Permit : CITY OF TIGARD
MECHANICAL PERMIT
4 i� DEVELOPMENT SERVICES PERMIT #: MEC2004 -00220
.� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/28/04
PARCEL: 1 S134DC -02800
SITE ADDRESS: 11310 SW TIGARD ST
SUBDIVISION: CHERRY HILL ACRE TRACTS ZONING: R -4.5
BLOCK: LOT: 010 JURISDICTION: TIG
CLASS OF WORK: OTR 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:
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: AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm: OTHER UNITS: 1
> 10000 cfm: GAS OUTLETS: 2
Remarks: Installation of tankless water heater, gas piping for water heater & gas dryer.
Owner: FEES
ANDREW WEAVER Description Date Amount
KATHERINE [TAX] 8% State Surchar€ 4/28/04 $5.80
11310 TIGARD, OR 97223 SW TIGARD ST [MECH] Permit Fee 4/28/04 $72.50
GA
Phone: Total $78.30
Contractor:
OWNER
REQUIRED INSPECTIONS
Phone: Gas Line Insp
Mechanical Insp
Reg #: 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 -00
Issue. By: '� , I & � ' f r %. Permittee Signature: ;1 r__ ,
Call (503) 63' -4175 by 7:00 P.M. for inspections needed the next business day
Mechanical Permit Application ' ' ' • i .or Bch: iii:: QN 1 .-l' :
Received
City 01€ 3i lgard Date /By. ja c Al Permit No.. f �/ �
13125 SW Hall Blvd., Tigard, OR 97223 " W
Plan Review
Phone: 503.639 4171 Fax: 503.598.1960 , \ Date/By. Other Permit.
Inspection Line: 503.639.4175 �: ` `I
„_,,,,, ^ I I Date Notified/Method y Supplemental See Page 2 for
Internet: www.ci.tigard.or.us J Notifed/Method Supplemental Information
TYPE OF WORK COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
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.
CATEGORY OF CONSTRUCTION Value: $
RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
® 1 and 2 family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other: Description 1 Qty. 1 Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: 11310 SW Tigard St Air conditioning or heat pump
(requires site plan showing placement) 14.00
City/State/ZIP: Tigard, OR 97223 Furnace 100,000 BTU (ducts/vents) 14.00
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: Tigard St and Gallo Ave. Proceed West on Tigard St [Acct work 14.00
\ Hydronic hot water system 14.00
{ `�h A v.1 AA. cv1 Y\ 1 ; <. v A A. C- cs,-Ci % � MAQ 51- t' t, cJ h k Residential boiler (radiator or
hydronic) 14.00
OA A '1 - 'ci tty ' 5k i Q a. I c- Ae tmt: rN r;. Vnr\ c ca r e e N Unit heaters (fuel -type, not electric),
I /L ry , t F'. - Y C� CIGA10 N.1 1 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 I 10.00 1 (3 . Ct j
Gas fireplace 10.00
Install new Natural Gas fired Tankless hotwater heater on utillity porch. 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 /Bue/vent 10.00
Other: 10.00
Name: Andrew & Katherine Weaver Environmental exhaust and ventilation
Address: 11310 SW Tigard St. Range hood/other kitchen
equipment 10.00
City/ State/ZIP: Tigard, OR 97223 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (503)684 -0692 Fax: (503)684-0692 call before faxing 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 i
E-mail: Fireplace
Range
CONTRACTOR Barbecue
Business name. of ) i li ER,- Clothes dryer (gas)
Other.
Address: MECHANICAL PERMIT FEES*
City / State/ZIP: Subtotal
Phone: ( ) Fax: ( ) Minimum permit fee ($72.50) 7g, SO
Plan review (25% of permit fee)
CCB tic.: State surcharge (8% of permit fee) 5 • ro
TOTAL PERMIT FEE 7g . 30
Authorized signature: 0,,, Y) Q---' This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
I Print name ) v O C \ y e , vJ e s w t . _ r 1 Date 9 \. \( t I • Fee methodology set by Tri -County Building Industry Service Board
CITY OF TIGARD 24 -Hour
BUILDING Inspection Line: (503) 639 -4175
INSPECTIQN DIVISION Business Line: (503) 639 - 4171 MST
BUP
Received Date Requested /6 — Z Z AM PM BUP
Location t 3 [ v —� Suite MEC do (f —66Z.7-'0
Contact Person Ph ( ) t f 0(0 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
Ext Sheath/Shear
Int Sheath/Shear
Framing
Insulation
Drywall Nailing
Firewall
Fire Sprinkler
Fire Alarm
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
Post & Beam
Rough -In
Gas Line
S � . e Dampers
Imo:
PART FAIL
CTRICAL
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: ❑ Unable to inspect — no access
Fire Supply Line
ADA
Approach/Sidewalk Date Inspector Ext
Other:
Final DO NOT REMOVE this Inspection record from the job site.
PASS PART FAIL