Permit C ITY OF TIGARD MECHANICAL PERMIT
' COMMUNITY DEVELOPMENT PERMIT #: MEC2007 -00501
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 8/13/2007
PARCEL: 2S114BD -01600
SITE ADDRESS: 09790 SW RIVERWOOD LN ZONING: R-4.5
SUBDIVISION: COPPER CREEK STAGE 2 LOT: 043 JURISDICTION: TIG
PROJECT: NELSON •
Project Description: Gas pipe install for tankless water heater.
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:
NAT 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:
OTHER UNITS: 1
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
GORDON NELSON Description Date Amount
9790 SW RIVERWOOD LN
TIGARD, OR 97223 [MECH] Permit Fee 8/13/2007 $72.50
[TAX] 8% State Surcha 8/13/20W $5.80
Total $78.30
Phone: 971 - 221 -8223
Contractor:
3 MOUNTAINS PLUMBING
20345 SW PACIFIC HWY SUITE 103
SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503- 925 -1342
Reg #: LIC 169499
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 dire - . - tions to OUNC by calling 503.246.6699 or 1.800.332.2344.
/i �
Issued B �J1/11/ Permittee Signature: fiC &Ti ce
Call 503.639.4175 by 7:00 a.m. for inspections that business day.
r mit 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.
08 -l.3 -2007 14:44 3 MTNS PLUMBING 5039259104 PAGE2
Mechanical Permit Ao licati i m. ECEflJED
City of Tigard AU D elB r /3 07- SCJ� P� ND.: friezzo�- ^ CX�5Q /
: II • 13125 SW HMI Blvd., Tigard, OR 97223 G 1 1 g 3 ZOO /
C Phone: 503.639.4171 Fax: 503.590.1960 2007
D m Review
ate/By: Other Permit:
r I r. n Inspection Line: 503.639.4175 CITY � TIC U�ie Stea dy/Hy: Jun see Page 2 rnr
Interne: www.tigard- or,gov BUI D 0N Named/Med.& 176-) Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
New construction Mechanical permit fees" are based on the value of the work
0 ® A ddition/alteration/replacement
❑ Demolition Other: performed. Indicate the value (rounded to the nearest dollar) of all
^ mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL
® 1- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building EQUIPMEN I / SYSTEMS FEES*
Multi-family For special iaformarion use checklist.
d y ❑ Master builder ❑ Other: Description 1 Qty, J Zia 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 9790 SW Riverwood Lane Air conditioning or heat pump
_ (remures site Plan slu,wing placement) 14.00
City/State/ZIP: 'Tigard 97224 Furnace 100,000 RTI1 (ducta/venta) 14.00
Furnace 100,000+ RTI1(duets/vents) ,, 17.90
Suite/bldg. /apt. no.: ` Project name: Gas heat pump 14.00
Cross street/directions to job site: Duct work 14.00
—
Hydronic hot walerastem 14.00
Residential boiler (radiator or
h dronic 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
- - Otter. 10.00
Tax map /parcel no.; Other fuel appliances
DESCRIPTION OF WORK Water heater 1 10.00 10.00
Gas fireplace 10.00
Gas pope install for tankless water heater Flue vent for water heater or gas
fireplace 10.00
- , Loglighter . _ 10.00
Wood/pellet stove 10.00
• Wood fireplace/insert 10.00
® PROPERTY OWNER J ❑ TENANT Ot Chimney/liner/flue/vent 10.00
Other: 10.00
Name: Gordon Nelson Environmental exhaust and ventilation
Range hood/other kitchen
Address: 9790 SW Riverwood Lane equipment 10.00
City /Statc/ZIP: Tigard Oregon 97224 Clothes dryer exhaust 10.00
Phone: (971)2214223 Fax: ( ) toilet r m
compartments, utility s) 6.80
❑ APPLICANT ❑ CONTACT PERSON Attic/crawispace fans _ 10.00
- --... """' Other: 10.00
Business name: Fuel piping
Contact name: $5.40 for first four; $1.00 for RACK additional
Furnace, etc.
Address: .
- Gas heat pump .
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax:: ( ) Water heater
•
E-mail; Fireplace
Range _
CONTRACTOR Barbecue
Business name: 3 Mountains Plumbing Clothes dryer (gas)
Other.
Address: 20345 SW Pacific Hwy Suite 103
MECHANICAL PERMIT FEES"
City/State/ZIP: Sherwood Oregon 97140 Subtotal
—
Phone: (503) 925 -1342 + Fax: (503) 925-9104 Minimum permit fee ($72.50) 72.50
CCR lie.: 169499 4) 5 / o g port - T'(�.Li l e Se.i,e1ri i .L L -- - _ Plan review (25% of permit fee)
1 State surcharge (8% of permit foe) 5.80
Authorized signature: /4410- TOTAL PERMIT FEE 78.30
l I - I Thu npnait annliratinn "mime if a nermlt is not obtained within IRA
CITY OF TIGARD 1
BUILDING DIVISION ' PERMIT ' #: MEC2007 -00501
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 8//312007
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ''''... /19/
INSPECTION WORKSHEET FOR DATE: 8/15/2007 TIME: 7:00AM PAGE: 55
SITE ADDRESS: 09790 SW RIVERWOOD LN CLASS OF WORK:
SUBDIVISION: COPPER CREEK STAGE 2 LOT #: . 043 TYPE OF USE:
PROJECT NAME: NELSON
DESCRIPTION: Gas pipe install for tanldess water heater.
OWNER: NELSON, GORDON PHONE #: 971 -221 -8223
CONTRACTOR: 3 MOUNTAINS PLUMBING PHONE #: 503 925.1342
Inspection Request Scheduled For: Date: 8/15/2007 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 053982 -01 503 -925 -1342 N
Corrections /Comments /Instructions:
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PASS 0 PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector` �� Date: " f 1 'C( J P hone #: (503).,718- Z` f