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Permit A CITY OF TIGARD MECHANICAL PERMIT 1 DEVELOPMENT SERVICES PERMIT #: MEC2004 -00085 '41,1- ` c l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/27/04 PARCEL: 1 S134AB -00600 SITE ADDRESS: 11312 SW IRONWOOD LP SUBDIVISION: ENGLEWOOD ZONING: R -4.5 BLOCK: LOT: 005 JURISDICTION: TIG 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: LPG 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: 1 Remarks: Install direct vent gas fireplace. • Owner: FEES NEWMAN, THOMAS D + BONNIE K TRS Description Date Amount 11312 SW IRONWOOD LOOP TIGARD, OR 97223 [MECH] Permit Fee 2/27/04 $72.50 [TAX] 8% State Surcharl 2/27/04 $5.80 Phone: 503 - 530 - 2423 Total $78.30 Contractor: ENERGY SAVERS PLUS, INC. 3747 SE 49TH AVE. • PORTLAND, OR 97206 REQUIRED INSPECTIONS Phone: 503 777 - 0389 Gas Line Insp Mechanical lnsp Reg #: LIC 103273 Final Inspection This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -00 Issued By: SG%+% ve-er-4o, Permittee Signature: L ( , Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day RECEIV ti) Mechanical Permit Apphjc ti 2004 FOR OFFICE USE ONLY ed City of Tigard Received a7 0,/ Permit No.: L;�� _ pp 2 Date/By: sr 13125 SW Hall Blvd., Tigard, OR 97223 «IT'( OF TIGARD Plan Review Phone: 503.639.4171 Fax: 503.598.196 Iya;.'d & Date/By: Other Permit: Inspection Line: 503.639.4175 BUILDING D , Ij, ,,1 l ' I Date ReadyBy: 0 See Page 2 for Internet: www.ci.tigard.or.us Notified/Method: / lL Supplemental Information \"� f ' ,; �.i '6- ',. '��> --, G' «:. iu. : -"2°.« : .;C y . .. , + .o-•#.,,' : � � 3 , .au::., t'e.a t , .*`$. _ s t TYP E:; € W RK , J * lS . ... _ ... `: , ,..� . � .. o - .sue. .a , . .. ;�•, - ? "1. ,. , k "',:, �GgOMM'ERC„,,,„ ,,,, • b E.`_- USE'CAECICLIST' El New construction P- Kddition/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. � n `I`I Gt?R �OF =C01\STRiJGTION ' ` - Value s s =, ',:m,,,, ' ' .1 , r .... 54.�,a_...k.., ,,, ;.,. ;'_.,,, . »sss st:'A: - .:.N :: ,a'.;,.,... .r.. : - - - -:.a. .,z.;; - . RESIDENTT,AL EQUIPMENT /-SYSTEMS - FEES* 111-arand 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total 101,11:110011441000-1111.K41:4". TION '` , ;, p Heating/cooling Job site address: Air conditioning or heat pump I) _.L - c 9 -� i a % rn c•Z a � . r _ e n r (requires site plan showing placement) 14.00 City/State /Z1P:- Furnace 100,000 BTU (ducts /vents) 14.00 1 i a ` ' ( �� a D 3 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 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 A a � DESGR TI0 1 Ok ,W RiC '. - - - a Water heater 10.00 a. . . :.� ,., , � ... ... ,,t., a •;,,,, ?� . * ta , ' Gas fireplace 10.00 1 .Sk -tr_. 11 ri t r..o ca V.40 .._ -4- /x -et-i �l-1 r.:9�) li ..e l , S a ,- Flue vent for water heater or gas 0 fireplace 10.00 Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplac nsert c A_____-- \ 10.00 1 0 . (TO 10.00 4 " l 8- i 'a e .i r e �" a ;' m Chimney/liner ue vent 10.00 . P.I RTY Q 18XS4U , t ® TENAN . :.ra r. V. ,.. � 4 ... ... its. Oth e Name: - T -`-__- l �,a, M Environmental exhaust and ventilation Range hood /other kitchen Address: 1 . .l ‘..._(...A__ 1r ,__�, 0 A 1„.....caa r equipment 10.00 City/State /ZIP: �-i C�. � � Clothes dryer exhaust 10.00 c c , - c 1 3 Single -duct exhaust (bathrooms, Phone: (SU3) s q p - 014 Fax: ( ) toilet compartments, utility rooms) 6.80 "" £ i Attic /crawlspace fans :Tai ' .` . P ©Wr fir A rrr "` ,; 17 ` 5 i.i4 CTt1'ERSON .: " ' 10.00 Other: 10.00 Business name: £ S ham.- � tt,U -L� l \ '- \ - Fuel piping Contact name: G , r 1 \ \.+, r- ik,_,_ c< w $5.40 for first four; $1.00 for each additional Furnace, etc. Address: 3 _74'1 S i q +_ 1 /,\_, L , _r Gas heat pump City/State /ZIP: p6 ...., G_ , 4 6-,, , O. `-/ J l., 4 , Wall /suspended /unit heater Phone: cS.' o. Fax: Water heater ( ) 1 - y ( Fireplace , .., ,,„...+- ce ,c, S 4'0 E -mail: Range u� x. ... ,-. .� fit." , ..,.r �_,, «; k.. . , , �.�_ , .. A : '� Barbecue Business name: ` _ Clothes dryer (gas) t, , ems- C S u.'t'`e. -� \. `'u �' Other: Address: 3 `7 G -7 S , t; /_u MEOHAN G AL P E�RM IP E ES;* t:.. City /State /ZIP: � D-r- �1 c , _ cI ON.z. t%1 J -t cP Subtotal 1. .L(. b Fax: Minimum permit fee ($72.50) - .so Phone: (s t?� ]1 �l -7 3 n 1 �� �� `� ` � - Plan review (25% of permit fee) CCB lie.: \ 03 .D _) 3 State surcharge (8% of permit fee) ». 6 TOTAL PERMIT FEE - This permit application expires if a permit is not obtained with in 180 Authorized Slgnatllr t _ �, � „& r.St days after it has been accepted as complete. il pb , 30 Print name: Y r A r -1.4,, ^ L\ ,,,.. Date: D - , 4, ` Fee methodology set by Tri- County Building Industry Service Board i.\ Building \Permits \MEC- PermiiApp.doc 12/03 440 - 46I7T (I1 /02 /COM/WEB) Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: T o t al ita ions .. a,Permi<t,Fee .0 .. . t.. r . .. $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. i:\ Building \Permits\MEC- PermitApp.doc 12/03 2 CITY OF TIGARD 24 -Hour BUILDING Inspection Line: (503) 639 -4175 INSPECTION DIVISION Business Line: (503) 639 -4171 MST / BUP Received Date Requested 3 - AM ✓ PM BUP Location 1 / � j/ — t= tJ't'd Suite MEC 1 7 – 6 0 C ?S Contact Person Ph ( ) F76 / PLM Contractor Ph ( ) SWR BUILDING Tenant/0 er \ ELC Footing Foundation Access: ELC Ftg Drain ELR Crawl Drain Slab Inspection Notes: SIT Post & Beam Shear Anchors Ext Sheath/Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Other: Final PASS PART FAIL PLUMBING 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 Gas Smoke Dampers • /PAS - PART FAIL CTRICAL .. Service Rough -In, UG /Slab Low Voltage Fire Alarm Final Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd. PASS PART FAIL SITE Please call for reinspection RE: 0 Unable to inspect — no access Fire Supply Line �. ADA Approach /Sidewalk Date Inspector Ext Other: Final. DO NOT REMOVE this inspection record from the Job site. PASS PART FAIL