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Permit CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00569 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/19/2008 PARCEL: 2S114BA - 10900 SITE ADDRESS: 16470 SW MEADOWOOD WAY ZONING: R - 4.5 SUBDIVISION: COPPER CREEK STAGE 2 LOT: 062 JURISDICTION: TIG PROJECT: NYGUIST Project Description: Gas piping installation to 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 JEANNE NYGUIST Description Date Amount 16470 SW MEADOWWOOD WAY TIGARD, OR 97224 [MECH] Permit Fee 11/19/20C $72.50 [TAX] 12% State Surch 11/19/20C $8.70 Total $81.20 Phone: 503- 476 -6520 Contractor: FAST WATER HEATER COMPANY 12601 132ND AVE NE KIRKLAND, WA 98034 REQUIRED ITEMS AND REPORTS Contact #: PRI 425- 636 -7054 FAX 425- 636 -7055 Reg #: LIC 168049 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: • � Permittee Signature: I� G���� Call /.4175 by 7:00 a.m. for inspections that busines( 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. From: • 11/18/2008 13:39 11774 P.002/003 ......:. *. Mechanical Permit A licatioe 0 • FOR OFFICE USE ONLY " • , v) City of Tigard fta,56 , .,,,, A Recei ew ved • .13125 SW Hall Blvd., TigardNORj 9; .74.-47 • a . , .., 1 ck fp3v,, , • ,_ . . Phone: 503.639.4171 Fax: 503.598.1960 ( ... \\ I N. 0 111 / 111 Plan Revi t II, t Da & Other Permit By: Da / iffM1 :II Permit N°.: 0.)c__„_ r : Inspection Line: 503.639.4175 \*"\ kt ik.-7.. Date Ready/By: Agit: See Page 2 for TIGARD El Internet www,tigard gov - , ,,,:„.. "It NotifiedAvlethod: .12z- Supplemental Information ' " i : '.' " - -' ' ' • : ' TYPE OF W - " , -,'',-," .''• '... r •-•',,, •'':'', ,•: •: • • . ' . COMMERCIAL ' FEE" SCHEDULE :' USE CHECKLIST . . .. New construction LAddition/alteration/replacement Mechanical permit fees* are based on the value of the work 0 R performed. Indicate the value (rounded to the nearest dollai) of all 0 Demolition CI Other: mechanical materials, equipment, labor, overhead, and profit. • .. • ::.- ..,. : .-' CATEGORY OF CONSTRUCTION • .: .''- .: ,,,;.,:.:.: .•,,, Value $ :.. . . , ,: ; =; ,• RESIDENTIAL:EQUIPMENT,../. FEES'''. X and 2 dwelling 0 Commercial/industrial 0 Accessory building For special information use checklist. 0 Multi-family 0 Master builder 0 Other: Description I Qty. _ Ea. Total . • ' • " ' .. . ," '. ''' ' - ,_ JOB SITE:INFORMATIONLANDf:E008.1ifON '.:. ''' ' '' ''• • - , Heating/cooling . Air conditioning or heat pump Job site address: \ t 0 E LA .) mt_a a• Lyi ( r.: i iii.s site plan showing placement) 14.00 City/State/ZIP: e 6 ) D (2. q '1,)...), 4- . rn Furnace 100,000 BTU (ducts/vents) 14.00 Furnace 100,000+ BTU (ducts/vents) 17.90 Suite/bldg./apt. no.: Project name: IQ 1 3 idtk s +_ . 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 hydronie) 14.00 _)•.__t t._,&. - D / t Unit heaters (fuel-type, not electric), in-wall, in-duct, suspended, etc. 14.00 Flue/vent for any of above 6.80 Subdivision: Lot no.: Other: 10.00 Tax map/parcel no.: Other fuel appliances . - . • . . D E S CRIPTI ON O ,.... 10.00 „,,.. :•H • , - , - .,: , • .. Gas fireplace 10.00 Flue vent for water heater or gas v\ sioL\ 6as f■?kr An RAIA.r._ fireplace Log lighter (gas) 10.00 10.00 n Wood/pellet stove 10.00 Wood fireplace/insert 10.00 ' : ".:.'': '' 0 4*0•47'W.:0**:;:;:,.:'..;::ii'"g:::N:44 Chimney/liner/flue/vent 10.00 Other: 10.00 Name: ------- 4 , „ t • L , • . U. si..