: ROGERS, HEIDI PHONE #: 503-523-2E41
CONTRACTOR: NW SUNDACE SERVICES PHONE #: 50338B-6881
Inspection Request Scheduled For: Date: 12/31/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Mess.
610 Gas line 078803-01 503-88116881 0 �+- ��
�
Corrections/Comments/Instructions:
.C5_Y_E ' M/I°
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•
's... ›‘ASS PARTIAL APPROVAL H CANCEL 0 NO ACCESS
FAIL CALL FOR INSPECTION ADDITIONAL FEES ASSESSED
__ __
|nepgotoc Omte: -^�� C ' O Phone #: 8503\ 718-
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INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: (a _ Opep f g REQUIRED ON GREEN INSPECTION CARD.
✓ 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
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
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 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
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
640 Exhaust hood
y . 695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in
915 Fire alarm rough in 305 Plumbing underslab
920 Suppression trip test 310 Crawl drain
995 Misc. inspection: 315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final 322 Shower pan
330 Water service
335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert /catch basin _
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
I: \ Building \ Forms \InspCard- AOP- Blank.doc 02/02/07
II If CITY OF TIGARD MECHANICAL PERMIT
° COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00618
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/29/2008
PARCEL: 2S 114BC -05100
SITE ADDRESS: 10321 SW BONANZA WAY ZONING: R -7
SUBDIVISION: RIVERVIEW ESTATES NO. 2 LOT: 088 JURISDICTION: TIG
PROJECT: ROGERS
Project Description: Run gas line for range.
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
HEIDI ROGERS Description Date Amount
10321 SW BONANZA WAY
TIGARD, OR 97224 [TAX] 12% State Surch 12/29/20C $8.70
[MECH] Permit Fee 12/29/20( $72.50
Phone: 503 -523 -2641 Total $81.20
Contractor:
NW SUNDACE SERVICES
10117 SE SUNNYSIDE RD SUITE Fl
CLACKAMAS, OR 97015 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 888 -6881
FAX 503 -981 -3347
Reg #: LIC 163547
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.
1 )
I
Issued " _ZJ _.f(r, id ✓,_ Permittee Signature: . 1 - 7 02)9 , 1
� e
•
Call 503.639.4175 by 7:00 a.m. for inspections t < .usiness 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.
•