Permit 11
a CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2009 - 00033
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/23/2009
PARCEL: 2 S 104AA - 90061
SITE ADDRESS: 12666 SW KAREN ST 6 ZONING: R -
SUBDIVISION: BELLWOOD TERRACE CONDOMINIUMS LOT: 006 JURISDICTION: TIG
PROJECT: ZAKOCS
Project Description: Install dryer vent.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
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:
> 10000 cfm: GAS OUTLETS:
Owner: FEES
ED ZAKOCS • Description Date Amount
PO BOX 189
YAMHILL, OR 97148 [MECH] Permit Fee 1/23/200 $72.50
[TAX] 12% State Surch 1/23/200 $8.70
Phone: 503- 662 -3010
Total $81.20
Contractor:
RELIABLE HOME IMPROVEMENT
PO BOX 230815
PORTLAND, OR 97281 REQUIRED ITEMS AND REPORTS
O h
Contact #: PRI 503 -481 -0240
Reg #: LIC 48637 %111
6
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I
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This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes and all other 0
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.
z- 10
Iss ed By: i 4' / „,,,a, Permittee Signature: 4,2,- .�' VA
Call 503.639.4175 by 7:00 a.m. for inspections that fusiness d_'
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.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: e�, c 9- eo REQUIRED ON GREEN INSPECTION CARD.
✓ Code Inspection Description PASS Date By ✓ Code Inspection Description ' PASS Date By
BUP - Building Permit ELC - Electrical Permit
405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 Electrical final
•
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 \ /tr proofing basement walls 135 Low voltage
260 Tilt -up panel 195 Misc inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
295 Misc. inspection: 620 Hydronic piping
899 MFG- Structure final 625 Duct work
498 Grading final 630 Fire damper
am p'
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection
y 699 Mechanical.fmal
BUP - Fire Protection System Permit
1 . 905 Sprinkler underfloor/slab
910 Sprinkler rough -in PLM - Plumbing_Permit
915 Fire alarm rough -in
305 Plumbing underslab
1 920 Suppression trip test 310 Crawl drain
995 Misc. inspecuon:
315 Post /beam plumbing
998 Alarm final 320 Plumbing rough -in
999 Sprinkler final
322 Shower pan
330 Water service
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335 Rain drain
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 _ Culvert /catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
Budding \ Nornis \InspCard- AOP- Blank.doc 02/(12/07
•
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC:200900033
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1/7312009
it# 11ft
Phone: (503) 639-4171 ai
Inspection Requests (24 Hrs.): (503) 639-4175
INSPECTION WORKSHEET FOR DATE: 2r „, 09 TIME: 7:03AM PAGE: a
ST ( k.4
SITE ADDRESS: 12666 SW KAREN ST 5 CLASS OF WORK:
SUBDIVISION: BELLWOOD TERRACE CONDOMINIUM LOT #: 006 TYPE OF USE:
PROJECT NAME: ZAKOCS
DESCRIPTION: Install dryer vent.
OWNER: ZAKOCS, PHONE #: 503-667-3010
CONTRACTOR: RELIABL.E HOME IMPROVEMENT PHONE #: 503-48
Inspection Request Scheduled For: Date: N2612009 Pour Time:
Code # Inspection Description Confirm # Contact # Message
62Li Duct work 080866-01 503-481-02410
6
Corrections /Comments/ Instructions:
Et k
• r
9,
- PASS i PirTIAL APPROVAL 0 CANCEL n NO ACCESS
pi FAIL ALL FOR INSPECTION 0 ADDITIONAL FEES ASSESSED
Inspector: 411111111! Date: Z 0./ Phone #: (503) 718- ZO__Y
CI TY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2009 - 00033
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 1/23/2009
PARCEL: 2S104AA - 90061
SITE ADDRESS: 12666 SW KAREN ST 6 ZONING: R -
SUBDIVISION: BELLWOOD TERRACE CONDOMINIUMS LOT: 006 JURISDICTION: TIG
PROJECT: ZAKOCS
Project Description: Install dryer vent.
CLASS OF WORK: ALT FLOOR FURN: EVAP COOLERS:
TYPE OF USE: MF UNIT HEATERS: VENT FANS:
OCCUPANCY GRP: R3 VENTS W/O APPL: VENT SYSTEMS:
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS: 1
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Owner: FEES
ED ZAKOCS Description Date Amount
PO BOX 189
YAMHILL, OR 97148 [MECH] Permit Fee 1/23/200 $72.50
[TAX] 12% State Surch 1/23/200C. $8.70
Total $81.20
Phone: 503- 662 -3010
Contractor:
RELIABLE HOME IMPROVEMENT
PO BOX 230815
REQUIRED ITEMS AND REPORTS
PORTLANDD, , O OR 97281
OR
Contact #: PRI 503 - 481 -0240
Reg #: LIC 48637
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.
