Permit CITY TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00489
cna; DATE ISSUED: 9/30/2008
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13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 PARCEL: 2S111 DC - 10200
SITE ADDRESS: 15575 SW OAKTREE LN ZONING: R -7
SUBDIVISION: SUMMERFIELD NO.10 LOT: 555 JURISDICTION: TIG
PROJECT: HANKS
Project Description: Kitchen remodel, gas line to range.
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:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1
> 10000 cfm:
Owner: FEES
MICHAEL & CAROLYN HANKS Description Date Amount
15575 SWOAKTREE LN
TIGARD, OR 97224 [MECH] Permit Fee 9/30/200E $72.50
[TAX] 12% State Surchar 9/30/200E $8.70
Phone:
Total $81.20
Contractor:
RAYBORN'S PLUMBING
19990 SW CIPOLE RD
PO BOX 69 REQUIRED ITEMS AND REPORTS
TUALATIN, OR 97062
Contact #: PRI 503- 692 -4139
FAX 503- 691 -2328
Reg #: LIC 87852
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 iifwork 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.
Issue By: i , I ,n Permittee Signa
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 requited on the job site at the time of each inspection.
CITY OF TIGARD
BUILDING ''DIVISION PERMIT #: MEN 200Fr0( <189
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 9/3(2008
Phone: (503) 639 -4171 ,24111'..
Inspection Requests (24 Hrs.): (503) 639 -4175 ,.,...� _;_
INSPECTION WORKSHEET FOR DATE: 10/212008 TIME: 7:00AM PAGE: �
SITE ADDRESS: 15'i75 SW OAKTREE LN CLASS OF WORK:
SUBDIVISION: SUMMERFIELD NO.10 LOT #: 556 TYPE OF USE:
PROJECT NAME: HANKS
DESCRIPTION: Kitchen remodel, gas line to range.
OWNER: HANKS, MICHAEL & CAROL.YN PHONE #:
CONTRACTOR RAYf3ORN'S PLUMBING PHONE #: 503 - 692 - 4139
Inspection Request Scheduled For: Date: 1e2/X888 Pour Time:
Code # Inspection Description Confirm # Contact # Message
610 Gas line 076204 -01 503 -692 -4139 Y
Corrections /Comments/ Instructions:
, -6 01-5 • ( -/-, --/-5-5,- .::-. g g-, ,*,., i ,..,,,„/„...
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: le 4.— G 0 Phone #: (503) 718- 1 In
•
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: Ne(„acOg -0644 9 REQUIRED ON GREEN INSPECTION CARD.
✓ Code I Inspection Description . I PASS Date I By ✓ Code Inspection Description I PASS Date I By
