Permit f+, �.
411,10 CITY OF TIGARD MECHANICAL PERMIT
PERMIT #: MEC2005 -00011
DEVELOPMENT SERVICES DATE ISSUED: 1/7/2005
13125 SW Hall Blvd., Tigard, OR '97223 (503) 639 -4171 PARCEL: 2S110BD -00500
SITE ADDRESS: 11790 SW WILDWOOD ST
SUBDIVISION: SHADOW HILLS ZONING: R -2
BLOCK: LOT: 003 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:
3 - 15 HP: COMML.INCIN:
MAX INPUT: BTU 15 - 30 HP: REPAIR UNITS
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES
GAS PRESSURE: 50 + HP:
'CLO DRYERS
FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS •
> 10000 cfm:
Remarks: Install gas pipe & gas insert in fireplace. •
Owner: FEES
STEVENS, MARLIN Description Date Amount •
11790 SW WILDWOOD ST [MECH] Permit Fee 1/7/2005 $72.50
TIGARD, OR 97224 [TAX] 8% State Surchart 1/7/2005 $5.80
•
Phone: 503 624 - 7946 Total $78.30
Contractor:
G P & W SYSTEMS INC
732 MARBLE RD
WASHOUGAL, WA 98671 -9601 REQUIRED INSPECTIONS
•
Phone: 360 - 835 - 3516 Gas Line Insp
Misc. Inspection
Reg #: LIC 108176 " 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 questions to OUNC by calling
(503)246 -6699.
Issued By: Permittee Signature:
d
Call (503) 639 -4175 by 7:00 P.M. for inspections needed the next business day
•
Jan 07 05 11:16a GP &W Systems, Inc. 360 -835 -5716 p.1
Mechanical Permit A „It!, , FOR OFFICE USE ONLY
R eceived
Ci of Tigard Penult L g � DDate/Sy: / -7 -1 S �l G `.614,2007 000 11
13]25 SW Hall Blvd, Tigard, OR J Q� Plan Review
� y
Phone: 503.639.4171 Fax: 503.598.1960 1 {,0 _.,.' ik �• Date/9y: Other Permit:
In A\ '{)�.• i
Inspection Line: 503.639.4175 `,p \` i Date Ready/13y: /min 13 See Page 2 for
Internet: www.ci.tigard.or.us ` �� ,�1G �. e Notified/Method: 1f I V Supplements] Information
COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction d alteration/replacement Mechanical permit foes" are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition 0 Other: , 1 alas mechanical materials, equipment, labor, overhead, and profit.
CATEGORY OF CONSTRUCTION Value: S
IFT Commercial/industrial and 2- family dwelling ❑ Co mercial/industrial 0 Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. I Ea. I Total
JOB STTE FORMATION AND LOCATION Beating/cooling •
Job site address: (179 0 se) w t l�COd S, Air site plan conditioning or heat pump
c.a.:. site p sbowittR placement) 14.00
City/State/ZIP: nt aura 4 7 Z VI Furnace 100,000 BTU (ducWvents) 14.00
Suite/bldg./apt. no.: I Project name: 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 I Lot no.: Flue/vent for any of above 10.00
Other. 10.00
Tax map/pared no.: Other fuel aepfiances
DESCRIPTION OF WORK Water heater 10.00
• c ,� t Gas fireplace 10.00
L n s'u ll 1.61.1 n 4C20 GLy „t,S'®l'r e Q � ( tAN Flue vent for water heater or gas
AR Case, - r Log lighter fireplace 10.00
Log phta (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace insert 10.00
'PROPERTY OWNER 1 ❑ TENANT Chim°ey/liner /flue/vent 10.00
Other: 10.00
Name: INVLIrt. `v1 S4- e-ueYS Environmental exhaust and ventilation
4 / L del was& sl . Range hood/other kitchen
Address: I I ^ )441 .rI' equipment 10.00
City/State/ZIP: - rul a vices 4 7 22 Y Clothes dryer exhaust 10.00
Single-duct exhaust (bathrooms,
Phone: 340) (j, - • q4 Falc ( ) toilet eompartraents, utility moms) 6.80
GYAPPLICANT (CONTACT PERSON Atticierawispace fans _ 10.00
Other: 10.00
Business name: 6 pa-u3 StS4Qnt , .9",r_._ Fuel piping
Contact namee j M 6 55.40 for first four, S1.00 far each additional
Address: . 73 2 INN -4.'g-ii LE Ra AO GGas as n h e hwat etc.
pump -
City /Slate/ZIP: U 6•4{ _ C� _ Wall/suspended/unit heater
Phone:) CAC.. 3 s / ( 0 I Fax:: OM ) t3 .- 5 7/63 Water heater
Fireplace
E -marl: Range
CONTRACTOR Barbecue
Business name: 6 t�'f -l.J -S S5 S - 3 . �t�L Clothes dryer�as)
Other
Address: -?3 Z YlitgliAjoki f MECHANICAL PERMIT FEES*
City/State/ZIP: [mod k � a� �l i, e t g'7/ Subtotal
� Minimum permit fee ($72.50) 77 .54
Phoned a t S, . 3 I( I Fax: 04o) t 3' - 5'►ep Plan review (25% of permit fee)
CCB lit:.: t 67 1 $lc, Aft1411, a 4 9
((( Stale surcharge (8% of permit fee) 5, et)
TOTAL PERIMIIT FEE 7$'e 3a
Authorized This p ermit application expires if a permit Is not obtained within 180
days after it has been accepted as complete.
Print name: 1 v Lo. As l Date: ) r 71d y • Fee methodology set by Tri- County Building industry Service Board
a _
CITY OF TIGARD 24 -Hour t 4-
BUILDING , 4- Inspection Line: (503) 639 -4175 MST
INSPECTION DIVISION ' Business Line: (503) 639 -4171
BUP
Received 7 Date Requested / — / .3 AM PM BUP
/
Location ! 6 7 9 "41* Suite u z, bd o /
Contact Person Ph (3_61L) 27 63 Z PLM
Contractor Ph ( ) SWR
BUILDING Tenant/ ry^ r a L/ — — 7 g 41 to ELC
Footing ELC "
Foundation Access:
Ftg Drain ELR
Crawl Drain
Slab Inspection Notes: j/ A k SIT
Post & Beam bC I •
Shear Anchors L h Q — 0 63 cA
Ext Sheath/Shear
Int Sheath/Shear
Framing
-
Insulation /�/ �����LVe—SLrYeiL
Drywall Nailing V , ,
Firewall -
-
Fire Sprinkler
Fire Alarm - iii i i S T 5 i OS • j 4� L.
Susp'd Ceiling
Roof /c Ai / A ./ u Z
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:
Anal
PAS *ART FAIL
Sas .
Smoke Dampers
Fna
TAW PAR
ELECTRICAL
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 0 Please call for reinspection RE: ❑ Unable to inspect — no access ..
Fire Supply Line
ADA D / $ Inspector / Ext
Approach/Sidewalk p
Other:
Final DO NOT REMOVE this inspection record from the job site.
PASS PART FAIL
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