Permit CITY TIGARD MECHANICAL PERMIT
DEVELOPMENT SERVICES PERMIT #: MEC2006-00418
� �I DATE ISSUED: 8/23/2006
13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 25111 CC -16700
SITE ADDRESS: 10130 SW HIGHLAND DR ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.4 LOT: 218 JURISDICTION: TIG
Project Description: Gas piping to water heater.
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:
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: 1
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
BOB NOTTINGHAM Description Date Amount
10130 SW HIGHLAND DR
TIGARD, OR 97224 [MECH] Permit Fee 8/23/200E $72.50
[TAX] 8% State Surcha 8/23/200E $5.80
Total $78.30
Phone: 503- 694 -5412
Contractor:
RAYBORN'S PLUMBING
19990 SW CIPOLE RD
PO BOX 69 REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Contact #: PRI 503- 692 -4139
Reg #: LIC 87852
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: , ' ps Permittee Signature: p
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.
USE MecLAug. 23. i 2006 2:43PM. Raybo rns _ Pl umb i ng No. 5679 P. 2
�s ar11 1 : i A t L-! Licatom t: City of Tigard NN t `t f (3125 SW Half Blvd., Tigard, OR 912 RDEEI _ I FOR OFl <'t( l; C)1V � \„:,'\ USE
` G � �� Per nil N O 6P ` V/ ) 3 �� Phone: 503,639.4171 Fax: 503.598,1960 �
Inspection Line: 503.639.4175 ^ t ' gi'M1 ��`� Date other permit;
b „ Note aimeth s See Page 2 for
Inlernet:.vtinv.ci.t;gard.or.us pu (,� -- g
[,'`��,, Notrfied/Method. Supplemental information
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❑ New construction AA,:d14i r n /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.
l.„ '.'I , . ,i' 1 1 4 4, ._ , 41 ' i r lg" : 7 " #3p t s C ',, , ptrr�F1 r` is . t `c' r� h, C ^ k ; f l Value: $
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1 and 2-family dwelling ❑Commercial /industrial ❑Accessory building <: _ _ I...ts„.._r „T IPTf1 ,,_._._.,. +r „4 „t r��,�,rrk. iTe
❑ Multi- family ❑ Master builder El Other: for special info,istallon use checklist.
�.'� y� - �r ? �"' Description I Qty. I Ea. .I Total
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Job site address: / ��� Air conditioning or (teat pump
-�-. 9 /aid h uirea site lap showin lacement 14.00
City / State/ZIP: / l�t�.l t�� [JCCa �ry�� �[ Furnace 100,000 BTU (ducts/vents) _ 14.00
Suite /bld /a t. no.: / / r Furnace 100,000•+• BTU (ducts /vents) 17.90
g' p Project name: Gas heat pump 14.90
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 rip.: Flue/ven for any of above _ 10.00
Tax map /parcel no.: Other 10.00
Other fuel appliances
Ma i, t., +, 7" ,•l ° I' {,yr t4,1 ;. fiti J_ ySrL 1 1 7-tlbc l ^`4:I ,A i+;..A c ..