BUP - Building Permit ELC - Electrical Permit
_ 405 Excavation 105 Underground /slab cover
410 Fill 110 Temporary electrical service
415 Grading 115 Electrical service
205 Footing 120 Electrical rough -in
805 MFG - Structure grading /footing 125 Wall cover
210 Foundation walls 130 Ceiling cover
215 Footing drain 135 Low voltage
220 Slab 140 Sign installation
310 Crawl drain 145 A/C or heating unit circuit
225 Post /beam structural ❑ 150 Hot tub /spa /pool
230 Underfloor insulation 195 Misc. inspection:
235 Shear walls /anchors 199 _ Electrical final
240 Exterior sheathing
245 Firewall
250 Roof nailing ELR - Restricted Energy Permit
255 Wtr proofing basement walls 135 Low voltage
260 Tilt -up panel • 195 Misc. inspection:
265 Masonry 199 Electrical final
270 Reinforcing steel (rebar)
275 Framing
810 MFG- Structure set -up MEC - Mechanical Permit
280 Insulation 605 Post /beam mechanical
285 Drywall nailing 610 Gas line
287 Suspended ceiling 615 Mechanical rough -in
. 295 Misc. inspection: 620 Hydronic piping
899 MFG - Structure final 625 Duct work
498 Grading final 630 Fire damper
299 Final inspection 635 Smoke detector shutdown
640 Exhaust hood
695 Misc. inspection:
699 Mechanical final
BUP - Fire Protection System Permit
905 Sprinkler underfloor /slab PLM - Plumbing Permit
910 Sprinkler rough -in
915 Fire alarm rough in 305 Plumbing underslab
310 Crawl drain
920 Suppression trip test 315 Post /beam plumbing
995 Misc. inspection:
998 final Plumbing rough -in
Alarm 999 Sprinkler final 322 Shower pan
fi
330 Water service •
335 Rain drain .
340 Storm drain
SIT - Site Work Permit 505 Sanitary sewer
405 Excavation 345 Culvert/catch basin
410 Fill 350 Septic tank
415 Grading 395 Misc. inspection:
205 Footing 399 Plumbing final
210 Foundation walls
215 Footing drain
420 Sprinkler supply lines SWR - Sewer Permit
495 Misc. inspection: 505 Sanitary sewer
498 Grading final 595 Misc. inspection:
499 Final inspection 599 Final inspection
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08:17:31 a.m. 09-30-2008 1 /2
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' 1 City of Tigard Received � s p L,J Q p�
n " /i�� U D By: / / t -- 0 Q O Peanut No ://lei -.ere t J
'k ° 13125 SW Hall Blvd., Tigard, OR 972 ( / v
1 1 Phone: 503.639.4171 Fax: 503.598.1960 Daz / a � G14
'j o�ttta °�a 1 ; Inspection Line: 503.639.4175 y Other Permit:
t r cit,. Internet: www.tigard or.gov �GI , O 'te Ready /By: hie - !a See Page 2 for
C� �� l ��gl NoofiedlMethod: iC Supplemental Information
TYPE OF WORK \\ COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
❑ New construction Addition/alteratio&plaeement 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.
CATEGORY OF CONSTRUCTION Value: S
341- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building RESIDENTIAL EQUIPMENT /SYSTEMS FEES*
❑ Multi- family ❑ Master builder ❑ Other: For special information use checklist.
Description I Qty. , Ea. r Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: ! . s7� .S ) D /_ 1„ L . Air conditioning o i n pump
./� /, (requires site plan showing placement) 14.00
City /State/ZIP: • ./ , ,tea/ - G V Furnace 100,000 BTU (ducts/vents) 14.00
Furnace 100,000+ BTU (ducts/vents) 17.90
SuitePoldg.lapt. no.: Project name:
Gas heat pump 14
Cross street/directions to job site: Duct work 1400 -_
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: IAA 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
/' / j l /Pi7 / t' 0 - 4 • Flue vent for water heater or gas
Pa n tee. fireplace 10.0
Log lighter (gas) 10.00
Wood/pellet stove i 0.00 •
Wood fireplace/insert 10.00
❑ PROPERTY OWNER l ❑ TENANT Chimney/liner /flue/vent
10.00
Name: Other: 10.00
Environmental exhaust and ventilation •
Address: Range hood /other kitchen
equipment 10
City /State/ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( ) Fax: ( ) toilet compartments, utility rooms) 6.80
❑ APPLICANT ACONTACT PERSON Attic/crawlspace fans 10.00
� Other: 10.00
Business name:
�/� /�"�„. e Inheht Ia�IZaj /0C.,, Fuel piping .
Contact name: fl i>. r - ri Qa S5.40 for first four; $1.00 for each additional
Address: f% JO / Furnace, etc.
Gas heat pump
City / State/ZIP: f { ? ? p / 7
�
"Fa f /GI� tie / U 6 �- Wall/suspended/unit heater
Phone: 3 )4 Jam- - / .2 Fax: : 9 , 3 ‘,2/- ? 3 Water heater
Fireplace
E -mail: /71 /S �,, erniij/,etrnscon. Range / .5
ONTRACTOR Barbecue
Business name: U C I? . /2/ / . ` Clothes dryer (gas)
u � Other:
Address: jJ� Bak 6 MECHANICAL PERMIT FEES*
City /State /ZIP: T�_rk�R 7Q� Subtotal '
Phone: 0 3 ) 69 .../ J 3 9 Fax: ---6 3 6 7/ a .8
3 Minimum permit fee ($72.50) 7„9.,„:" 7„9.,„:" 1° / Plan review (25 % of permit feee )
CCHlie.: g State surcharge (12% of permit fee) 8r 7$
1 iNWSI TOTAL PERMIT FEE 237, a.0
Authorized signature 127C ' - Mani is permit application expires if a permit is not obtained within ISO
days after it has been accepted as complete.
Print name: /27/ SS y t� � Date: 11/44,4'16 p • Fee methodology set by Tn -County Building industry Service Board
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