Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2004 -00438
��111 DATE ISSUED: 7/2/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S1 03C D -06400
SITE ADDRESS: 11735 SW FAIRVIEW LN
SUBDIVISION: TERRACE TRAILS ZONING: R -4.5
BLOCK: LOT: 024 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: DOMES. INCIN:
LPG 3 - 15 HP: COMML.INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm: GAS OUTLETS:
Remarks: Modification to existing gas line for pool.
Owner: FEES
GARDNER, GREGORY E AND Description Date Amount
CARMA J [MECH] Permit Fee 7/2/2004 $72.50
11735 SW FAIRVIEW LN [TAX] 8% State Surchart 7/2/2004 $5.80
TIGARD, OR 97223
Phone: Total $78.30
Contractor:
BK REILLY & CO
DBA THE POOL AND SPA HOUSE
13025 SW PACIFIC HWY REQUIRED INSPECTIONS
TIGARD, OR 97223 Gas Line Insp
Phone: 503 620 - 9200 Final Inspection
Reg #: LIC 147444
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 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) 4 . -:. • • .
Iss d By: _ /ri�i� Permittee Signature:
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next iness day
Mechanical Pe'� Application FOR O FFICE 'USE ONLY ` •
City of Tlgal (� Received e " '? Permit F1 o.: holge T [ ✓ �z V
13125 SW Hall Blvd., Tigard, OR 97223
P n Review
O 7
Plan
Phone: 503.639.4171 Fax: 503.598.1960 h. r '' Date/By: Other Permit:
Inspection Line: 503.639.4175 • Date Ready/By: Jur 8 See Page 2 for
Internet: www.ci.tigard.or.us - ��w Notified/Method: /a Supplemental Information
'��'.,x�� =.'�. ��. ':`�^� �; ywe� i;�..m�: �:c',�;;�.��ar�ac�. �;;:c;.��,',) ^Sfx „' ��7 �#" �„ . `: �a °�z -\." "rtY C.��,.a:.� §��;:< ...a +,�
r§ .R , "t" " A �, � - ; i, 4b16, � ,3 A " � " -, . s tti1r ERCIAII., 'SCT3EDUL =E' - =T3
❑ 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.
g
RV s C�ATEGORi OFfirGONSTRU 0 . -„ • . :*„4 �s. a ue
1 - and 2 -famil dwellin �RESIDFiNT�hAL EQU -/ SY
y g ❑ Commercial /industrial ❑ Accessory building ' " ` k< '
Multi - family ❑ Master builder ❑ Other: For special information use checklist.
Description Qty. Ea. Total
`�, ; , ')3 ° t�J OB SITE�INF O LOCATION r =)~;? Heating/cooling
Air conditioning or heat pump
Job site address: 1
1 7.3 5 PG ti- v is�v.3 U� (requires site plan showing placement) 14.00
City/State /ZIP: rs il.G f Ce.- \ 2_2_._ Furnace 100,000 BTU (ducts /vents) 14.00
Fumace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: k.,4fd ✓`C,✓ Gas heat pump 14.00
Cross street/directions to job site: oPF ' i 5 Duct work 14.00
Hydronic hot water system 14.00
Residential boiler (radiator or
( 5 5 /' C Ti-' -ow As 1 7 ` c.( -_. hydronic) 1 4.00
C� ) e \ C L 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
1%1 .; r `1 `'1 4: bESCRIP�'?ION CliFORIC , " ` * ,4...5:47.,w,,,,:;511,, '` b ' W ater heater 10.00
;t.. � ag a� --- ,,� * ,, .x .� y , ' A. ra5 � a:: Gas fireplace 10.00
�' v ' � ( �1 LG�� 0V"\ ' t ElC∎s 1 1 • Flue vent for water heater or gas
S+0"-) W
% \r/V ✓l
11 r" '--- Rep(--- IA E_Ca Cf' fireplace 10.00
ff L Log lighter (gas) 10.00
S . 1 ♦ ,1 �(,/.) I1 ,j L Wood /pellet stove 10.00
L1/4) ` 1r / �VNt IZ - ?_ '� fC, CC��- Wood fireplace /insert 10.00
