Permit CITY TIGARD MECHANICAL PERMIT
, �'+ t DEVELOPMENT SERVICES PERMIT #: MEC2003 -00335
`^ e �" 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/19/03
PARCEL: 2S110AB -05400
SITE ADDRESS: 11455 SW JACKIE CT
SUBDIVISION: HAWK MEADOWS ZONING: R -4.5
BLOCK: LOT: 007 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: REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: 1
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 2
> 10000 cfm: GAS OUTLETS: 3
Remarks: Install gas piping to water heater, range and clothes dryer.
Owner: FEES
PASTER, BRIAN Description Date Amount
14155 SW JACKIE CT
TIGARD, OR 97224 [MECH] Permit Fee 6/19/03 $72.50
[TAX] 8% StateTax 6/19/03 $5.80
Phone: 503 708 - 7155 Total $78.30
Contractor:
BABBITT PLUMBING INC.
7611 SW ALDEN ST.
PORTLAND, OR 97223 REQUIRED INSPECTIONS
Phone: 503 Gas Line Insp
Final Inspection
Reg #: LIC 3086907/25/2004
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -00
Issued By: : a.0, : Permittee Signat e: Q etre0
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mecha-nittal Permit Application FOR OFFICE USE ONLY
�� Received /�� p Mechanical
r DateBy: - f-t ! PermitNo.: M 003 - 0
City Of Tigard Planning Approval Building
Date/By: Permit No.:
13125 SW Hall Blvd. Plan Review Other
Tigard, Oregon 97223 Date /By: Permit No.:
Phone: 503- 639 -4171 Fax: 503 -598 -1960 Post - Review Land Use
4 ' Date/By: Case No.:
Internet: www.ci.tigard.or.us ,__i�,�. 4 ' ' I$ Contact Juris : ® See Page 2 for
24 -hour Inspection Request: 503- 639 - 4175 ° "`- 4- ° ' Name/Method: 770 Supplemental Information.
i ,, *;;; ' atiNi YPE ORATO2K . - . ": i _".'IM ' r 7g:COMMERCIAL: FEE* SCHEDULE' =11SE 011akLIST "& ,_•,;
❑ New construction ❑ Demolition Mechanical permit fees* are based on the total value of the work
® Addition/alteration/replacement ❑ Other: performed. Indicate the value (rounded to the nearest dollar) of all
mechanical materials, equipment, labor, overhead and profit.
$ `;.CATEGORY OFCONSTRUCT'ION ]1 ;",.,'
ig 1 & 2 Family dwelling ❑ Commercial /Industrial Value: $ See Page 2 for Fee Schedule
❑ Accessory Building ❑ Multi Family ,: EQUIPIVIENT/SSTEMS FLEE* SCHEDULE ;, t;
Description Qty Fee(ea.) Total
❑ Master Builder El Other: ,, n ,
• '_ - Heating/Cooliri� . ; 3: `=�`. P >� •
�.-
���.,��.: ,�� �JOBSITEINFORIYIAIONfana:0001Q0. ' alt. Furnace - add -on air conditioning ** 14.00
Job site address: 1 / 4 6 ' 5 " - SrW ZI e It/'c 'f: Gas heat pump 14.00
Suite #: Bldg. /Apt. #: Duct work 14.00
Project Name: /blr- 4 /N s eaS10 a- Hydron t hot water system 14.00
Residential boiler
Cross street/Directions to job site: (for radiator or hydronic system) 14.00
Unit heaters (fuel, not electric)
tA (in wall, in -duct, suspended, etc.) 14.00
c.c S 1 1 — ,. Flue /vent (for any of above) 10.00
Subdivision: Repair units 12.15
ubdivision: Lot #:
":FOiher ?Fact ic ' 4,,, . ,.. "
Tax map /parcel #: Water heater 10.00
if.4? , . MSTS1 ESCRIbTION OF WORI{ .., 7 '1 . E Gas fireplace 10.00
Flue vent (water heater /gas fireplace) 10.00
Log lighter (gas) 10.00
Wood/Pellet stove 10.00
Wood fireplace /insert 10.00
Chimney /liner /flue /vent 10.00
;; '3 PR®P ER=TYWOWNER I $❑a,. ° WANT . , „ if , Other:
n a Eni eciiimeiii4D haustl;34V=entilition ^ n "`
Name: M' ,k s 6rtf i Star ,.: .. /.. � - -._
` Range hood/other kitchen equipment 10.00
Address: I I `/ SS '5 M', ��3.e-hi: C Clothes dryer exhaust 10.00
City /State /Zip: '77 rc! O 9722:3 Single duct exhaust
Phone: 7a,5• _ 7/5 Fax: (bathrooms, toilet compartments,
APPLICANTi "airl° v"` ?' "; I ONTAlOT:PERSW; .,.E,`.; utility rooms)
Name: Attic /crawl space fans 10.00
Other: 10.00
Address: . ; : • Fiiier:P.iiin °Rr V . -a - " ,`: , . 74
City /State /Zip: * *($5.40 for first 4, $1.00 each additional) •
Furnace, etc. **
Phone: Fax: **
Gas heat pump
E -mail: Wall /suspended /unit heater **
... .i . : . ®Ri , • `' s' , . , Water heater f, **
$ � �fl' � 1 **
Business Name: r��Jll9 1 ��� Fire place
Range I. **
Address: 7‘11 5 Ii A f e y , fr RBQ **
City /State /Zip: r A � iet' tr e «7 7J�,2 .3 Clothes dryer (gas) t **
Phone: $d3 - Yy Sa7c Fax: 41 r- 3 Other: **
CCB Lie. #: 50 g6,7 7- — --0, Total:
- Mechanical;P,erinit'Fees* `, .; =. Cr '- "
Authorized 7 Subtotal: $
p"is 4.4-0 Signature: Date: d/ i7
e ) Minimum Permit Fee $72.50 $ 7p(
e �a ADf, Plan Review Fee (25% of Permit Fee) $
//
.4 ( Please print name) State Surchar:e 8% of Permit Fee $ Jr' , gv
TOTAL PERMIT FEE I $ 7g • 3 .
