Permit CITY TIGARD MECHANICAL PERMIT
i& DEVELOPMENT SERVICES PERMIT #: MEC2004 -00285
! I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/17/2004
PARCEL: 2S 112CB -08200
SITE ADDRESS: 15029 SW KENTON DR
SUBDIVISION: ASHFORD OAKS NO. 2 ZONING: R -7
BLOCK: LOT: 096 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: 1 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: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS:
> 10000 cfm:
GAS OUTLETS:
Remarks: Furnace and AC installation.
Owner: FEES
HAWKINS, JEREMY Description Date Amount
15029 SW KENTON DR [MECH] Permit Fee 5/17/200 $72.50
TIGARD, OR 97223 [TAX] 8% State Surchart 5/17/2002 $5.80
Phone: 503 968 - 7089 Total $78.30
Contractor:
SUPREME COMFORT HEATING
9425 SW COMMERCE CIRCLE #16
WILSONVILLE, OR 97070 REQUIRED INSPECTIONS
Mechanical Insp
Phone: 682
Cooling Unt Insp
Reg #: LIC 21892 Final Inspection
•
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Ore. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is
not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law
requires you to follow rules adopted in the Oregon Utility Notification Center. Those rules are set forth in OAR
952 - 001 -0010 through OAR 952 - 001 -0100. You may obtain copies of these rules or direct questio, s to OUNC by calling
(503)246 -6699. - -
i
Issued By: Permittee Signature: ' + 1 �
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application FOR OFFICE U SE ONLY
,City of Tigard
Date/By: C D 17 / g� Permit No.M ' �Dt� ms' s
Y
13125 SW Hall Blvd., Tigard, OR 97223 Plan Revie
Phone: 503.639.4171 Fax: 503.598.1960 urd i Date/By: Other Permit:
Ins ection Line: 503.639.4175 All
p � Date Read /B Jur H See Page 2 for
Internet: www.ci.tigard.or.us Notified/Method: i) Supplemental Information
, - . �:$ ,. ' .. - r_,,.' ';:;=.:
.: °.. r . ? ° .. , ,. ' . . :7( '� `a _.,... FEE* S E- �' ^USE .
i ,a_ a , ,w TYPE =°O W ' C
Mechanical permit fees* are based on the value of the work
❑ New construction Addition/alteration/replacement
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
a ° w Y ° "r ': ; 4 , n Value: $
;, at* t ( ak t ai T.EGOIV9F. GONSTI :ION,, .. ? ' 1 ,
:,,,,, -..� .ad.,.�.,:w e4 . 9<t,..,,x,,.,,., aaa ^a _wr, - -,- :.srv� ' , .r.s,� y .... a. ,. . nf r , x ° - �., • ..
; „,, , RESID ;EN IAL3EQUIP P / F
gt1-- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building
Master builder For special information use checklist.
Multi -famil
❑ Multi-family ❑ ❑ Other:
Description Qty. Ea. Total
t, , JOB ; SITE >I NFORM 1 5 O AND LOC ': Heating/cooling
�. , Pr- Air conditioning or heat pump
Job site address: /60 29 Sk)
(requires site plan showing placement) ( 14.00
City/State /ZIP: 1 lid a_ 72-74— Fumace 100,000 BTU (ducts /vents) ( 14.00
Suite/bldg. /apt. no.: r Project name: ./ f,J r_� Furnace 100,000+ BTU (ducts /vents) 17.90
Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
' r 0 " - . Hydronic hot water system 14.00
Fib � 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 t✓Ptie -') ( 10.00
• Other:1414W 10.00
Tax map /parcel no.: Other fuel appliances
DESGRIP ,- id WORK ` ` � 0 Water heater 10.00
aZ.,:. �'.�t�.. n ,> - ' 0� � ,.r -„s : . - r� r&- g ar -.rst^ - :r _. ,:n' °i. " .'P l #� � ,.%
'� Gas fireplace 10.00
(lye, g4ij --if.0 1/Lej add d 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
V:: ,y43:; °;3 li i .rt•.::i 'a �.: 0.1 _ :rrw• R, ..-�. ,:, ;' ';�c,;,v. , _ Chimney /liner /flue /vent 10.00
tROPERTY ' WNER. .. -
a EtANT� . " ,
. „., .�.�,:.,..�� �,..a�.�,.. � €,” 10 00
Name: f- V /Vl'i u 6, k ,, c, Environmental exhaust and ventilation
Address: 16 d 7-A- 51,0 �p - IA /i l(• Range hood /other kitchen
equipment 10 00
City/State /ZIP: r J't"d (_ G 7 . Clothes dryer exhaust 10.00
Phone: (6O , ) 6m- iQ Fax:
Single-duct duct r ents (bathrooms, o
( ) toilet compartments, utility rooms) 6.80
,:. �' A t .. T ' .: r- ONTACT °PERSON Attic /crawlspace fans 10.00
n � Other: 10.00
Business name: (,,t,99� � fVW`` e- Fuel piping
Contact name: pA,ut. Vi/ I - $5.40 for first four; $1.00 for each additional
Furnace, etc.
