Permit CITY TIGARD MECH PERMIT
DEVELOPMENT SERVICES PERMIT #: ,MEC2004-00539
`V DATE ISSUED: 81,10/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 1'04DA -14300
SITE ADDRESS: 13040 SW CADDY PL MODEL HOME
SUBDIVISION: QUAIL HOLLOW - WEST ZONING: R -4.5
BLOCK: LOT: 129 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: 1 DOMES. INCIN: ,�
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:
Remarks: Install new A/C unit.
Owner: FEES
KIMBLE Description Date Amount
13040 SW CADDY PL [MECH] Permit Fee 8/10/200 $72.50
TIGARD, OR 97223 [TAX] 8% State Surcharl 8/10/200 $5.80
Phone: 503 - 504 - 5599 Total $78.30
Contractor:
BRAUK ENTERPRISES INC
DBA/BULL MT MECHANICAL
13580 SW RHETT CT REQUIRED INSPECTIONS
TIGARD, OR 97224 Cooling Unt Insp
Phone: 503 702 - 2945 Final Inspection
Reg #: LIC 157814
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: 1 Permittee Signature: /A:e.t�c_....-
Call (503) 639 -4175 by 7:00 P.M. for inspections needed a next business day
Mechanical Permit Application FO OFFICE USE ONLY
City of Tigard Received permit No. --,/ 13125 SW Hall Blvd., Tigard, OR 97223 P Date/By: k a Y
Plan Review
Phone: 503.639.4171 Fax: 503.598.1960 /CAN i , a , Date/By: Other Permit:
Inspection Line: 503.639.4175 �li
Internet: www.ci.tigard.or.us ._. Note fie ed/ d/Meett o: Jars: See Page 2
g Notified/Method: T `� Supplemental Inn for
Information
4i: =:a, ; :.,,� � - * :�� -;r; - -5e :.r - .�s,-_ ��rt'. -= ' ^� >�� - :P :,;��a ,a�:�x�a���,�� z�rr. .;r;::.+s.� ��.:.,�� -- _-
z ",gas ,R - ; , a r „.>,x,�i ,x":t" "4 ;.; , ',� �,::., , l't , ,� . a - ' - .
a fi �E rT: EOF "WORK :,1'�, ,,, . 4 z *:. r. _ nHEKLI T
t°r;~���x��;.:. ". �€• .•, �`:` �Y .,� � .. . � .m � ���� .. _ _,,_x ,, �r,�,�� ,COMiVIFsRCIA. Ti'EE „'�SCI3ED.iJLEu' S
Mechanical permit fees* are based on the value of the work
❑ New construction ,1 Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
a
,` ;CATEGORY OF CONS~TR.i7CTIOPT a _ Value: -
`�' ,s'N�z�a3._ „;.e:.�•Xi�3 � .:+as ,. .�:s., ..�;i�:..� , a. .Ls: nS�:s,.�. ;v,Ea„�.
",a .m :�., x � .�: '^,�:e. - �_ =ex ,
"' RESI,PER -E QU I PM .NT; /:SY ST EMS,EE E S *
❑ 1 -and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building `
❑ Multi - family ❑ Master builder ❑ Other: For special information use checklist.
��;� �. :..� -,v,. r g ,�:x .,.° tee:. �� -�,-�w _..::� : ,. a ,,. ;
Description Qty. Ea. Total
,. ` ;. JOB SITE INFORMATION AND" UOCA �IONr, 'r"
.:.:., m...2�i;i ..�- .���'��� :�r-..,.u:. .. ._.; n. ��. zu-... z,. ^w�s�.''�Ks4.uf.s�«�+a'.a�..� a�.a #S ��s,,,gi Heating /cooling
Job site address: /J " / t/ ? U 0 I ' ,l 0 l/ P `� ' Air conditioning or heat pump
T5 (;( C A! (requires site plan showing placement) / 14.00
City/State /ZIP: " J � /1.. a D 7/2 y 7 2- Fumace 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),
in -wall, in -duct, suspended, etc. 10.00
Subdivision: (,J Flue /vent for any of above 10.00
Cot no.:
�f [d�l L t 1 .) _ Other: 10.00
Tax map /parcel no.: Other fuel appliances
; , • `.. t k a Water heater 10.00
;=�` , _ s .
