Permit n CITY OF TIGARD MECHANICAL PERMIT
II
° COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00723
TIGARD • 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 12/13/2007
PARCEL: 2 S 102 C D - 04902
SITE ADDRESS: 09777 SW O'MARA ST ZONING: R-4.5
SUBDIVISION: PP1992 - 012 LOT: 001 JURISDICTION: TIG
PROJECT: BURK
Project Description: Fireplace insert. Gas line.
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: 1
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
FIRE DAMPERS ?: 30 - 50 HP: REPAIR UNITS:
GAS PRESSURE: 50 + HP: WOODSTYERS:
FURN < 100K BTU: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: 1
Owner: FEES
NATHAN BURK Description Date Amount
9777 SW O'MARA
TIGARD, OR 97223 [MECH] Permit Fee 12/13/20C $72.50
[TAX] 8% State Surcha 12/13/20C $5.80
Phone: 503- 753 -0709
Total $78.30
Contractor:
OWNER
REQUIRED ITEMS AND REPORTS
Contact #:
Reg #:
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.
Issued By:
Ar Permittee Signature: X / .4
Call 503.639.4175 by 7:00 a.m. for inspections that b , siness 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.
II
Mechanical Permit Appli : 9 i , rEl V' FOR OFFICE USE ONLY
City of Tigard DEC 1 3 2007 Date/By: I' ® /7 3 - Permit No.:446 v 1 /)9 0 4 7
I I lIl • 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review ��
Phone: 503.639.4171 Fax: 503.590� Date/By : Other Permit:
Ins ection Line: 503.639.4175
T I G A R D p BU�LD11uC7D WSlO�� Date Ready/By: IiiM EI See Page 2 for
Internet: www.tigard -or.gov Notified/Method: Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction Additio alteration/ placement Mechanical permit fees* arc bascd on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ er: mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial /industrial ❑ Accessory building
For special information use checklist.
❑ Multi- family ❑ Master builder 0 Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heatinp./cooling
Air conditioning or heat pump
Job site address:
7 7 1 s W 0 r..-a -✓x Si (requires site plan showing placement) 14.00
City/State /ZIP: - f q ,,4 0 i q7 2-Z-3 Furnace 100,000 BTU (ducts/vents) 14.00
J 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 10.00
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. 14.00
Subdivision: Lot no.: Flue /vent for any of above 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
/ T/� C- / _ Gas fireplace 1 10.00 /4'.. es a
erd e- e ra...ee �^ e o.. . vta
� &IL ire - r Flue vent for water heater or gas I
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: Ada t 4 ., Q w r- k Environmental exhaust and ventilation
G f 7 ? s w Range hood/other kitchen
Address:
04,......., equipment 10.00
City /State /ZIP: T Gi. c)1t 97 2-2-1 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (5 ) -75- ? D 7 0 I Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ❑ CONTACT PERSON , Attic /crawlspace fans 10.00
Business name: Other: 10.00
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
Clothes dryer (gas)
Business name: (v it A Other:
Address: MECHANICAL PERMIT FEES*
City /State /ZIP: Subtotal
Minimum permit fee ($72.50) -7,2_ co
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: • State surcharge (8% of permit fee) go
TOTAL PERMIT FEE i 3 j�
Authorized signature: Thi p ermit app li c ati o n expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: /116„1--.6, n e t✓„ &„ I Date: • Fee methodology set by Tri -County Building Industry Service Board
I:\ Building \PermitsUMEC- PermitApp.doc 01/19/07 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 $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.
1:\ Building \Pennits\MEC- PennitApp.doc 01/19/07 2
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MFC2flQ7 -00723
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 12/13/2007
Phone: (503) 639 -4171 , _21,1, N ti I
Inspection Requests (24 Hrs.): (503) 639 -4175 4 "I ..
INSPECTION WORKSHEET FOR DATE: 12/19/2007 TIME: 7 : 00AM PAGE: 21
SITE ADDRESS: 09777 SW O'MARA ST CLASS OF WORK:
SUBDIVISION: PP199d - Q12 LOT #: 001 TYPE OF USE:
PROJECT NAME: BURK
DESCRIPTION: f=ireplace insert. Gas line.
OWNER: BURK, NATHAN PHONE #: 503763 -0709
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 12/19/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 061844 -01 503-753-0709 N
R ei - -, ,.�nc._
Corrections /Comments /Instructions:
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: / —O Phone #: (503) 718 - Z. -�
CITY OF TIGARD •
BUILDING 151 VISION PERMIT #: MEC2007 -00723
13125 SW Hall Blvd., Tigard, OR 97223 ' DATE ISSUED: 12/130007
Phone: (503) 639 -4171 t tili
Inspection Requests (24 Hrs.): (503) 639 -4175 =� ' ' :L
INSPECTION WORKSHEET FOR DATE: 12/14/2007 TIME: 7 :01AM PAGE: 55
SITE ADDRESS: 09777 SW Y O'MARA ST CLASS OF WORK:
SUBDIVISION: PP1992 - 012 LOT #: U01 TYPE OF USE:
PROJECT NAME: BURK
DESCRIPTION: Fireplace insert. Gas line.
OWNER: BURK, NATHAN PHONE #: 503-753 - 0709
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 12/14/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
695 Micc. inspection 061518 -02 503 - 753.0709 N
Corrections /Comments /Instructions:
0 I J
V
P i ` �
O v i y i�krtL --
W i cto, wi he i 6/D Grmil 4 4'9
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
..p
Inspector: J Date: ( Phone #: (503) 718-