Permit C 1TY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00074
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 2/8/2007
PARCEL: 2S114BA -14700
SITE ADDRESS: 09500 SW MARTHA ST ZONING: R -7
SUBDIVISION: COPPER CREEK STAGE 4 LOT: 112 JURISDICTION: TIG
Project Description: Exhaust for bath conversion. .
CLASS OF WORK: OTR FLOOR FURN: EVAP COOLERS:
TYPE OF USE: SF UNIT HEATERS: VENT FANS: 1
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:
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:
Owner: FEES
BARBARA BROWN Description Date Amount
9500 SW MARTHA ST
TIGARD, OR 97223 [MECH] Permit Fee 2/8/2007 $72.50
[TAX] 8% State Surcha 2/8/2007 $5.80
Total $78.30
Phone: 503- 624 -9448
Contractor:
ALLEN NOBUICHI IBOSHI
12335 SW MCKAY CT
BEAVERTON, OR 97008 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 644 -9518
Reg #: LIC 119182
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.
9
Issued By: ���� Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for inspections that business 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.
• Mechanical Permit Application c)rrlcl: usl QV1.1
City of Tigard CON � V r Received " ) Permit No.. e _
II A �� `
13125 SW Hall Blvd., Tigard, OR 9 % Plan Review
Phone: 503.639.4171 Fax: 503.59 •'.1 • .0 Date/By.. Other Permit:
T 1 G A ii 17 Inspection Line: 503.639 E8 ® 'tQQI
Date Ready/By: Julia: ® See Page 2 for
Internet: www.tigard- or.gov 11°°1° 14 No Supplemental Information
TYP OF Vd3kW ,114 COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction (ddition /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
,.,1 CATEGORY OF CONSTRUCTION Value: $
1 - and 2 - famil dwellin RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y dwelling ❑ CommerciaUindustrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND // L OCATION Heating/cooling
Job site address: " f SD"Z' 5 ti) m Q¢6/ 'b`�,�, - Air conditioning or heat pump
(requires site plan showing placement) 14.00
city / State/ZIP: (,, 1 2(r' C t'j }-z4- Furnace 100,000 BTU (duds/vents) 14.00
1
Suite/bldg. /apt. no.: Project name: gr, �_ ' �ji r J ,L Furnace 100,000+ BTU (ducts/vents) 17.90
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
DESCRIPTION OF WORK Water heater 10.00
Gas fireplace 10.00
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
❑ PROPERTY OWNER I ❑ TENANT Chimney/liner/flue/vent 10.00
Other: 10.00
Name: Environmental exhaust and ventilation
Address. Range hood/other kitchen
equipment 10.00
City / State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 1 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name:
Fuel piping
Contact name: $5.40 for first four; $1.00 for each additional
Address:
Furnace, etc.
Gas heat pump
City /State/ZIP: Wall/suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
Fireplace
E-mail: Range
CONTRACTOR Barbecue
Business name: �� �� At. �-� 5 i .
Clothes dryer (gas)
�) Other:
Address: Y - 0 , t7»( 3 MECHANICAL PERMIT FEES*
City/ State/ZIP: / - / 70 7 Subtotal
Phone: (5 - 1- 0 /-- t .4' `j I Fax: (50) 6 a--1.- 11 '1jz, Minimum permit fee ($72.50)
Plan review (25% of permit fee)
CCB lic.: j /' 1 State surcharge (8% of permit fee) �"
TOTAL PERMIT FEE '7 Q „Id
Authorized signature: This permit application expires if a permit is not obtained within 180
!'� days after it has been accepted as complete.
Print name: 4 14 (C .4,1 Z S'e1.-_ ' J Date: P11(//.7 7 • Fee methodology set by Tri- County Building Industry Service Board
I :\ Building \Penmits\MEC- PermitApp.doe 04/06/06 4404617T(11/02/COM/WEB)
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: 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 $10 $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:\ Buildin \Permits\MEC- PermitApp.doc 12/30/05 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC2007.00074
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/8/2007
Phone: (503) 639-4171
Requests (24 Hrs.): (503) 639 -4175 i `-
INSPECTION WORKSHEET FOR DATE: 2/8/2007 TIME: 7 :04AM PAGE: 23
1; V R.PF -k I ft,
SITE ADDRESS: 09500 SW MART HA ST CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 4 LOT #: 112 TYPE OF USE:
PROJECT NAME: BROWN
DESCRIPTION: Exhaust for bath conversion.
OWNER: BROWN, BARBARA PHONE #: 603- 624 -9448
CONTRACTOR: ALLEN NOBUICHI IBOSHI PHONE #: 503 -201 -9665
Inspection Request Scheduled For: Date: 202007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
616 Mechanical rough -in 043198 -02 503-201 -9665 N
Corrections /Comments /Instructions:
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ F ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 6/y?r Date: Z / Phone #: (503) 718 - Z —/
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MI~G2007 -00074
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 2/8/2007
Phone: (503) 639 -4171 .at j •Inspection Requests (24 Hrs.): (503) 639 -4175 ____.. • _..
INSPECTION WORKSHEET FOR DATE: 2/2312007 TIME: 7 :01AM PAGE: 9
SITE ADDRESS: 09500 SW MARTHA ST CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 4 LOT #: 112 TYPE OF USE:
PROJECT NAME: BROWN
DESCRIPTION: Exhaust for bath conversion,
OWNER: BROWN, BARBARA PHONE #: 503 -6M 9448
CONTRACTOR: ALLEN NOBUICHI IBOSHI PHONE #: 543 -201 -9665
Inspection Request Scheduled For: Date: 2/23/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
699 Mechanical final 043810 -02 503 - 201 -9665 N
Corrections /Comments /Instructions:
r.4 PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: /7 Date: 4 Z_ _ 5 67 Phone #: (503) 718- 7‘Vy