.,:; - :�;;> : ;, n" ; t� ;:. ;; Chimney /liner /flue /vent 10.00
" ;.. °` PROPERTl OWN x Px ?.:. .. , _ �TENMI-
--,e a; x Other: 10.00
Name: � e&,02 y , fJ , Environmental exhaust and ventilation
Address: `,A Range hood /other kitchen
G �+/ /"L J equipment 10.00
City/State/ZIP: Clothes dryer exhaust 10.00
� Single -duct exhaust (bathrooms,
Phone: ( J &se/ 9 g Fax: ( ) toilet compartments, utility rooms) 6.80
`` = AI'P.I ICANT F M MVei I?ERSON Attic /crawlspace fans 10.00
T -ic_ x � � ll��, , c. Other: ' 10.00
Business name: '
Q{ C Fuel piping
Contact name: k %d $5.40 for first four; $1.00 for each additional
Address: 1 302_ r c I 41. C.,_. � c Furnace, etc. 0
Gas heat pump
City/State /ZIP: - - �`'C f Ck 0 c 2_Z3 C Wall /suspended /unit heater
Phone: ) to [ '- (eJ`�' -.-{�` C�'� Fax: : ( o3 ) .o� - 59: 0 7 Water heater
Fireplace
,( f� 1,-‘04.4
E -mail: V..-101.A.4 ACS ° � - �TGY��.-Cl � a Range
t. w ., , x ;ci -rte �sg. .±�".. s was "-a r Y ` '°- aj'
14. � I ' g I I /; I r` r ON TRAGi OR 2 r a ` , 0 Barbecue
Clothes dryer (gas)
Business name: S Gr._ ce-S coDo v
Other:
Address: � _t. , . ,Q, -t w�.. >;� . n, s, • .
" a . k,Fi s1VIE, ;CHA, � I IC'AI PERVITT FE. , _.
City/State /ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lit.: i \ - 7 L_{.L _f #5h State surcharge (8% of permit fee)
�
i/ / TOTAL PERMIT FEE
Authorized signature: /1/ This permit application expires if a permit is not obtained within 180
- i days after it has been accepted as complete.
Print name: ,-61 ,S1-41-1E,-2.0 ,-7 Date: 7 2_ -of * Fee methodology set by Tri- County Building Industry Service Board
i:\ Buildmg\Permits \MEC- PemutApp.doe 12/03 440 -4617T (I l /02 /COM/WEB)
a _
Mechanical Permit Application - City of Tigard w
Page 2 - Supplemental Information
Commercial Fee Schedule:
Tot a^ l1?al iaton MV
$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
i ,-
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. •
a
v r t
• C ) !
f f' ' r .;
is\ Building \Permits\MEC- PermitApp.doc 12/03 2
CITY OF TIGARD ; , 24 -Hour • -
BUILDING Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION Business Line: (503) 639 - 4171
/ BUP
Received Date Requested 7 �° AM PM BUP
Location 21 35 Suite MEC a 06 4 - 66 4 10
Contact Person Ph ( ) PLM
Contractor Ph ( ) -O —94R Od SWR
BUILDING Tenant/Owner ELC
Footing --
Foundation ELC
Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear / /
—s CO
Framing `Y 14, �t�.T- T`G - �T' Q
Insulation
_
Drywall Nailing 7Z !Jr ff�1 - '
Firewall
Fire Sprinkler �� 00 --le" zatc_‘ 7 12 ' ' `
Fire Alarm 122. 4 4
Susp'd Ceiling
Roof
Other:
Fin -
•ASS *ART FAIL
Pttn BI
Post & Beam
Under Slab
Rough -In
Water Service
Sanitary Sewer
Rain Drains
Catch Basin / Manhole
Storm Drain
Shower Pan
Other:
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough -In
; n01111i1-4,
Smo a Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspection fee of $ required before next inspection. Pay at Ci all, 13125 SW Hall Blvd.
PASS PART FAIL
SITE El Please call for reinspection RE: Unable to inspect - no access
Fire Supply Line
ADA ��
Approach/Sidewalk Date 7 Inspector Est
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL