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Permit
d v CITY OF TIGARD MECHANICAL PERMIT COMMUNITY DEVELOPMENT PERMIT #: MEC2008 -00498 TIG ARD, 13125 SW Hall Blvd., Tigard, OR 97223 503.639.4171 DATE ISSUED: 10/7/2008 PARCEL: 25111 BD -00700 SITE ADDRESS: 14980 SW 96TH AVE ZONING: R - 3.5 SUBDIVISION: DARMEL NO. 2 LOT: 016 JURISDICTION: TIG PROJECT: PALMER Project Description: Installing gas fireplace, gas line and venting for fireplace. 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: CLO DRYERS: FURN < 100K BTU: AIR HANDLING UNITS OTHER UNITS: 1 FURN > =100K BTU: <= 10000 cfm: GAS OUTLETS: 1 > 10000 cfm: Owner: FEES CHARLES PALMER Description Date Amount MARJORIE F 14980 SW 96TH [MECH] Permit Fee 10/7/200€ $72.50 TIGARD, OR 97224 [TAX] 12% State Surch 10/7/200E $8.70 Phone: Total $81.20 Contractor: JIM SAUBLE CONSTRUCTION LLC 23405 SW MTN HOME RD SHERWOOD, OR 97140 REQUIRED ITEMS AND REPORTS Contact #: PRI 503 -544 -1415 FAX 503- 628 -0748 Reg #: LIC 163459 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: I Call 50 4175 by 7:00 a.m. for inspections tbusiness day. This permit card shall be kept in a conspicuous place on the job a until completion of the project. Approved plans are required on the job site at the time of each inspection. ,t { � i. "e7t-�" ,' �'�,'`fa'� C'�S'+F� a3 ,, t.t at + 1 k '�" , - Y< '�t T�II Y !9' Xi �u1�F41 Mechanical Permit Application 4� 7 Zta r kgSio s FOR OFFICE US ON , r F lt * >(4" - 1 1r rr Received © 'w.•.w. -.ti fi.:- K�ra..Y..�, � ,��r,,,� .. t' ir.4. ww � i i71 � � ,. .�� G yt `` ,:r � � Received � � City of Tigard �` DateB t V Permit N : /, r q jj III .� p y: f/ Q 13125 SW Hall Blvd., Tigard, t Plan Review r J 2 Phone: 503.639.4171 Fax: R" .1'1 :. Other Permit: CJ Inspection Line: 5036394175 Q Date/By: Alf. � 1J p.. OU' Date Ready /By: 0 See Page 2 for iTIGA / `1 � .t . 4,i, Internet: www.tigard- or.gov U( 964 Notified/Method: Supplemental Information Filli I OJ1 a ` • , • . , - , . • TYPE O ��,�� , ... COMMERCIAL FEE* SCHEDULE- - USE CHECKLLST ❑ New construction Addition /* l t�i b n /replacement 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: $ RESIDENTIAL EQUIPMENT / SYSTEMS FEES* . ,- and 2- family dwelling ❑ Commercial /industrial ❑ Accessory building For special information use checklist. ❑ Multi - family ❑ Master builder ❑ Other: Description Qty. Ea. Total JOB SITE INFORMATION AND LOCATION. Heating/cooling r � .�.� Air conditioning or heat pump Job site address: ` G go d2� �� ' A . E' (requires site plan showing placement) 14.00 City /State /ZIP: o 0 f- 91 Z z4, Fumace 100,000 BTU (ducts /vents) 14.00 Fumace 100,000+ BTU (ducts /vents) 17.90 Suite/bldg. /apt. no.: Project name: PALAq Gas heat pump 14.00 Cross street/directions to job site: Duct work 10.00 �,�, Hydronic hot water system 14.00 sp I*J vj OF V1 ,p Residential boiler (radiator or hydronic) 14.00 Unit heaters (fuel -type, not electric), in -wall, in -duct, suspended, etc. 14.00 Flue /vent for any of above 6.80 Subdivision: Lot no.: Other: 10.00 Tax map /parcel no.: -I c is I el) o 0 7 0 0 / j _ Go 3 o Cr Other fuel appliances / Water heater 10.00 DESCRIPTION OF WORK ' ' Gas fireplace I 10.00 (0...e) - - Flue vent for water heater or gas fireplace 6 10.00 ..c,(' A') D cs-A s p 1. IA NGa-- Log lighter (gas) 10.00 Wood /pellet stove 10.00 Wood fireplace /insert 10.00 Chimney /liner /flue /vent 10.00 PROPERTY. OWNER ❑ TENANT Other: 10.00 Name: C -2, PirL Environmental exhaust and ventilation G Range hood /other kitchen Address: I y it t j c1, f /k v equipment 10.00 per C� City /State /ZIP: - 0 l�. y 7 2,24 Clothes dryer exhaust 10.00 1 4 Single -duct exhaust (bathrooms, Phone: ( 503) b 2 - 3 ii Fax: ( ) toilet compartments, utility rooms) 6.80 ik APPLICANT ❑ CONTACT PERSON Attic /crawlspace fans 10.00 Other: 10.00 Business name: j{,k 5A-14B LE Ca- A3 sr, i-t- Cd Fuel piping Contact name: jri M $5.40 for first four; $1.00 for