• Environmental exhaust and ventilation Range hood/other kitchen Address: \ t *I 5 , try ft (i 6 L0000 A ,...0 equipment 10.00 City/State/ZIP: 1 -- 1'.) p..., el D,,_4 Clothes dger exhaust Single-duct exhaust (bathrooms, 10.00 Phone: (563 ,- Lk 1 - ( Fax: ( ) toilet compartments, utility rooms) 6.80 APPLICANT Attic/crawlspace fans 10.00 Other: 10.00 Business name: W ikk_ ckit(?ckA---e....1( Fuel piping Contact name: ( 4 c \ ' --- p N.0,y _ JA ‘.\ 55.40 for first four; 51.00 for each additional Furnace, etc. Address: N ( ,, c) . , .... ,: i t Gas heat pump . City/State/ZIP: ....,\, v -- \c \ a , )..) v\ 91)05 Wall/suspended/unit heater Phone: 4„).5 -L., 73 .....--/ 0 s• . Fax: : ' , - , 6 -4 E-1 Water heater Fireplace E-mail: eata).\Kcc;) ..,rkss.\100,...,kr • , .. r, c (3 , ,, ---- Range I i " : .'. '•::'."."' I : .; - 2'"': : ' : . '' CONTRACTOR Barbecue Business name: .." \ - -- c ; s .k... u o 0 ,k... ex - A.,.k._Qc_d_ex-- Clothes dryer (gas) ,, Other: Address: V'a...CA k, ptife...31,vy_ ,i.,-!:-.,,,,:-;•-:::ii#0,t,,,,*;o:'..000fil*Es•-,--*.::_:,.••::'...: City/State/ZIP: ' \\a rt_O G A-34-\ Cl Subtotal .--, .. permit f Phone: O ". 1 C.6 IN Fax:4- 3 ' ee 6 - (03‘:;S Plan review (25% of permit fee) CCB lie.: i t .6.._k ( A , State surcharge (12% of permit fee) q' 70 TOTAL PERMIT FEE R' i a C) \ , This permit application expires if a permit is not obtained within 180 • AuthorizedIature: Ck ii days after it has been accepted as complete. Print name. ce u,.. yy \ Date: 1 1 1/4 k $11A * Fee methodology set by Tri-County Building Industry Service Board l:\BuildinPerniitn\M0C-PeimitApp.doc 01119/07 440-4617T (11/02/CONI/WEB) CITY,- O.TIGARD BUILDING DIVISION ' # PERMIT hAFC200B -00569 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1•i /1r3/2008 Phone: (503) 639 -4171 441 Inspection Requests (24 Hrs.): (503) 639 -4175 J INSPECTION WORKSHEET FOR DATE: 11/250008 TIME: 7:01AM PAGE: 35 SITE ADDRESS: 16470 SW MEADCWOOD WAY CLASS OF WORK: SUBDIVISION: COPPER CREEK STAGE 2 LOT #: 061 TYPE OF USE: PROJECT NAME: NY a11ST DESCRIPTION: Gas piping installation to range. OWNER: NYGUIST, ,fl"ANN PHONE #: 503- 476 -5521 CONTRACTOR: FAST WATER HEATER COMPANY PHONE #: 425 636 - 7054 Inspection Request Scheduled For: Date: 11/25/2000 Pour Time: Code # Inspection Description Confirm # Contact # Message 699 Mechanical final 07646&Q2 503-476.6520 Y Corrections /Comments /Instructions: •V<SS n PARTIAL APPROVAL n CANCEL ❑ NO ACCESS ❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED Inspector: Date: ii— Z-' a Phone #: (503) 718 - -"4-4-4—Y--- ��N�~�� �����������&���� -, ��u u ��_n�"w`� u n���mnm�� ~ � . BUILDING DIVISION PERMIT #: MFC200a-0066 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/190008 -Phone: (5U3)O3S'4171 Inspection Requests (24 Hrs.): (503) 639-4175 ~�� «��� INSPECTION WORKSHEET FOR DATE: 11/26/2OO8 TIME: TO1ouk4 PAGE: 36 SITE ADDRESS: 16470 SW MEADOWOOD WAY CLASS OF WORK: SUBDIVISION: COPPER CREEK STAGE 2 LOT #: 062 TYPE OF USE: PROJECT NAME: NYGUIST DESCRIPTION: piping instHation to range. OWNER: NYGUIST, JEANNE PHONE #: 603'476-6620 CONTRACTOR: FAST WATER HEATER COMPANY PHONE #: 42Er636'7U54 Inspection Request Scheduled For: Date: 11/26/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 07B465-01 503-47G'8520 Y Corrections/Comments/Instructions: . • . . . PASS 0 PARTIAL APPROVA 0 CANCEL El NO ACCESS 7 FA|L LL FOR INSPECTION 0 AD0TlC�N FEES ASSESSED AL . Inspector: ���� » Date: �� Phone (503) ~���c\`� . � ` � �' ~-- - #: ` ' . '