Address: 94'2 6k) C/ CC r. C Gas heat pump
wl
City/State /ZIP: , ( 0V1-(t t6( t CIL 'T 76 Wall /suspended /unit heater
Phone: 60 ,) 6 Z -(mil l Fax: : ( 5'o-9 6 Z -(U t iC Water heater
Fireplace
E - mail:
Range
) ..K r* CONTRACT " r : .. ° Barbecue _
A — Clothes dryer (gas)
Business name: 1f j (�P L(C Other:
Address:
. .,.., , - - I . .. ... .... . ... *
,
�.. MECHANICA)1�PERMTT FEES *:° ,
City/State /ZIP: Subtotal
Phone: ( ) Fax:.( ) _ Minimum permit fee ($72.50) 7p _
— Plan review (25% of perrrmit fee)
CCB lic.: 2 I fgC Z &/-71/1< State surcharge (8% of permit fee) 5W
TOTAL PERMIT FEE 7 K. 30
Authorized signature: This permit application expires if a permit is not obtained within 180
�� r days after it has been accepted as complete.
Print name: hAAJ , a t ( '�4- Date: 511 7/0 4 * Fee methodology set by Tri- County Building Industry Service Board
i:\Bui lding\Permits \MEC- PermitApp.doc 12/03 440 -46I7T (I l /02 /COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
w 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.
i:\Building\Permits\MEC- PermitApp.doc 12/03 2
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CITY OF TIGARD 24 -Hour
BUILbING Inspection Line: (503) 63•. 175
•
INSPECTION DIVISION • Business Line: (503) • -4171 MST
BUP
Received _s / ®y Date Requested 2 PM
•
Location �� Z % P� E` d ��� Suite 410Zoc. 4 l — Z —
Contact Person Ph ( ) PLM
Contractor Ph ( ) SWR
BUILDING Tenant/Owner ELC
Footing
Foundation ELC
Access::
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors Ai/A-
Ext Sheath /Shear
Int Sheath /Shear �y � f _ (� ) ,- e
Framing
Insulation AI 4,,-4„‹,t0
Drywall Nailing
Firewall® 1 f r OF1
Fire Sprinkler —
Fire Alarm
Susp'd Ceiling
Roof t . • C L Ate' 7 C
Other:
Final
PASS PART FAIL
PLUMBING
Post : Bea
Rou•0
ervice
Sani Try Sewer
Rai, Drains
C- c Basin / Manhole
or Drain
how-r Pan
PASS : T FAIL
Post & Beam
Rough -In
Gas Line
''Smm•�• . - Dampers
- • SS •ART FAIL
L _ _.' ' !CAL
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: I , d nable to inspect - no access
Fire Supply Line — — —
ADA 2� - Q Approac h/Sidewalk Date Inspector KAHL-
Other:
Final DO NOT REMOVE this Inspection rec' rd from the job site.
PASS PART FAIL •
CITY OF TIGARD r'- 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTION DIVISION ' 1 Business Line: (503) 639 -4171 MST
i . BUP
Received Date Requested -°1-6 AM V PM BUP
Location LSD 0 �,e 'l A Suite MEC a 06) O `'
Contact Person ' Ph ( ) (.0,?- (1 8:5 PLM
Contractor Ph ( &-Q) S/ 6 0 - aa SZo SWR
BUILDING Tenant/ 1 j (a ,F - 70 el ELC ROC z,-/-06, 74,
Footing
Foundation Access: ELC
Ftg Drain j 4 ELR
Crawl Drain �J
Slab Inspection Notes: SIT
Post & Beam
Shear Anchors
Ext Sheath /Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing \ Q
Firewall 11 1,6 1 t5 z v tJ l Y s L OJI,,.Q Q� 5 � ‘,a a60vs-
Fire Sprinkler �/� "� ,�
Fire Alarm ( 4 J
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 .
Po & Bea
Rough -
G G me .
oke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough -In
UG /Slab
. Low Voltage
Fi - alarm
Fin., Ell Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd.
• PART FAIL
SI - ❑ Please call for reinspection RE: 0 Unable to inspect — no access
Fire Supply Line
ADA �f�� vie Approach /Sidewalk Date g Inspector v 1� Inspector V vCiJ '
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL