Permit {
v y �� CITY OF TIG MECHANICAL PERMIT
IN ° `.. COMMUNITY DEVELOPMENT PERMIT #: MEC2008 - 00566
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/14/2008
PARCEL: 1 S 135DB -05800
SITE ADDRESS: 11445 SW 94TH AVE ZONING: R -4.5
SUBDIVISION: MILLER LOT: 007 JURISDICTION: TIG
PROJECT: LABEAUX
Project Description: Replacing furnace and installing gas piping for furnace and 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: 1
STORIES: BOILERS /COMPRESSORS HOODS:
FUEL TYPES 0 - 3 HP: DOMES. INCIN:
NAT 3 - 15 HP: COMML. INCIN:
MAX INPUT: BTU 15 - 30 HP:
REPAIR UNITS:
FIRE DAMPERS ?: 30 - 50 HP: WOODSTOVES:
GAS PRESSURE: 50 + HP:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
OTHER UNITS:
FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 2
> 10000 cfm:
Owner: FEES
LABEAUX DAMIAN Description Date Amount
SHINODA, KEIKO
11445 SW 94TH [MECH] Permit Fee 11/14/20C $72.50
TIGARD, OR 97223 [TAX] 12% State Surch 11/14/20C $8.70
Total $81.20
Phone: 503- 385 -7694
Contractor:
TRI COUNTY TEMP CONTROL
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS
Contact #: PRI 503 -557 -2220
FAX 503 -557 -0919
Reg #: LIC 72623
•
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: �i ' Permittee Signature:� �/ ��� GYv-
Call 503.639.4175 by 7:00 a.m. for inspections that business .
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.
NOV -13 - 2008 04:54P FROM: TO: 5035981960 P.1
:
Mechanical Permit Application YO OIFic'F..Ilsr ONLY
ill; t °° City of Tigard R eceived
Date/By , Ur oil ii
13125 SW Hall Blvd., Tigard, OR 972 ,. C ^ iii( / lI
y
1 ` Phone: 503.6.19.4171 Fax: 503.5•A 'i i L00% Other Permit:
T fG A R D Inspection Line: 503.639.4175 `, N T• Date Ready/By. ?u it See Page 2 for
Internet: www.tigard -or gov v A N ot ified/Method j ./y Supplemental Information
OG ,cI C' S lO
•
TYPE OF WOI �` G v COMMERCIAL FEE* SCHEDULE - USE CHECKLIST
i@1F*ffcement Mechanical permit fees* are based on the value of the work
❑ New construction ' Addition /alterat
DD'` performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit
CATEGORY OF CONSTRUCTION Value: $ —
1- and 2-family dwelling RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
y g ❑ Commercial/industrial builder i stri ❑ Accessory buildi
Multi or special information use checklist.
y ❑ Master buil ❑ Other: Description p Qty. Ea. 1 Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
Job site address: , t l t5 5 44th f 11ta W() Air conditioning or heal pump
(requires site plan showing placement) 14.00
City /State /ZIP: port( 4'7223 Furnace 100,000 BTU (ducts /vents) I 14.00
Furnace 100,000+ Ulf 1 (ducts /vents) 17.90
Suite/bldg. /apt. no.: Project name: A 1-. Qet,wx 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 1 6.80
Other: 10.00
Tax map /parcel no.: Other fuel appliances
DESCRIPTION OF WORK Water heater 10.00
• 0 ITC. 6.--) Ids CV1 Gas fireplace 10.00
VIS�I� 1 Flue vent for water heater or gas
• fireplace
(gas) 10.00
Wood /pellet stove 10.00
Wood fireplace /insert 10.00
IA PROPERTY OWNER ❑ TENANT Chimney /liner /flue /vent 10.00
y� 1 '/� I Other: 10.00 _
" `
Name: ia, l J f U, Environmental exhaust and ventilation
�� ��..rr"��J� Range hood /other kitchen
Address: equipment 10.00
City /State /ZIP: Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: ( )' %;NCI Fax: ( ) toilet compartments, utility rooms) 6.80
APPLICANT ❑ CONTACT PERSON Attic /crawlspacc fans 10.00
Business name: Other: 1000
'n Fuel piping
I
Contact name: VW., MQr 1 $5.40 for first four; $1.00 for each additional
Address:
�✓" Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit healer
Phone: ( ) F :: ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Clothes dryer (gas)
Business name: r C (� yy�aaC, .