each additional Address: a,..,3 tf0 5 St.A.l M-h ,best, • Gas heat etc. Gas heat pump City /State /ZIP: sHeat / p p, en 144:3 Wall /suspended/unit heater Phone: (co 3) s-4q /4 is Fax: : (,c03) (,2 07 48 Water heater Fireplace 1 4; `ic) E -mail: 5'avtble j w4o, C m Range CONTRACTOR . .. Barbecue Business name: S A , 4 o�� Clothes dryer (gas) Other Address: MECHANICAL PERMIT FEES* City /State /ZIP: Subtotal Minimum permit fee ($72.50) _ Al•91 Phone: ( ) Fax: ( ) Plan review (25% of permit fee) CCB lic.: ' 6.3 4 6 1 State surcharge (12% of permit fee) 5 -'7d TOTAL PERMIT FEE 57 , This permit application expires if a permit is not obtained within 180 Authorized si ature: . days after it has been accepted as complete. Print name: ' , Date: 7 * Fee methodology set by Tri- County Building Industry Service Board 1. \Building\Perm , EC- PermitApp.doc O1/19/07 440 -46t7T (11 /02 /COI91/WEB) f 7 Mechanical Permit Application - City of Tigard Page 2 - Supplemental Information Commercial Fee Schedule: Total Valuation: Permit Fee: ;: $ 1.00 to $2,000.00 Minimum fee $72.50 $2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30 for each additional $100.00 or fraction thereof, to and including $5,000.00. $5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and $1.80 for each additional $100.00 or fraction thereof, to and including $10,000.00. $10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and $1.35 for each additional $100.00 or fraction thereof, to and including $50,000.00. $50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and $1.25 for each additional $100.00 or fraction thereof, to and including $100,000.00. • $100,000.01 and up $1,396.50 for the first $100,000.00 and $1.10 for each additional $100.00 or fraction thereof. Note: All new commercial buildings require 2 sets of plans. 1; \Building \Permits \MEC- PermitApp.doc 01/19/07 2 • , CITY OF TIGARD 0 BUILDING DIVISION ,,,-- PERMIT #: tv1EC1008-00498 13125 SW Hall Blvd., Tigard, OR 97223 OAT hi DATE ISSUED: 10/7/2008 Phone: (503) 639-4171 ikostrip ‘1 V Inspection Requests (24 Hrs.): (503) 639-4175 1 ,41 AIL 1 INSPECTION WORKSHEET FOR DATE: 12/18/2008 TIME: 7 PAGE: 1 SITE ADDRESS: 14980 SW 96TH AVE CLASS OF WORK: ei SUBDIVISION: DARNEL NO 2 LOT #: 016 TYPE OF USE: PROJECT NAME: PALMER DESCRIPTION: Installing as fireplace, gas line and venting for fireplace. IR ; or OWNER: PALMER, CHARLES PHONE #: r CONTRACTOR: JIM SAUBLE CONSTRUCTION LLC i PHO • 5034-1-,A41.., c 6 . ;,(fc Inspection Request Scheduled For: Date: 12/18/2008 Pour Time: — fr Cr 2,, 7, Code # Inspection Description Confirm # Contact # Messa 699 Mechanical final 079123-01 603-544-1415 Y ,......------._ Corre , ions/C•mments/Instructions: / 6 ....... > ul a Cif-pc( / .?" Vd -- (*) ,,----- -, 4 v —4-‘)-, yl.p....oss I I PARTIAL APPROVAL El CANCEL fl NO ACCESS I I FAIL 0 CALL FOR INSPECTION n ADDITIONAL FEES ASSESSED Inspector: , 1 : c j it/1" Date: 1 D/0 r Phone #: (503) 718- k .. 1 : ' ' • , - •, . - , . _ . i CITY OF TIGARD BUILD1N DIVISION PERMIT #: MEC2003.00.490 13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 1017/2008 Phone: (503) 639 -4171 ergpuull�t Inspection Requests (24 Hrs.): (503) 639 -4175 INSPECTION WORKSHEET FOR DATE: 1211/2008 TIME: 7 :00AM PAGE: 17 SITE ADDRESS: 14980 SW 96TH AVE CLASS OF WORK: SUBDIVISION: DARMEL NO. 2 LOT #: 016 TYPE OF USE: PROJECT NAME: PALMER , DESCRIPTION: Installing gas fireplace, gas line and venting for fireplace. OWNER: PALMER, CHARLES PHONE #: CONTRACTOR: JIM SAUBLE CONSTRUCTION LLC PHONE #: 503-5444416 Inspection Request Scheduled For: Date: 12/11/2008 Pour Time: Code # Inspection Description Confirm # Contact # Message 610 Gas line 070972-01 503 - 6`79415129 Y Corrections /Comments /Instructions: - 'S L.-iNE 0 i 2" 7iu AI OW if pv. er • PASS ❑ PARTIAL APPROVAL n CANCEL ❑ NO ACCESS I FAIL I I CALL FOR INSPECTION I I ADDITIONA FEES ASSESSED Inspector: Date: �`� i l °L/ Phone #: (503) 718- %