Permit 'PI CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00317
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 6/19/2008
PARCEL: 1 S 134AC -02660
SITE ADDRESS: 11338 SW COTTONWOOD LN ZONING: R-4.5
SUBDIVISION: ENGLEWOOD NO.3 LOT: 226 JURISDICTION: TIG
PROJECT: LOLICH
Project Description: Installation of gas piping for kitchen 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
CHERYL LOLICH Description Date Amount
11338 SW COTTONWOOD LN
TIGARD, OR 97223 [MECH] Permit Fee 6/19/200€ $72.50
[TAX] 12% State Surch 6/19/200€ $8.70
Phone: 503 - 590 -9281
Total $81.20
Contractor:
WATSON PLUMBING CO.
7935 E BURNSIDE ST
PORTLAND, OR 97215 REQUIRED ITEMS AND REPORTS
Contact #: PR] 503- 256 -3720
Reg #: LIC 111855
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
Issued , / ` I Permittee Signature: , / (/1 A ., ___ Call 503.639.4175 by 7:00 a.m. for inspections that business 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.
°. McVhanical Permit Application FOR. USE ON .
City of Tigard Date/By: Permit No.: ye „ , , U mss/
. - a 13125' SW Hall Blvd., Tigard, OR 97223 Plan Review ` ` r
' Phone: 503.639.4171 Fax: 503.598.1960 Other Permit:
Inspection Line: 503 639.4175 Date
TI G A R D Date Ready/By: luris: 61 See Page 2 for
Internet: www.tigard - or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
Mechanical permit fees* are based on the value of the work
❑ New construction [.Addition /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 TION Value: $
�,' RESIDENTIAL EQUIPMENT / SYSTEMS'FEES*
- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
Multi-family M builder For special information use checklist.
El y ❑ ❑ Other:
Description Qty. Ea. Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: ( ( '3 3 � - ,.... CAD ( Fr ��, - ! E d12 L, re t f, Aig u fires s pl ingo an sho w in ggtp ump acement )
v P "` (requires site plan l 14.00
City /State /ZIP:7'6- /,. Furnace 100,000 BTU (ducts /vents) 14.00
1 Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name:
Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
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. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
//'' _ /L c_ �q v Gas fireplace 10.00
(,�'" to 70Q/ o- `�—O - C� / p 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
❑ PROPERTY OWNER Chimney /liner /flue /vent 10.00
❑ TENANT Other: 10.00
Name: Environmental exhaust and ventilation
—
Address: Range hood /other kitchen
equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) 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
Address: Fumace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR : Barbecue
�(�
Business name: 1 ,C _ G , p (_„ pi/�(- Clothes dryer (gas)
7C " ! t Other:
Address: 7 9 ? 3 ( - 6 a rz J p 6 MECHANICAL PERMIT FEES*
City /State /ZIP: f✓ ,tt - / 7v 0 / 2 �, Subtotal
Phone: 2 - z 7,v--0 � ax: >3 zi (- 0d ( Minimum permit fee ($72.50) ~7z�Y°
Plan review (25% of permit feee )
CCB lic.: { /�� a a /O State surcharge (12% of permit fee) -. 7 °
L C ")Z7/---- TOTAL PERMIT FEE _( Z O.
Authorized si ature: fillr This permit application expires if a permit is not obtained within 180
d ays after it has been accepted as complete.
Print name' X—C) / ( /(1�� ��Q Date:4 —7 -0 * Fee methodology set by Tri- County Building Industry Service Board
\ \
1: \BuddingPermits MEC- PermitApp doe 01/19/07 440 -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
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
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I:\ Building \Permits \MEC- PermitApp.doc 01/19/07 2
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N liMIIIIIIIIIIFIIIV
LA TIGARD
BUILDING DIVISION
A6,1: PERMIT #: MEC2008-00317 •
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6119/2008
Phone: (503) 639-4171 irtt/f1
Inspection Requests (24 Hrs.): (503) 639-4175 •
INSPECTION WORKSHEET FOR DATE: 805/2008 TIME: 7:00AM PAGE: 33
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOLICH
DESCRIPTION: Installation of gas piping for kitchen range.
OWNER: LOLICH, CHERYL PHONE #: 603'590-928
CONTRACTOR; WATSON PLUMBING CO. PHONE #: 503-256-3720
Inspection Request Scheduled For: Date: 8/2512008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 074525•01 503-515-7703 N
Corrections/Comments/Instructions:
,,,---
E PASS El PARTIAL APPROVAL r] CANCEL fl NO ACCESS
0 FAIL 1 0 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED
Inspector: Date: / 5 Phone #: (503) 718- 2-4-4iC—
CITY OFTIGARD
BUILDING DIVISION
PERMIT #: MEC2008-00317
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 6/19/2000
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 6/23/2008 TIME: 7:01AM PAGE: 54
SITE ADDRESS: 11338 SW COTTONWOOD LN CLASS OF WORK:
SUBDIVISION: ENGLEWOOD NO.3 LOT #: 226 TYPE OF USE:
PROJECT NAME: LOUGH
DESCRIPTION: Installation of gas piping for kitchen - range.
OWNER: LOLICH, CHERYL PHONE #: 503-590-9281
CONTRACTOR: WATSON PLUMBING CO. PHONE #: 503-26-3720
Inspection Request Scheduled For: Date: 6/23/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 071691-01 503-256-3720
Corrections/Comments/Instructions:
14 El PARTIAL APPROVAL El CANCEL NO ACCESS
I FAIL II CALL FOR INSPECTION fl ADDITIONAL FEES ASSESSED
Inspector: > Date: Phone #: (503) 718- 7sil-clw<