I3 (so I l ly DYI Other:
Address, r � y, OIL PERMIT FEES*
City/State /ZIP: A o t t (~ g' 'v OIL t 1 Subtotal
Phone: ( 5b5 [
L;I►� 5s ' T Fax: ( � �� �J rr 7 Qg14 Minimum permit fee ($72.50) 7a 5 2
1 Plan review (25% of permit fee) )
CCB lie.: . 72_420 ! State surcharge (12% of permit fee) �1
Authorized signature: d �-ll
p / TOTAL PERMIT FEE
+ • This permit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: IGMITt ,Y4 Date: ( we: • Fee methodology set by Trl- County Building Industry Service Board
I Building \PermusWMEC•PermitApp.doc 01/19/07 440.4617T 01 /o2/COM/wax)
, >
�~��~�� TIGARD ~
�wn�. w n�m��na"~ `~
BUILDING DU /°G DUVUSUON PERMIT #: MEC200800588
13126 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 11/14/2008
Phone: (503) 639-4171
Inspection Requests (24Hmj:(5U3)83Q'4175 -A- m
INSPECTION WORKSHEET FOR DATE: 11/70/2008 TIME: 7:00Am PAGE: 23
.
SITE ADDRESS: 11445 5WS4THAVE CLASS OF WORK:
SUBDIVISION: MILLER LOT #: 007 TYPE OF USE:
PROJECT NAME: LABE8UX
DESCRIPTION: Replacing Furnace and installing gas piping for furnace and range.
OWNER: DAM<A4.LAFNEAUX PHONE #: 603.385.7694
CONTRACTOR: TR1 COUNTY TEMP CONTROL PHONE #: W3-557'2220
Inspection Request Scheduled For: Date: 11C20/2O08 Pour Time:
Code # Inspection Description Confirm # Contact # Message
899 Mechanical final Un307'01 503.567-2220 N
Corrections/Comments/Instructions: •
.
,
•
ASS -
| | FART|ALAPPROVAL -- CANCEL NO ACCESS
_
I I FAIL CALL FOR INSPECTION 111 ADDITIONAL FEES ASSESSED
Inspector: ^' ��' ^ Date: Phone #: (603) 718- `
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MEC;2l7flt0ii566
13125.SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 11/14/2008
Phone: (503) 639 -4171 /� u- +4iul�i li
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 11/2012008 TIME: 7:00Alvi PAGE: 22
SITE ADDRESS: 1145TH AVE CLASS OF WORK:
SUBDIVISION: MILLER LOT #: 007 TYPE OF USE:
PROJECT NAME: LAI3EAUX
DESCRIPTION: Replacing furnace and installing gas piping for furnace and range.
OWNER: DAMIAN, LABEAUX PHONE #: 503- 385 -7694
CONTRACTOR: TRi COUNTY TEMP CONTROL PHONE #: 503 - 557 -2220
Inspection Request Scheduled For: Date: 11/20/2008 Pour Time:
Code # Inspection Description Confirm # Contact # Message
61U. Gas line 078307 -02 503 -557 -2220 Y
• Corrections /Comments /Instructions:
- ' ' C . r -- _ ,,./ ,-
•
1 /
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I FAIL CALL FOR INSPECTION I I ADDITIONAL FEES ASSESSED
Inspector: / Date: 7J —3------21 ¢2 Phone #: (503) 718- _.L(t
,,. ( S ( . t' r „
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: 7/2 } v, r y---c r o.5 - 6( y REQUIRED ON GREEN INSPECTION CARD.
Code I Inspection Description I PASS Date By / Code Inspection Description PASS Date 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 X 610 Gas line 1 1 :r e k`
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 /f Lo —o
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 Alarm final 320 Plumbing rough -in
• 999 Sprinkler final 322 Shower pan
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
T: Building \Forms \lnspCard- AOP- Blank.doc 02/02/07
'I n CITY OF TIGARD MECHANICAL PERMIT
COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00566
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 11/14/2008
PARCEL: 1 S135DB -05800
SITE ADDRESS: 11445 SW 94TH AVE ZONING: R - 4.5
SUBDIVISION: MILLER LOT: 007 JURISDICTION: TIG
PROJECT: LABEAUX
Project Description: Replacing furnace and installing gas piping for furnace and 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: 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:
WOODSTOVES:
FURN < 100K BTU: 1 AIR HANDLING UNITS CLO DRYERS:
FURN > =100K BTU: <= 10000 cfm:
OTHER UNITS:
> 10000 cfm: GAS OUTLETS: 2
Owner: FEES
LABEAUX DAMIAN Description Date Amount
SHINODA, KEIKO
11445 SW 94TH [MECH] Permit Fee 11/14/20C $72.50
TIGARD, OR 97223 [TAX] 12% State Surch 11/14/200 $8.70
Phone: 503 -385 -7694
Total $81.20
Contractor: f
TRI COUNTY TEMP CONTROL n
13150 S. CLACKAMAS RIVER DR
OREGON CITY, OR 97045 REQUIRED ITEMS AND REPORTS Q
00
Contact #: PR] 503 -557 -2220
FAX 503 -557 -0919 a
O
Reg #: LIC 72623 til,
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: 0 �� Permittee Signature: �7/ n �J -�
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 required on the job site at the time of each inspection.