. .'°� . ¢t_.... r,w :r nS�R>PTIor10>�wOZUC + s �`�,t� ��•.. � �.( � �`„�.. �` '
A I , 0 D _ f/� / /] / 0 1. Gas fireplace 10.00
0 f (N 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
o "Aft'.#,_. . f �>> -. .rb:: - t i t; �� Chimney/liner/flue/vent 10.00
to P O.'NER `' EN 'i " �' " t y
�: ,'�'€ , �, ;� �_���. �ia�� ��- � ��_ ,��,.> �.�� >,� __ r. .� !`f` Other: 10.00
Name: 1/ ir .6 L E Environmental exhaust and ventilation
Address: / 3 0 WO 6 . G. ) e12 J p p IlL Range hood /other kitchen
equipment 10.00
City/State/ZIP: -7 A , n 9 /L 4 2 2-23 Clothes dryer exhaust 10.00
J v ® Fax : Single -duct exhaust (bathrooms,
Phone: (30) 67) 5 , 1 " 9 ( ) toilet compartments, utility rooms) 6.80
tr, e r^� r - a *vim i ., . ', ,�
s;= , -* P .�GAl\T v LL „1 `�" , k y . CQN " AC;I PERSON= r ' ; Attic /crawlspace fans 10.00
Business name: g 14 if 4 6 , N e c J/ ■1 COL Other: 10.00
l Fuel piping
Contact name: �71 G hf4 #iJ 56 � $5.40 for first four; $1.00 for each additional
Address: J3 cg D SZ' k h t-4 e,-Z- Fumace, etc.
Gas heat pump .
City/State /ZIP: -- rI /9_40 Q1, C 722f WalUsuspended/unit heater
Phone: (9; 7de 2 q 4/6 Fax: : (403) 52 4 •65 t 7 Water heater
Fireplace
E - mail:
Range
c� .F C0kriACTO „ Barbecue
. "_, r Mrs � „u"��. :� . _ y ���,fr � . � _ �'�° ;..?�.v a "
Business name: gm f f m 64 , i:,��7 44-2, Clothes dryer (gas) ,:x Other:
Address: I c ,9 6 - 4 !� / `T _� ,- 'MECHANlCAI P_ R1VI *':' '
) ��
City/State /ZIP: r 17 / '. 9 7.2 2 Subtotal
Phone: ( l 3 7 / 62 2 � ys Fax: 4 ) £2 if G ", Minimum permit fee ($72.50) 7a. J
P lan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee) ,'. ro
// 17461-1-'*"-----) TOTAL PERMIT FEE 78 , 380 Authorized signature: This permit application expires if a permit is not obtained within 180 (i77-
/ days after it has been accepted as complete.
Print name: Z f ' (r/ Date: (^rt_ d * Fee methodology set by Tri- County Building Industry Service Board
i:\Building\Permits \MEC- Pernut pp doc 12/03 440 -4617T (I I /02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Fee ee Schedule:
$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
7.r y Jou
„A/10 91
L-71
(4166t 1)7 9
h E
•oci
- ..... _
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION Business LiAe: (503) 639 - 4171 MST
BUP
Received Date Requested a AM PM BUP
Location 3 4 /0 C L Suite ab4 y —D 653
Contact Person Ph ( ) SZ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC NJ V Q
Footing ELC
Foundation Access: .s 4(_- Atv z
Ftg Drain Y2 ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear I ^ ,� �� L 1 e '' � 6'
Framing V V / l U
Insulation
Drywall Nailing
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 PART FAIL_
tiMECHANICAL
'Post & Beam
Rough -In t J
Gas Line 1,11
. e Dampers
PA PART FAIL
CTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: ❑ Unable to inspect — no access
Fire Supply Line �? /� �
ADA U ' / • v
Approach /Sidewalk Date Inspector _ L/ ■-■• ■ Est
Other: -
Final DO NOT REMOVE this inspection reco •rom the Job site.
PASS PART FAIL