~( 1g.) .�� tl' 1 = i ) � i tS , sr r , a l '' - "' 11 i 1 } Water heater /
t14 f t,•,a <, wail, l�l�r, +i^t... r?" J.I. .:e .:tw I e,.: ; 4 5,.,!.a,, , 11 . 1 ;.>r 1 .,i.: . J k , y. 10.00
irl / o l �- Gas fireplace 10.00
&krt. /1P,�.(.!i}' 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
�g �
s)J $'(tiBl„ den �t ®�ri'' !`A ^ t 'r ? i ` r { „ ! r �1`t7Jfi�irs r " 4 �'��r�r.F ,e t 7 4 . i: ' ' Chimney /liner /flue /vent 10.00
Id''• ,i.d'1'-=:'im:.4•7; aii.t.f1i c- ocsl;A ,•to' r . ? ;t * }. i)f .....;�I.o.,y,. m. Pi , 7, fry. ,. ti 1t W L_. i}: t a . , ,n . ! P 1
other; 10.00
Name: �� �� '
/ % 4/ Environmental exhaust and ventilation
Address: l d� 5� � [1 /Q Range hood /other kitchen
`� O dyr i equipment 10.00
City /State/ZIP: 7;
/ dc - 4 t L ��7_y� Clothes dryer exhaust 10.00
/ - , �� /� / °7 Single -duct exhaust (bathrooms,
Phone:
X03) ,-f/ Fax ( ) toilet compartments, util y rooms) 6.80
S 4>.'l F •� r rtl, , .T L x y .6 Ta b' 3" �. rrT^,,,, - ,�'T�.T t °" ."" 1 , gr lr t .
l ty , i{µ+7} } �'�; lli. .w5 4 i . hi rF.�f ,,,. i' r l ,„ , ,, ,,o k, ,. , l 01, : 4 ,1 7e , r I ] , I l t ry} , ;. , . . A ttic/crawls acefans 10.00
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Business name: yn !S• P / /nc poi Other: 10.00
.Fuel piping
Contact name: / ( 4 in. 55.40 for liirst four; 51.00 for each additional
Address: p 2�r 47
Furnace, etc.
` Gas heat pump
u iP..
City / State/ZIP: ,1 / D le 97/ Wall /suspended/unit heater _
L 7 -
Phone; 3) 6 9.:) _ ,V / . & 7 I Fax: : ( )g91._ Water heater
E -mail: /k , ,tom yjs CO7•yl Range
y }r, gt r�r �1 it, R ?1,C� 2'`2 „�S .,,f n Range
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rialitarile / Clothes dryer (gas)
/., !i i
Address: 1 i Othe T
City /State/ZIP: T� j a 971)....2-) Subtotal SO
Phone: (513 .3) ‘ �i/A3 / F ax: , G 3 / �J ' 3 Minimum permit fee ($72.5 �,�
p Plan review (25% of permit feee )
O
CCB lic.: 785 42 ' 1c -7 State surcharge (8% of permit fee) J r e ', 813
TOTAL PERMIT FEE r1
Authorized signature: _ This permit application expl if a permit is not obtained wi e O
drys after it kas been accepted es complete.
Print name. 41 r S „ � L J Date: s/ 4 / - Fce methodology set by Tri- County Building Industry Service Board
I:\ 1;UUIdinetPermits1MEC -Pcr App.doc 12/01 440 (11 /02 /COM/WEB)
�,
` / 1TY OF TIGARD
BUILDING DIVISION PERMIT #: MEC200&.00410
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8/23/2006
Phone: (503) 639 -4171 41iijlI
Inspection Requests (24 Hrs.): (503) 639 -4175 J ' . F.
INSPECTION WORKSHEET FOR DATE: 9/6/2006 TIME: 7:06AM PAGE: 71
SITE ADDRESS: 10130 SW HIGHLAND DR CLASS OF WORK:
SUBDIVISION:• SUMMERFIELD NO.4 LOT #: 211:3 TYPE OF USE:
PROJECT NAME: NOTTINGHAM
DESCRIPTION: Gas piping to water heater.
OWNER: NOTTINGHAM, BOB PHONE #: 503-694 -5412
CONTRACTOR: RAYBORNS PLUMBING PHONE #: 503.692-4139
Inspection Request Scheduled For: Date: 9160006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 036050-01 503.692 -4139 Y
Corrections /Comments /Instructions: I 7 ✓`-
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, 4111
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go
1 it t Atr"
PASS n PARTIAL APPROVAL CANCEL I NO ACCESS 4. I I FAIL I I CALL FOR INSPECTION I I ADDITI•NAL FEES ASSESSED
Inspector: i ei * Date: t 7 AIIP Phone #: (503) 718-