Permit k •
CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006 -00462
61I. 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 DATE ISSUED: 9/29/2006
PARCEL: 25111 CC - 01600
SITE ADDRESS: 10275 SW CENTURY OAK DR ZONING: R -7
SUBDIVISION: SUMMERFIELD LOT: 013 JURISDICTION: TIG
Project Description: Remodel: lea. dryer, rangehood, fan. Gas line.
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: 1
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: 1
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS: 1
Owner: FEES
DAN /MARY COUGHLIN Description Date Amount
10275 SW CENTURY OAK DR
PORTLAND, OR 97224 [MECH] Permit Fee 9/29/200€ $72.50
[TAX] 8% State Surcha 9/29/200€ $5.80
Total $78.30
Phone: 503- 620 -2629
Contractor:
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: o` � /� / Permittee Signature:
Call 503 - 639 -4175 by 7:00 a.m. for inspections that bu ness 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.
RECEIVED ..
Mechanical Permit Application FOR O _ FFICE USE :O; LY
114 . q City of Tigard 3EP Z 9 2006 Dateiey `. ' �� j L � Permit N .. G „p... t�' V,
13125 SW Hall Blvd., Tigar4l`,QRiQ•7223-
J t I Plan Revi Date /By:
11 Jr : ' Phone: 503.639.4171 F 03 5 8 I , ARC Other Permit:
TI G A R D Inspection Line: 503.639.4175 u U VISION Date Ready/By: ® See Page 2 for
Internet: www.tigard- or.gov Notified/Method: WA Supplemental Information
TYPE' OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ 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: R ,,, (_Z mechanical materials, equipment, labor, overhead, and profit.
CA TEGORY OF CONSTRUCTION Value: $
• 1 - and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
gt,
y g ❑ Commercial /industrial ❑ Accessory building
Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description Qty. I Ea. Total
JOB SITE INFORMATION AND LOCATION Heating /cooling
/0 /� + Air conditioning or heat pump
Job site address:
/ 0 2 / S 5 L ' Ce. it, OZ y (7,f t S 7)4.. (requires site plan showing placement) 14.00
City /State /ZIP: '1'( C 4- � i 2 2 `./ Furnace 100,000 BTU (ducts/vents) 14.00
f ) Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.: Project name: L. 0 " 2 H 1 / ry 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
D 4 y e. / G ``10 S T- ,, �- /✓ U. `' (? " Flue vent for water heater or gas
K( e l 7-u- / 4 / / . c v n /7 fireplace 10.00
(� 7 j vCt� Log lighter (gas) 10.00
"ID2 y e )1 054- , - - 5 �ja / - L� . ice'(/ Wood/pellet stove 10.00
Wood fireplace /insert 10.00
❑ PROPERTY OWNER ❑ TENANT Chimney /liner /flue/vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation
Range hood/other kitchen
Address: equipment 10.00 G
City/State /ZIP: Clothes dryer exhaust 10.00 /0
Single -duct exhaust (bathrooms,
. 'Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80 IC
APPLICANT CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name: v 7 ( i-D . Coe /9G rZ 4 a re-1 _ Fuel piping
Contact name: (7 , 617 w E S C `D $5.40 for first four; $1.00 for each additional
Address: CJ Z 2 —Z._ c C 4/0 S' 7 c /< pia,. Furnace, etc.
Gas heat pump
City /State /ZIP: PG •1 T 1- p., - ) /t - q 2 - ‘ C Wall/suspended/unit heater
Phone: (sc, j )17 / - ( p C Fax: : (5 -y 7 / - / a- 7 / Water heater
� Fireplace
9
E -mail: l �.!,9 t_. C / { 7 (O (= e o . C CI Range
CONTRACTOR ' Barbecue
. A l Clothes dryer (gas)
Business name:
Mil Other:
Address: .MECHANICAL PERMIT. FEES* .
City /State /ZIP: tab /(4 Subtotal --- , ��
Minimum permit fee ($72.50)
Phone: ( ) .Fax. ( ) Plan review (25% of permit fee)
CCB tic.: L6 ( 3 7 s - State surcharge (8% of permit fee) '
l � TOTAL PERMIT FEE 7. 30
Authorized signature: _ This permit application expires if a permit is not obtain within 180
days after it has been accepted as complete.
Print name: \ P C� n i , m f- E 0 Date: g . 2 y . G Sp * Fee methodology set by Tri- County Building Industry Service Board
1:\ Building ennits'MEC- PenitApp.doc 04 /06/06 4 4617T(II /02/COM/WEB)
!1 /1
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 12/30/05 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2008.00452
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/29/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 '' �..
INSPECTION WORKSHEET FOR DATE: 10/10/2006 TIME: 7:06Al PAGE: �l3
SITE ADDRESS: 10275 SW CENTURY OAK DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: 013 TYPE OF USE:
PROJECT NAME: COUGHLIN
DESCRIPTION: Remodel: lea. dryer, rangehood, fan. G ine.
OWNER: COUGHLIN, DANINIARY PHONE #: 503 -620 -2629
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 10/10/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
615 Mechanical rough -in 037946 -01 503- 771 -9606 N
Corrections/Comments/Instructions:
PASS n PARTIAL APPROVAL I I CANCEL ❑ NO ACCESS
I FAIL n CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: jj44 Date: (� /� Phone #: (503) 718 - r 1 O
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200&00462
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/29/2006
Phone: (503).639 -4171 nqwi tl� r�
4
Inspection Requests (24 Hrs.): (503) 639 -4175 M e'I��
INSPECTION WORKSHEET FOR DATE: 2128/2007 TIME: 7 :02AM PAGE: 22
SITE ADDRESS: 10275 SW CENTURY OAK DR CLASS OF WORK:
SUBDIVISION: SUMMERFIELD LOT #: 013 TYPE OF USE:
PROJECT NAME: COUGHLIN
DESCRIPTION: Remodel: lea. dryer, rangehood, fan. ine.
OWNER: COUGHLIN, DAN /MARY PHONE #: 503-620-2629
CONTRACTOR: PHONE #:
•
Inspection Request Scheduled'For: Date: 2/28 /2007 Pour Time:
Code # Inspection Description Confirm "# ' Contact # Message
699 Mechanical 'final 044087 01 503-771-9606 N
Corrections /Comments /Instructions:
p& S S ' IAL APPROVAL ❑ CANCEL I NO ACCESS
FAIL ' • R INSPECTION n ADDITION,. FEES ' SSESSED
Inspector: - �- Date: Ze Phone #: (503) 718 - ZC Y/7