Notice: This permit application.expires if a permit is not obtained within *Fee methodology set by Tri -County Building Industry Service Board.
180 days after it has been accepted as complete. * *Site plan required for exterior A/C units.
i:\Dsts\Permit Forms\MecPermitApp.doc 01 /03
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
eitAirt
$1.00 to $5,000.00 Minimum fee $72.50
$5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52
for each additional $100.00 or fraction
thereof, to and including $10,000.00.
$10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and
$1.54 for each additional $100.00 or
fraction thereof, to and including
$25,000.00.
$25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and
$1.45 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 and up $742.00 for the first $50,000.00 and
$1.20 for each additional $100.00 or
fraction thereof.
' 4 .M.S7P 1 40.4-VAI4.40 ° ,40. e . r . „ . „
Value Total
Description: Qty (Ea) Amount
Fumace to 100,000 BTU, including 955
ducts & vents
Furnace > 100,000 BTU including ducts 1,170
& vents
Floor furnace including vent 955
Suspended heater, wall heater or floor 955 •
mounted heater
Vent not included in appliance permit 445
Repair units 805
<3 hp; absorb, unit, 955
to 100k BTU
3-15 hp; absorb. unit, 1,700 •
101k to 500k BTU
15-30 hp; absorb. unit, 501k to 1 mil. 2,310
BTU
30-50 hp; absorb. unit, 3,400
1-1.75 mil. BTU
>50 hp; absorb. unit, 5,725
>1.75 mil. BTU •
Air handling unit to 10,000 cfm 656
Air handling unit >10,000 cfm 1,170
Non-portable evaporate cooler 656
Vent fan connected to a single duct 446
Vent system not included in appliance 656
permit
Flood served by mechanical exhaust 656
Domestic incinerator 1,170
Commercial or industrial incinerator • 4,590
Other unit, including wood stoves, 656
inserts, etc.
Gas piping 1-4 outlets 360
Each additional outlet 63
TOTAL COMMERCIAL $
VALUATION: •
■
•
i: \DstsTermit Forms \MecPermitAppPg2.doc 01/03 •
CITY OF TIGARD • 24 -Hour
BUILDING v, Inspection Line: (503) 639 -4175 MST '
INSPECTION DIVISION • Business Line: (503) 639 -4171
• BUP
Received r Date Requested t AM PM BUP •
Location I 1 4 7 cc) Jet Ck< - i-C G ±' Suite MEC 20 33 .5
Contact Person. Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner • ELC
Footing
Foundation ELC
Ftg Drain Access: ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall 7r / -- 421015
Fire Sprinkler J
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:
Fin
FAIL
ECHANICAL
Po'&'Beam
Rou '•h-
a- --
�� • ,_. Dampers
••• * ART FAIL
• 'ELECTRICAL. _
Service
Rough -In
UG /Slab
Low Voltage
Fire Alarm
Final Reinspectibn fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
PASS PART FAIL
SITE ❑ Please call for reinspection RE: EI Unable to inspect — no access
Fire Supply Line
ADA
Approach /Sidewalk Date 2C -0J Inspector 6/7 a Ext
Other:
Final , DO NOT REMOVE this inspection record from the Job site.
PASS PART FAIL
CITY OF TIGARD • • • 24 -Hour `
503
Inspection Line:
BUILDING p (503) 639 -4175 MST'
INSPECTION DIVISION Business Line: (503) 639 -4171
BUP1
Received 11 `l.5 Date Re•uested — ° 2 7 AM PM BUP
: S
Location '' Suite ME 3 o v33
Contact Person Ph ( ) p 4 Sc-_7? PLM
Contractor Ph ( ) SWR
BUILDING. Tenant/Owner ELC
Footing
ELC
Foundation Access:
Ftg Drain ELR
Crawl Drain .L - &i 2
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath/Shear
Int Sheath /Shear
Framing 1 f !/ILS Ll AT/.0 A/
•
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
Rough -In
mo e Dampers
Final
PASS PART
ELECTRICAL
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: ❑ Unable to inspect — no access
Fire Supply Line
ADA C – � d-Z I ns
ector Ext
Approach /Sidewalk Date p
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
•