Iss ed By: Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for inspections that ausiness
This permit card shall be kept in a conspicuous place on the job ' e until completion of the project.
Approved plans are required on the job site at the -time of each inspection.
Mhanical Permit Application ; FOR OFFICE USE ONLY;
s Received City of Tigard EDIV Date/By: / 2 3 Q q / Permit No.: H t1 9—c33
III ° 13125 SW Hall Blvd., Tigard, O h! ' Plan Review
Phone: 503.639.4171 Fax: 50 .598.1960 Date /By: Other Permit.
TIGARD Inspection Line: 503.639.4175 'AN S 3 .5\ Date Read /B Tuns:
Internet: www.ti and -or. ov Notified/Method: Ready /By. / Supplemental See Page for
g g ^^ � Supplemental Information
to - TYPE Oti'1'4 G� :: ' ,. " _ . r 'COMMERCIAL£FEE *SCHEDULE' USE,CILECKLIST,
❑ New construction AZAdditioAlteration /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. • CATEGORY , OF CONSTRUCTION. a,n. - , - Value: $
1 - and 2-family dwelling RESIDENTIAL EQUIPMENT /SYSTEMS FEES *� - ,
El y g ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
8- Multi- family ❑ Master builder ❑ Other: Description Qty. Ea. Total
JOB STI'Er,:INFORMATION AND LOCATION,' ; *t" = Heating/cooling
/ n Air conditioning or heat pump
Job site address:
`,„, 4 ce S C) (�� � i A , el 3 (requires site plan showing placement) 14.00
City /State /ZIP: � 7 ' 20 - G i d_ ct 71) ') Furnace 100,000 BTU (ducts /vents) 14.00
'? Furnace 100,000+ BTU (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: t'J L Gas heat pump 14.00
Cross street/directions to job site: Duct work 10.00
�J�
//�C t -,1 .1��KJz' Reside tc hot water system 14.00
/p ` J (� Residential boiler (radiator or
hydronic) 14.00
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
" = - a, Water heater 10.00
' "-: ° "��� 'DESCRIPTION ;OE' WORK � : - 'k;
Gas fireplace 10.00
Z-A) S7r LG 1 rt-r 0 pi-e -t_ et/ -e,-Y- - 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
Chimney /liner /flue /vent 10.00
: . _ ° ®==PR O PE RTY.OW NER . , ',„ a'" z ❑:T ENANT
Other 10.00
Name: d=- 1) Z 44 /(/2 -�J ' Environmental exhaust and ventilation
Address: ` Range hood /other kitchen
[) • 6 f ic equipment 10.00
City /State /Z1P: A. • / 0 ,� Clothes dryer exhaust 1 10.00
A / iv Single -duct exhaust (bathrooms,
Phone: (So, 3) 4044 —, 3o / (D Fax: ( ) toilet compartments, utility rooms) 6.80
: ' ° . ELICANT . "' ❑ CONTACL PERSON° , Attic /crawlspace fans 10.00
/ a 7 ,- ro Other: 10.00
Business name: R G G /A X31-€ (. t� 7- .4.,fre-ev'-yne--i.-' • Fuel 1 in
P�P g
Contact name: G' v II /u 7. $5.40 for first four; $1.00 for each additional
l� Furnace, etc.
Address: / 2 t �
t � �� � OV 3 � el � Gas heat pump
City /State /ZIP: /vU 7 _ 0 G //e_ 17,21-( Wall /suspended/unit heater .
Fax: Water heater
Phone:
s 6 3) cis,/ — t. v o ( ) Fireplace
E -mail: Range
.' .. 8_._. _ , CONTRACTOR .. e ?" Barbecue
Business name: )� o /, Clothes dryer (gas)
CG �
Other:
Address: MECItANICAL PERMIT„FEES* '.
. City /State /ZIP: (I) 0 IZ Z/v m,v /i GZ 7 ,-( Subtotal /�)
Phone: (j o2 . 1(1— 0? (../ G Fax: ( ) Minimum permit fee ($72.50) 79.. S
C Plan review (25% of permit fee)
CCB lic.: L/Q ',1, State surcharge (12% of permit fee) C 70
/
(v 2 °
Authorized signature: / T his p ermit application expires if a permit is not obtained wi 180
/ ... // days after it has been accepted as complete.
Print name: � 1�-+r7vi yG2 I4r>� !!�' Date: / — 3 Z -- GE" * Fee methodology set by Tri -County Building Industry Service Board
1.\ Building \ Permits \MEC - PermitApp.doc 01/19/07 440 -4617T (1 I /02 /COM/WEB)
Mechanical Permit Application - City of Tigard '
Page 2 - Supplemental Information
Commercial Fee Schedule:
TotalValuatiori�` Permit Fee:
$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.
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1: \Building \Permits \MEC- PermitApp.doc 01/19/07 2